[Genito-urinary tuberculosis inthe male, apropos of 22 cases]

An evaluation of the epidemiological, clinical, prognostic and therapeutic characteristics of male genito-urinary tuberculosis, complemented by review of the literature. We retrospectively studied 22 patients with confirmed genitor-urinary tuberculosis. The diagnosis was based on clinical, bacteriological, radiological and histological findings and radiological examination. The most common presenting symptom was chronic epididymitis [11 patients] followed by scrotal fistula [6 cases], obstructive uropathy [3 cases], hydrocele [6 cases] and infertility [1 case]. Clinical examination revealed epididymal nodules in 11 and hydrocele in 10 patients. Leucocyturia was found in one patient. Scrotal ultrasound demonstrated epididymal lesions in 8 cases. The definite diagnosis was based on histological examination of resected specimens [13 cases], biopsy specimens [8 cases] and on the discovery of the tubercle bacillus in the urine [1 case]. Intravenous urography, which was carried out routinely, detected associated urinary lesions in 5 cases. The follow-up was uneventful in all patients. The diagnosis of male isolated genitor-urinary tuberculosis is difficult in the absence of an endemic prevalence of tuberculosis. Any longstanding epididymo-orchitis should raise the suspicion of tuberculous etiology, especially in cases with hypofertility. Medical treatment has proven effective in early diagnosed cases, while surgery is reserved for resistant or complicated cases

[Bilateral hemorrhagic renal angiomyolipoma. Case report and review of the literature]

Renal angiomyolipoma is a rare benign tumor representing 0.3% of renal tumors. In its bilateral from it is frequently part of a hereditary syndrome, such as tuberous sclerosis of Bourneville [TSB]. We report the case of a 32-year-old who has been followed up for TSB since 1995. In April 2004 she was hospitalized after several episodes of total hematuria with blood clots in the bladder causing severe exsanguination and the need for repeated blood transfusions. Serum creatinine was normal. Ultrasound and CT scan showed the presence of bilateral renal angiomyolipomas. The bleeding could be controlled by arterial embolization of the right kidney. One month later, the patient was admitted again with massive hematuria and hemorrhagic shock, and right nephrectomy was done to achieve hemostasis. The follow-up period of 24 months has been uneventful