ABSTRACT
Tuberculosis is an ancient disease. It is responsible for causing a major health problem in developing countries. Genitourinary tuberculosis is the second most common form of extra pulmonary tuberculosis after lymph node involvement. This study was carried out to determine the pattern of genitourinary tuberculosis in patients with active pulmonary tuberculosis. It is a cross sectional descriptive study. Carried out in the Urology Department of Jinnah Hospital and T.B outdoor of Gulab Devi Hospital, Lahore during the period Oct, 2002 to Oct, 2004. Two hundred patients with pulmonary tuberculosis, 117 males and 83 females, ranging from 17 to 80 years of age [mean 37.9 years] were included in the study. Hundred patients were freshly diagnosed cases [group-1] and the remaining hundred patients were already diagnosed cases of pulmonary tuberculosis and had received antituberculous treatment [ATT] for at least three months [group-2]. Diagnosis of pulmonary tuberculosis was based on positive sputum smear for acid fast bacilli [AFB] by Ziehl Neelsen [ZN] staining technique. Twenty four hours urine was collected from each patient. Each specimen was examined for the presence of mycobacterium tuberculosis by ZN staining and culture on Lowenstein Jensen [LJ] medium. Positive for one or both of these procedures was taken as positive for genitourinary tuberculosis. Biopsy of urogenital tract was carried out and histopathological examination was done in patients with positive bacilluria and having urinary symptoms. Genitourinary organs of 9 patients in group-1 and 18 patients in group-2 were found involved for genitourinary tuberculosis. Among 9 patients in group-1, the urinary bladder and kidney involvement were highest 3 [33.3%] followed by epididymis 2 [22.2%] and Ureter 1 [11.1%]. Among the 18 patients in group-2, urinary bladder involvement was highest 9 [50%] followed by kidney 5 [27.8%], epididymis 3 [16.7%] and testis 1 [5.5%], Genitourinary organ involvement in patients already on antituberculous treatment is more common as compared to freshly diagnosed cases. Urinary bladder involvement is highest in both groups