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

ABSTRACT

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