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Objectives: To identify the causes of delayed diagnosis of urogenital tuberculosis (UGT) through a qualitative study of patients with contracted bladder due to UGT. Materials and Methods: Eight patients diagnosed with contracted bladder due to UGT were evaluated. Data were obtained using face-to-face in-depth interviews and supplemented with medical records analysis and personal medical files. The identification of situations of diagnosis delay was coded by 2 urologists after data analyses. Codes were divided into 3 categories related to its causes: (1) health system; (2) disease factors; and (3) medical factors. Results: The 8 interviews produced 220 minutes of audio and 1.3 GB of scanned documents. The most frequent categories were "Medical factors," followed by "Disease factors" and "Health system." The codes "No clinical-laboratory-radiological suspicion" and "No clinical suspicion" were the most frequent, both belonging to "Medical factors." Clinically, tuberculosis simulates other pathologies and lacks specific tests with adequate sensitivity. The low representation of "Health system" codes indicates that access to public and private health services does not influence delayed diagnosis. The lack of clinical and radiological suspicion and the lack of knowledge of UGT features are the main reasons for diagnosis delay. Conclusions: The causes of delayed diagnosis in our sample were related to "Medical factors," followed by "Disease factors." Better understanding UGT features is an important topic in continuous medical education. [ABSTRACT FROM AUTHOR]

Background: Disseminated tuberculosis (TB) is the presence of two or more noncontiguous sites resulting from hematogenous dissemination of Mycobacterium tuberculosis. We report a case of disseminated TB with testicular involvement. Case: A 21-year-old male patient presented to the outpatient department with bilateral testicular enlargement and tenderness for last six months. It was suspected to be a case of epididymo-orchitis and empirical antimicrobial therapy was initiated. However, ultrasonography findings were inconsistent with epididymo-orchitis. Two weeks later the patient again presented with increased nodularity in the right testes. Non-seminomatous germ cell tumor was suspected. However, tumor markers came back normal. Magnetic resonance imaging revealed enlarged lymph nodes in the right inguinal and retroperitoneal region raising a suspicion of testicular lymphoma. Positron emission tomography with computed tomography showed multiple lymphadenopathies. Histopathology of the left axillary lymph node finally confirmed the diagnosis to be tuberculosis. No drug resistance were found and the patient responded well to anti-tubercular drugs. Conclusion: Diagnosing disseminated TB is difficult as it mimics conditions, such as infarction, cancer, torsion, etc. Attention to small details is necessary. We faced a similar situation in our patient. The patient went through a myriad of tests before finally being diagnosed with TB. Histopathological study was able to get it whereas cytology could not. Similar and totally opposite cases were found in the literature. This highlights the difficulty and importance of these type of cases.

Introduction. Fournier gangrene is a life-threatening form of perineal necrotizing infection characterised by affecting immucompromised patients, including those with tuberculosis.Objective. To evaluate the treatment results of patients with Fournier gangrene and tuberculosis process.Materials & methods. Five case histories of patients diagnosed with "Fournier gangrene" at the Tuberculosis Extrapulmonary Division of Clinic No. 2, Moscow Research Clinical Centre for Tuberculosis Control from 2012 to 2022 were analysed retrospectively using the continuous method. The Fournier's Gangrene Severity Index (FGSI) was used for assessment.Results. The analysis of case histories revealed the main features of management in patients with Fournier gangrene whose underlying process was tuberculosis. Our clinical experience confirms the role of Mycobacterium tuberculosis as a specific agent, as well as an immunosuppression factor in the development of Fournier’s gangrene. One should be wary of this pathology in patients with tuberculosis. The aggressive nature of the infectious process dictates the need for early detection of this disease for competent comprehensive treatment, including early rehabilitation of chronic foci of infection in patients with urogenital pathology and reconstructive-plastic methods of surgical treatment.Conclusion. Fournier gangrene in tuberculosis patients is a rare difficult-to-treat disease accompanied in most cases by septic shock and a high mortality risk. Alertness towards Fournier gangrene in patients with tuberculosis, correctly chosen treatment tactics reduces the risk of lethal outcomes.

Tuberculosis (TB) is a potentially curable disease that is a leading cause of death globally. While it typically affects the lungs, this disease may involve many extra-pulmonary sites, particularly in patients with risk factors. Extra-pulmonary TB often mimics a variety of different diseases, posing a diagnostic dilemma. Imaging aids in early diagnosis of TB, especially in patients with non-specific or atypical symptoms found at extra-pulmonary infra-thoracic locations. Imaging also helps guide appropriate laboratory investigation, monitor disease progress, and response to treatment. This review aims to highlight the imaging spectrum of TB affecting the infra-thoracic region, that is, gastrointestinal tract, abdominal lymph nodes, peritoneal cavity, intra-abdominal solid organs, and urogenital system. [ABSTRACT FROM AUTHOR]

Introduction Urogenital tuberculosis (UGTB) is a frequent presentation of extrapulmonary tuberculosis. Recognizing this condition is paramount for healthcare providers, especially in patients living with human immunodeficiency virus (HIV), as it significantly influences both mortality and quality of life. Case report This report presents the case of a 57-year-old male patient diagnosed with de novo HIV infection who presented with respiratory and urinary symptoms, and prostate abscess in a computed tomography. He was ultimately diagnosed with a tuberculous prostate abscess through real-time polymerase chain reaction. Conclusions This case underscores the importance of utilizing molecular diagnostic tools in identifying UGTB, shedding light on their invaluable role in timely diagnosis. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a communicable disease that is a major cause of ill health. Urogenital TB was a frequent urological disease in the pre-antibiotic era: about 20% of patients in urological hospitals had renal TB, mostly in the form of pyonephrosis. We composed a narrative review of the literature with keywords "urogenital tuberculosis', "prostate tuberculosis" "kidney tuberculosis", "treatment of tuberculosis". Urogenital TB (UGTB) includes TB of the kidney and the urinary tract and male and female genital TB. Each clinical presentation requires tailored antibiotic therapy depending on stage and general management. Anti-TB therapy should be multicomponent, continuous, long-lasting and controlled with a follow-up for 2-3 years. Otherwise, the risks of development of drug-resistance and relapse increase. Index of suspicion on UGTB is generally low, causing a delay in diagnosis; consequently, complicated forms of UGTB respond poorly to anti-TB therapy, while timely diagnosed "minor" forms are curable medically without surgery. Even with timely diagnosed UGTB, non-optimal therapy may result in over-fibrosis, scarring and strictures of the urinary tract, making surgical repair inevitable. Nevertheless, we have a wide enough spectrum of anti-TB drugs to cure urogenital TB. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the hypothesis that ureteral obstruction may activate kidney latent tuberculous though qualitative study of Urogenital Tuberculosis patients. Methods: A qualitative study was conducted using semistructured interviews in eight patients with Urogenital Tuberculosis. The progression of the disease from the initial symptoms was characterized through the analysis of the clinical and radiological data. The presence of ureteral obstruction prior to the onset of renal tuberculosis was observed in three patients. Results: Patient 1: A 58-year-old female had five episodes of acute left ureteral lithiasis in two years prior to left kidney tuberculosis. Patient 2: A 55-year-old male patient had a 1.2 cm proximal left ureteral stone and in the following six months, the diagnosis of tuberculosis was made in a nonfunctioning left kidney with ureteral thickening and stenosis. Patient 3: A 47-year-old male patient had a 1.2 cm stone in the proximal right ureter and developed urinary tuberculosis with a nonfunctioning right kidney and a contracted bladder. Conclusion: Kidney tuberculosis may appear in the same kidney that had previously suffered stone ureteral obstruction, which may have created local conditions for the activation of latent foci of renal tuberculosis.

Background. Tuberculosis is a serious medical and social problem that does not lose its importance, despite all the advances in pharmacology and surgery. Diagnosis of urogenital tuberculosis (UGTB), as a rule, is delayed due to low index of suspicion to tuberculosis and the absence of pathognomonic symptoms. Aim. Determining the change in the ratio of clinical forms of renal tuberculosis from 1999 to 2020. Materials and methods. A retrospective cohort comparative non-interventional study on the spectrum of the incidence of extrapulmonary tuberculosis (EPTB) was carried out. Among all 13852 extrapulmonary tuberculosis patients which were diagnosed from 1999 to 2020, patients with renal tuberculosis were selected, and the spectrum of their clinical forms in three periods was analyzed: 1st period 19992004 (1155 patients), second period 20052014 (2657 patients), and the third period 20152020 (671 patients). The clinical features of nephrotuberculosis in 88 patients was also estimated. Results. Over the 20 years of the analyzed period, the number of patients with UGTB decreased by 80.6%; for the year of the COVID-19 pandemic, this figure fell by another third. In the first period, destructive complicated forms of nephrotuberculosis prevailed (922 patients 79.8%), while the so-called "minor forms" were diagnosed in 233 patients (20.2%). In the second period, the situation was statistically significantly more favorable: the proportion of destructive and complicated forms of renal tuberculosis decreased to 43.8% (1124 patients), "small forms" were diagnosed in 1443 patients (56.2%). In the third period, destructive and complicated forms of nephrotuberculosis were diagnosed in 531 patients (77.6%), and the proportion of "small forms" in comparison with the previous period decreased by half, to 22.4%. Analysis of the clinical features of renal tuberculosis, depending on the prevalence of the destruction, showed that an asymptomatic course is possible, and pain, dysuria, intoxication and renal colic are present with different frequencies, and the clinical picture of tuberculosis of the renal parenchyma differs significantly from the clinical picture of tuberculous papillitis, cavernous nephrotuberculosis and symptoms of renal tuberculosis as whole. Conclusion. Currently, there is no screening on urogenital tuberculosis at all. Patients are diagnosed by referral, with a long history, after receiving multiple courses of antibacterial treatment; mainly through the pathomorphological examination of the operating material. Thus, a sharp decrease in the proportion of UGTB patients does not mean the disappearance of tuberculosis of this localization, but only states the tragic defects in timely diagnosis and low index of suspicion of medical doctors in relation to UGTB.

The problem of extrapulmonary tuberculosis (EPT) remains urgent since, along with a decrease in the incidence of the disease, there is an increase in the number of neglected, late diagnosed cases. Female genital tuberculosis (FGT) is a relatively rare disease difficult to diagnose, occurring on average in 0.52.0 cases per 100,000 population; in recent years, an increase of EPT in this localization has been observed. Tuberculosis can affect any organ of the female genital system, either single or in combination. The most frequently involved are the tubes (95100%), endometrium (5060%), ovaries (2030%), cervix (515%), myometrium (2.5%) and vagina/vulva (1%). The most common symptom of FGT that makes patients seek medical advice is infertility. Other symptoms of FGT include menstrual irregularities (oligo-, hypo-, dis-, amenorrhoea as well as meno- and metrorrhagia), pelvic pain, and abnormal vaginal discharge. In postmenopausal women, FGT is characterized by symptoms resembling endometrial malignancy, such as postmenopausal bleeding, persistent leukorrhea, and pyometra. The diagnosis is based on a thorough history, clinical examination, and proper examination of the sample material obtained by endoscopy. Tuberculin test with intradermal injection of 2 TU of tuberculin (Mantoux test) was positive in 42.6% of patients with genital tuberculosis. Hysterosalpingography is an important method for diagnosing FGT, which assesses the internal structure of the female reproductive tract and the patency of the fallopian tubes. On ultrasound, the fallopian tubes may appear dilated, thickened, or filled with serous discharge (hydrosalpinx) or caseous mass (pyosalpinx). Laparoscopy and dye hydrotubation are reliable tools for the diagnosis of genital tuberculosis, especially for the involvement of the fallopian tubes, ovaries, and peritoneum. Microbiological examination of sampled material in FGT using solid media is low-informative; polymerase chain reaction and other molecular diagnostic methods should be used. It should be acknowledged that FGT is not a rare condition, but it is often overlooked. The two main reasons for late diagnosis are vague clinical signs and low alertness. Since infertility is a frequent complication of FGT, all infertile women should be screened for tuberculosis: tuberculin, ultrasound, hysterosalpingography, and in complicated cases, diagnostic laparoscopy with obligatory tissue sampling for pathomorphological and microbiological studies.

Objective: To report 2 cases of adverse pregnancy outcomes due to delayed diagnosis of urogenital tuberculosis and propose a screening algorithm for patients from tuberculosis-endemic countries. Design: Case report. Setting: Academic medical center. Patient(s): Two patients with delayed diagnosis of urogenital tuberculosis leading to a fetal loss and a preterm delivery of an infant with congenital tuberculosis. Intervention(s): Endometrial biopsy, acid-fast bacilli culture of urine, and endometrium. Main outcome measure(s): Pregnancy outcomes. Result(s): Fetal loss at 19 weeks and preterm delivery of an infant with congenital tuberculosis before urogenital tuberculosis treatment. Conclusion(s): Patients who are at risk of urogenital tuberculosis should be screened in advance of infertility treatment to potentially prevent adverse pregnancy outcomes.

Tuberculosis of the genitourinary system has not lost its relevance. During the years of the pandemic of a new coronavirus infection, the number of newly diagnosed cases of tuberculosis of all localizations has decreased, but their structure has become more severe and mortality has increased. There is a wide variation in the statistics of urogenital tuberculosis (UGT) in the literature. The true incidence of scrotal tuberculosis is not known; at the end of the last century, it was believed that it was 7% of all cases of tuberculosis. It is believed that the share of isolated tuberculosis of the genital organs of men accounts for no more than 30% of all localizations of UGT, and most often tuberculosis develops in the epididymis. The spread of M. tuberculosis to the organs of the scrotum, as a rule, occurs by the hematogenous route from the primary focus in the lungs or kidney. However, the infection can also spread retrogradely from the prostate and seminal vesicles to the epididymis and testicles. Tuberculosis of the testis and its epididymis is often complicated by infertility and the formation of fistulas. This disease has no pathognomonic symptoms. Differential diagnosis is carried out between tuberculous epididymo-orchitis, testicular tumor, testicular torsion, bacterial epididymo-orchitis. Ultrasound examination is of great diagnostic value in tuberculosis of the scrotal organs. The ultrasound picture in tuberculosis of the testis and its epididymis is divided into 4 types: diffuse enlargement, heterogeneous hypoechogenicity; diffuse increase, uniform hypoechogenicity; nodular enlargement, heterogeneous hypoechogenicity; miliary dissemination. The world literature does not describe an example of tuberculosis of the scrotal organs, when the disease would be diagnosed during the patient’s initial visit to the doctor. As a result of late diagnosis or low suspicion for TB, up to 70% of patients undergo unnecessary surgery, although TB orchiepididymitis can be treated medically. The lecture also analyzed a number of clinical observations.

Introduction. Urinary tract infections (UTIs) are one of the most common disease among women.Aim. To determine the efficacy and tolerability of furazidin in the treatment of patients with exacerbation of chronic recurrent cystitis.Material and methods. a purpose was to determine the efficacy and tolerance of furazidin in the treatment of patients with chronic recurrent cystitis. In the study 56 female patients were enrolled, 28 of whom received ciprofloxacin (CG) and 28 – furazidin (FG). The patients received furazidin 100 mg three times a day for seven days (FG) or 500 mg of ciprofloxacin twice a day for seven days (CG). As well we analyzed the histories of 37 patients with bladder tuberculosis (TMP) stage 4in order to estimate the negative effect of non-optimal antibiotic therapy for UTI on the timely diagnosis of urogenital tuberculosis.Results. At the end of antibacterial therapy, dysuria persisted in one patient in the FG and in two in the CG. Urinalysis was normal in both groups in 96.4% of patients. The growth of uropathogens was in one case in each group. For 6 months, there were 5 recurrence episodes in the FG, and there were 11 relapses in the CG (p < 0.05). There were no side effects in the FG, but in the CG, adverse reactions developed in 9 patients (32.1%). Patients with TMP had annually from 4 to 7 exacerbations of cystitis, fluoroquinolones were prescribed to all; none investigations for M. tuberculosis were performed.Conclusion. Immediate results did not show statistically significant differences between the groups of patients treated with furazidin and ciprofloxacin, however, the tolerance of ciprofloxacin was lower (p < 0.01). Long-term results have demonstrated a significant advantage of furazidin in the complex treatment of recurrent cystitis. All cases of stage 4 TMP are iatrogenic; an irreversible disabling complication was developed as a result of non-optimal therapy (primarily fluoroquinolones) for UTIs, which hided tuberculosis.

ObjectivesWe aimed to describe the epidemiology and clinical characteristics of urogenital tuberculosis (UGTB) in Sabah, Malaysia. MethodsWe performed a retrospective, descriptive study based on medical records of UGTB cases identified between January 1, 2014, and November 30, 2020. ResultsWe identified 131 cases of UGTB in Sabah. Patient gender was balanced except for a mild male predominance in the 35 to 44 age group. No cases were reported in children. The majority of the patients (96%) were diagnosed in the government facility. Among the UGTB cases, 72% of patients were from rural areas, and 29% were illiterate. The commonest presentation was frequency of micturition (28%), followed by abdominal pain (26%) and loss of appetite (26%). The common sites included renal (32%) and scrotal (25%). Diagnosis was achieved via histopathology in 39.7% of patients and smear microscopy in 35.9%. Anti-tubercular treatment duration was 8.6 (±SD 4.0) months, and 81% of patients have completed treatment. A total of 50.4% of patients had received surgical intervention; 10.7% had undergone incision and drainage, 9.9% had cystoscopy, and 6.9% underwent orchidectomy. ConclusionUGTB has varied non-specific symptoms, which poses a diagnostic challenge, leading to morbidity. Ensuring awareness via widespread education within government and private health care, along with rural outreach programs, will contribute to early recognition and treatment.

Urogenital tuberculosis (UGTB) is almost 8%–15% of the extrapulmonary site of TB of all kinds, and epididymal involvement is rarer, counted only 28% of UGTB. Isolated tuberculous epididymitis (ITE), without the inclusion of prostate or clinical evidence of renal involvement, is an even more rare entity and is challenging to diagnose. However, isolated epididymis TB presented as a huge scrotal abscess with scrotal sack involvement is exceptionally uncommon. The symptoms of such ITE resemble the epididymo-orchitis or malignant tumor, which results in misdiagnosis or delay in diagnosis. A 32-year-young man, sexually inactive, was presented with a rapid, painless scrotal growing. There was no clinical evidence for TB. Clinical examination of the genitalia revealed an enlarged right tactical with intratesticular masses (abuses) and swollen spermatic cord along with inflamed epididymitis. The radiological and laboratory shows no evidence of TB with clear chest X-rays, normal blood, and urine analysis. There were no symptoms of Mycobacterium tuberculosis during the microdot enzyme immunoassay analysis. A repeated magnetic resonance imaging and ultrasonic investigations were performed that revealed findings suggesting a chronic inflammatory process with severe abscess involving the spasmatic cord and scrotal sack, which mislead the diagnosis of epididymo-orchitis. Later, the extensive formation of superficial abscess breaches the scrotal sack. A pathological investigation of excretion and intrascrotal tissues established the diagnosis of ITE. The patient was kept on anti TB treatment medications for 12 months due to delay in diagnosis (12 weeks), continuous discharge, and severe involvement of epididymitis along with a scrotal sack and spermatic cord and had a remarkable recovery. The delayed diagnosis of ITE could lead the severe complication, which could result in surgical intervention or an orchiectomy. The first line of treatment should be the pharmacological approach for cases of epididymis TB, and surgery should be the 2nd option. A surgical procedure should be considered only in cases where the diagnosis is not established or when there is a strong clinical indication such as abscesses, cutaneous fistulas, or extensive involvement of the epididymis and testis.

Objectives: To identify the causes of delayed diagnosis of urogenital tuberculosis (UGT) through a qualitative study of patients with contracted bladder due to UGT., Materials and Methods: Eight patients diagnosed with contracted bladder due to UGT were evaluated. Data were obtained using face-to-face in-depth interviews and supplemented with medical records analysis and personal medical files. The identification of situations of diagnosis delay was coded by 2 urologists after data analyses. Codes were divided into 3 categories related to its causes: (1) health system; (2) disease factors; and (3) medical factors., Results: The 8 interviews produced 220 minutes of audio and 1.3 GB of scanned documents. The most frequent categories were "Medical factors," followed by "Disease factors" and "Health system." The codes "No clinical-laboratory-radiological suspicion" and "No clinical suspicion" were the most frequent, both belonging to "Medical factors." Clinically, tuberculosis simulates other pathologies and lacks specific tests with adequate sensitivity. The low representation of "Health system" codes indicates that access to public and private health services does not influence delayed diagnosis. The lack of clinical and radiological suspicion and the lack of knowledge of UGT features are the main reasons for diagnosis delay., Conclusions: The causes of delayed diagnosis in our sample were related to "Medical factors," followed by "Disease factors." Better understanding UGT features is an important topic in continuous medical education.

The literature review provides data on tuberculosis of the urethra in men. This disease is rarely recorded, as a rule, at the stage of formation of the urethral stricture, which can develop many years after the onset of the disease. Urethral tuberculosis is usually secondary to other localizations of extrapulmonary tuberculosis, such as tuberculosis of the prostate, penis, kidney, and bladder, but there are also isolated forms of this disease. The most common symptoms of urethral tuberculosis are the presence of strictures, skin-urethral and recto-prostatic fistulas, and purulent urethritis. Almost always, with this disease, conservative specific therapy was carried out, which in some cases made it possible to completely eliminate the symptoms and ensure the patient’s clinical recovery. Tuberculous urethral strictures are operated on according to generally accepted rules, but there is no single algorithm for the surgical treatment of strictures of this etiology, often limiting itself only to urine diversion or urethral dilation. Of the urethroplasty, the most commonly used end-to-end urethral anastomosis. In our opinion, a promising direction is the use of various grafts for the surgical treatment of this disease.

Testicular tuberculosis (TB) is a rare disease, and it tends to mimic other testicular diseases which are more common. We highlight the case of a 37-year-old male who presented to the emergency department with testicular torsion. Further investigations revealed evidence of TB.

Isolated ureteral involvement in urogenital tuberculosis is rare. The diagnosis can be difficult to evoke. The radiological aspect often evokes tumor involvement, hence the importance of mentioning this pathology in endemic countries. The purpose of this study is to show that it will be necessary to think of ureteral tuberculosis in the presence of ureteral thickening living in an endemic country. We reported a case of ureteric tuberculosis in a 46-years old man mimicking a tumor.

Urogenital tuberculosis (UGTB) is almost 8%–15% of the extrapulmonary site of TB of all kinds, and epididymal involvement is rarer, counted only 28% of UGTB. Isolated tuberculous epididymitis (ITE), without the inclusion of prostate or clinical evidence of renal involvement, is an even more rare entity and is challenging to diagnose. However, isolated epididymis TB presented as a huge scrotal abscess with scrotal sack involvement is exceptionally uncommon. The symptoms of such ITE resemble the epididymo-orchitis or malignant tumor, which results in misdiagnosis or delay in diagnosis. A 32-year-young man, sexually inactive, was presented with a rapid, painless scrotal growing. There was no clinical evidence for TB. Clinical examination of the genitalia revealed an enlarged right tactical with intratesticular masses (abuses) and swollen spermatic cord along with inflamed epididymitis. The radiological and laboratory shows no evidence of TB with clear chest X-rays, normal blood, and urine analysis. There were no symptoms of Mycobacterium tuberculosis during the microdot enzyme immunoassay analysis. A repeated magnetic resonance imaging and ultrasonic investigations were performed that revealed findings suggesting a chronic inflammatory process with severe abscess involving the spasmatic cord and scrotal sack, which mislead the diagnosis of epididymo-orchitis. Later, the extensive formation of superficial abscess breaches the scrotal sack. A pathological investigation of excretion and intrascrotal tissues established the diagnosis of ITE. The patient was kept on anti TB treatment medications for 12 months due to delay in diagnosis (12 weeks), continuous discharge, and severe involvement of epididymitis along with a scrotal sack and spermatic cord and had a remarkable recovery. The delayed diagnosis of ITE could lead the severe complication, which could result in surgical intervention or an orchiectomy. The first line of treatment should be the pharmacological approach for cases of epididymis TB, and surgery should be the 2nd option. A surgical procedure should be considered only in cases where the diagnosis is not established or when there is a strong clinical indication such as abscesses, cutaneous fistulas, or extensive involvement of the epididymis and testis. [ABSTRACT FROM AUTHOR]

Introduction. The problem of tuberculosis (TB) has not lost its significance due to the overlapping epidemic of HIV infection and the addition of specific lesions at its late stages. It is due to the lack of adherence to antiretroviral therapy in a large number of patients. The high mortality rate in HIV-associated TB requires an increase in the interest of all doctors for the early detection of various TB localizations against the background of HIV, allowing the patient to be cured. For urologists, information on the frequency of genitourinary TB in HIV patients is of interest to improve its diagnosis.Purpose of the study. To identify the proportion of genitourinary TB in the structure of the specific lesions in patients with HIV-associated TB.Materials and methods. The case-records of 115 deceased patients with a combination of HIV infection and TB were retrospectively analyzed using a continuous method. The number of men among them was 81.7 ± 3.6% (94). The average age of men was 37.1 ± 27.2 years, women — 31.9 ± 6.3 years. The research results were processed statistically.Results. The average period from the moment of HIV infection detection to the registration of a lethal outcome was 2.8 ± 1.3 years, from the moment of TB diagnosis — 6.96 ± 7.3 years. The majority of patients with HIV infection had a stage of secondary diseases (93.1 ± 2.4%). At the time of admission to the TB dispensary, the average CD4 + lymphocyte level was 131.06 ± 75.8 cells/pL, 10.03 ± 2.5%. Anti-retroviral therapy was observed only in 19 (16.5 ± 3.5%) patients. In deceased patients disseminated pulmonary TB was more often verified at autopsy — 52.2 ± 4.7%, miliary — 7.8 ± 2.5%, infiltrative — 11.3 ± 3.0%. In patients with disseminated and miliary pulmonary TB, foci of dropout were often observed in the spleen (71.7 ± 5.8% and 55.6 ± 16.6%) and liver (46.7 ± 6.4% and 33.3 ± 15,7%). The kidney damage occurred in 60.0 ± 6.3% of patients with disseminated and 44.4 ± 16.6% miliary pulmonary TB. Kidneys TB was confirmed by bacterioscopic urine examination in three cases only (2.6 ± 1.5%) during life. Prostate TB was confirmed by analysis of expressed prostatic secretion on Mycobacterium tuberculosis (2.6 ± 1.5%) and was combined with kidney TB. The lesions of the lymphatic system during life were exposed in 17.4 ± 3.5% of patients. A pathomorphological examination revealed TB of intrathoracic lymph nodes in 37.4 ± 4.5%, intra-abdominal lymph nodes — in 22.6 ± 3.9%, peripheral — 6.1 ± 2.2%, more often in miliary and disseminated pulmonary TB. TB meningitis was registered in 31 cases as well as meningoencephalitis in 32 patients during life and at autopsy, respectively. Intestinal TB was confirmed by autopsy in 9.6 ± 2.7% of patients; during life, it was accompanied by the detection of the pathogen in the feces. The pancreatic TB was detected in 2.6 ± 1.5%, TB spondylodiscitis in 1.7 ± 1.2%, myocardial TB in 0.9 ± 0.9% and pericardium TB in 0.9 ± 0.9% cases.Conclusion. Thus, generalized TB is diagnosed in patients in the late stages of HIV infection, in the structure of which kidney damage is in second place, yielded only to spleen damage. Obtaining this information should form the alertness of urologists in terms of detecting and diagnosing genitourinary TB in patients with HIV infection.

Abstract Background The genitourinary tract is one of the commonest regions that can be affected by extrapulmonary tuberculosis where the diagnosis can be quite difficult. A high index of suspicion and an awareness of the atypical clinical manifestations of urogenital tuberculosis (UGTB) are important, especially in patients from regions where tuberculosis continues to be a major public health problem. Case presentation Herein, we report a 33-year-old male who presented with a non-healing fistula at the site of suprapubic catheter following an emergency repair of traumatic bladder rupture. Further evaluation revealed a scarred, small capacity bladder with urinary fistulae along with a poorly functioning kidney which was suspicious of a tuberculous etiology. Urinary isolation of Mycobacterium tuberculosis and a positive bladder biopsy confirmed our suspicions that the findings were indeed part of the spectrum of UGTB. The patient was started on anti-tubercular chemotherapy and underwent a nephrectomy along with an ileal conduit and is doing well at 1-year follow-up. Conclusion To conclude, urogenital tuberculosis always has to be kept in mind especially when dealing with patients with non-healing urinary fistula, especially in endemic countries. A high index of suspicion along with careful and methodical workup of patients with atypical complications following common surgeries can lead to identification of this morbid condition and thereby avoid mismanagement and progression to chronic kidney disease.

Introduction. Tuberculosis remains a global problem of our time. Kidney tuberculosis, especially complicated by tuberculosis of the urinary tract, becomes a surgical disease if it diagnosed late or the therapy was not optimal.Materials and methods. 93 patients with urogenital tuberculosis (UGTB) was included in this study who were admitted to the Novosibirsk Scientific and Research Institute of Tuberculosis consecutively. All of them underwent surgical intervention on the kidney. 51 patients underwent open surgery, and 42 patients underwent laparoscopic surgery. The results of treatment and the incidence of complications in both groups were analyzed and compared.Results. The age of the patients ranged from 23 to 75 years, averaging 50.9 ± 6.7 years; there were 45 men and 48 women. Tuberculosis of the left kidney was diagnosed in 41 patients, on the right - in 52 patients. The indication for nephrectomy was polycavernous tuberculosis of the kidney with no function in 74 cases, while in 11 cases polycavernous tuberculosis was complicated by stage 4 bladder tuberculosis. In 9 patients, nephrectomy was performed with cystectomy simultaneously. In 2 patients with severe renal dysfunction, cystectomy for microcystis was not performed, preferring laparoscopic nephrectomy with heterotopic urine diversion. In the group of patients operated on with an open approach, complications developed in 14 patients (27.4%), in the group of laparoscopic operations - in 5 (11.9%). The laparoscopic approach made it possible to activate the patients much earlier: after 2.4 hours, while in the openaccess group - after 38.7 hours.Conclusion. Due to the peculiarities of the pathogenesis of UGBT, it is accompanied by the local development of gross deforming scars, which significantly complicates the implementation of the surgical procedure - both open and laparoscopic access. Nevertheless, modern technology allows to perform the entire spectrum of operations laparoscopically to UGTB, and the complication rate is 2.3 times lower than in open operations. Early activation of the patient, less need for analgesics are also positive factors of minimally invasive surgery for UGTB.

Objectives: Effective methods for diagnosing urogenital tuberculosis (UGTB) are important for its clinical management. Therefore, we undertook a systematic review to assess the performance of the urine-based Xpert MTB/RIF assay for UGTB. Methods: PubMed, Embase, Web of Science, the Cochrane library, and Scopus were systematically searched up to July 30, 2019. A hierarchical summary receiver operating characteristic (HSROC) was applied to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and odds ratio (OR) for the diagnostic accuracy of the Xpert test. Results: Our search identified 858 unique articles from which 69 studies were selected for full-text revision, with 12 studies meeting the inclusion criteria. Eleven studies comprising 1202 samples compared Xpert with mycobacterial culture, while 924 samples from eight studies compared it with a composite reference standard (CRS). The values for pooled sensitivity, specificity, PLR, NLR, and OR were 0.89, 0.95, 20.1, 0.18, and 159.53, respectively, when compared with the mycobacterial culture. Likewise, when compared with a CRS, the respective pooled sensitivity, specificity, PLR, NLR, and OR values were 0.55, 0.99, 40.67, 0.43, and 166.17, thereby suggesting a high level of accuracy for diagnosing UGTB. A meta-regression and sub-group analysis of TB-burden countries, study design, decontamination, concentration, and reference standard could not explain the heterogeneity (p > 0.05) in the diagnostic efficiency. Conclusions: Our results suggested that Xpert is a promising diagnostic tool for the diagnosis of UGTB via urine specimen.

Abstract Background Urogenital tuberculosis (TB) is rare in children and usually develops due to reactivation of the foci in the genitourinary tract after the latency period following initial infection. Urogenital TB in children has no pathognomonic clinical features that can result in overlooking or misdiagnosing this clinical entity. Here, we report important findings regarding the pathogenesis and transmission of TB by using genotyping and whole-genome sequencing (WGS) in a study of renal TB case in a child. Case presentation A 13-year-old boy was admitted to the hospital because of high fever, severe dry cough, flank pain and painful urination. Abdominal ultrasonography and CT revealed an 8 mm calculus in the kidney, and clinical findings were initially interpreted as nephrolithiasis. Nevertheless, due to the atypical clinical presentation of kidney stone disease, additional investigations for possible TB were performed. The QuantiFERON®-TB Gold Plus test was positive, and the Mantoux test resulted in 15 mm of induration, confirming infection with Mycobacterium tuberculosis (Mtb). Chest X-ray was normal. Chest CT revealed calcified intrathoracic lymph nodes. The urine sample tested positive for acid-fast bacilli, and Mtb cultures were obtained from urine and bronchial aspirate samples, resulting in a final diagnosis of intrathoracic lymph node and renal TB. Contact investigation revealed that the child’s father was diagnosed with TB when the child was 1 year old. Genotyping and WGS analysis of Mtb isolates of the child and his father confirmed the epidemiological link and pointed to the latency of infection in the child. Conclusions This case report confirmed the development of active TB from calcified lesions in adolescent after 12 years of exposure, demonstrated the absence of microevolutionary changes in the Mtb genome during the period of latency, and proved the importance of appropriate evaluation and management to prevent the progression of TB infection to active TB disease. The use of WGS provided the ultimate resolution for the detection of TB transmission and reactivation events.

Testicular tuberculosis (TB) is a rare disease, and it tends to mimic other testicular diseases which are more common. We highlight the case of a 37-year-old male who presented to the emergency department with testicular torsion. Further investigations revealed evidence of TB. [ABSTRACT FROM AUTHOR]

Objectives: To describe characteristics, details of diagnosis and outcomes of urogenital tuberculosis (UGTB) in a low‐prevalence country. Methods: We conducted a retrospective observational study of 37 consecutive patients diagnosed with UGTB between 1st January 2014 and 31st October 2019 in an East London hospital. Results: 68% (25/37) of patients were male and the median age was 42 years (IQR 34–55). 89% (33/37) of patients were born outside the United Kingdom with 65% (24/37) born in the South Asian region. Renal (32.4%), epididymal (24.3%) and endometrial TB (21.6%) were the most prevalent forms of UGTB. Only 13.5% of UGTB patients had concurrent pulmonary TB. The median length of time from symptom onset to treatment was 163 days, while endometrial TB had an average delay to diagnosis of 564 days. Approximately half of patients with UGTB were culture positive (51.4%). However, 70% of early morning urines (EMUs) sent in urinary TB were culture positive. 11 patients (30.6%) underwent two or more invasive procedures, such as biopsy to obtain specimen samples. The mean treatment length for all UGTB cases was 7.3 months (SD 3.1). Notably, 25% of patients with endometrial TB required surgery despite antituberculous treatment. Conclusions: UGTB is challenging to diagnose as early disease is often asymptomatic. Clinicians faced with non‐specific symptoms, or features suggestive of urogenital malignancy amongst patients from TB‐endemic areas, should maintain a high suspicion of UGTB. [ABSTRACT FROM AUTHOR]

Objective: to determine the incidence of urogenital tuberculosis (UGTB) in the 2 diagnostic reference centers of Cochabamba. Methods: retrospective cross-sectional study from January 2013 to March 2020; Study population: patients with suspected UGTB with culture request for BK. Data collection: Laboratory database and review of clinical records. Results: 2266 patients with clinical suspicion of UGTB who had urine cultures for TB were identified; of which 133 (5.87%) patients were culture positive: 87 male (65.4%) and 46 female (34.6%); Of these, 115 patients do not have complete follow-up and only 18 patients were evaluated, of which 83.3% had renal TB, 11.1% genital and 5.6% bladder; 77.8% had lower urinary tract symptoms, 33.3% had some type of comorbidity and 1 required urological surgery. Antituberculosis treatment was standard in 100%, 1 presented adverse reaction, but no resistance or deaths associated with the treatment. Discussion: the incidence of 5.87% is not negligible, due to the fact that a high index of suspicion is required and to have the culture for diagnosis, follow-up and termination of therapy and thus reduce irreversible damage affecting functionality. [ABSTRACT FROM AUTHOR]

Mycobacterium tuberculosis causes tuberculosis, a fatal infection resulting in widespread illness and death. In 2020, approximately 10 million people were diagnosed with tuberculosis. The top 30 tuberculosis-endemic countries accounted for 86% of all estimated occurrence cases worldwide. In this context, eight of these accounted for two-thirds of the global total, with India having a prevalence of 26%. Aside from lung inflammation, the risk factors for tuberculosis in women include extra-pulmonary infection, particularly genital tuberculosis, tuberculous mastitis, and tuberculous in the peritoneum, intestine, and spine. Depending on the epidemiologic context and screening methods, different tuberculosis symptoms and disease diagnoses are more or less common among expectant mothers. The disease is almost certainly going to have a global impact. The social stigma and anxiety associated with tuberculosis may have a much more significant negative impact on women's health behaviors than men. Notably, the abdominal sites of miliary tuberculosis could mimic tumor likely, carcinoma and lymphoma. Also, the results of the diagnostic accuracy tests for the condition demonstrate that extra-pulmonary tuberculosis can be quickly and accurately diagnosed in various sites using both the T-SPOT assay and the GeneXpert/PCR test. Therefore, this review exemplified the prevalence of extra-pulmonary tuberculosis at various points in women's lives. On the contrary, it also illustrated the symptoms and dangers of TB as they relate to women's health., Competing Interests: Conflicts of interest The authors have none to declare., (Copyright © 2023 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Introduction. Tuberculosis of the prostate is difficult for diagnosis, especially in the early stages.Material and methods. In an open prospective cohort study 84 patients with clinical and laboratory manifestations of chronic prostatitis were included.Purpose of the study. Тo estimate the most significant diagnostic criteria for prostate tuberculosis; role of prostate biopsy in differential diagnosis.Results. In 45 patients (53.6%) prostate tuberculosis was diagnosed, and in 39 patients (46.4%) chronic bacterial prostatitis was diagnosed. The diagnosis of prostate tuberculosis was confirmed microbiologically in 33.3% of patients, radiologically - in 24.4% of patients. A prostate biopsy followed by histological, bacteriological and molecular-genetic examination of the biopsy specimen confirmed the diagnosis in 20% of patients.Conclusion. The most informative in the differential diagnosis of tuberculosis and chronic prostatitis is the identification of M. tuberculosis; verification of diagnosis radiographically is possible only with the development of destruction of the parenchyma. The biopsy of the prostate should be examined not only pathologically, but also by molecular genetic methods.Disclosure: The study did not have sponsorship. The authors have declared no conflicts of interest.

Abstract Endometrial tuberculosis is a rare diagnosis in the postmenopausal period, and it can mimic a carcinoma. The present article describes the case of a 54-year-old female patient with weight loss, abdominal pain, and ascites. An ultrasonography showed endometrial thickening, and a video hysteroscopy revealed a uterine cavity with formations with cotton aspect covering the entire endometrial surface and the tubal ostia. An anatomopathological evaluation diagnosed endometrial tuberculosis. The treatment was with a standardized therapeutic scheme (ethambutol, isoniazid, pyrazinamide and rifampicin), and the patient evolved with clinical improvement and normal uterine cavity at hysteroscopy. Considering the lack of pathognomonic hysteroscopic findings of the disorder, it is important to disclose the images of the case.

Abstract Background Urogenital tuberculosis is still a frequent presentation, and it constitutes a current public health problem in endemic areas. The clinical presentation of this form of the disease may be misleading. The pseudotumoral type of renal tuberculosis is extremely uncommon. Case presentation We present a case of a 52-year-old African woman who presented with urogenital tuberculosis in its pseudotumoral form. This case was initially diagnosed and managed as renal cancer. Histopathology confirmed the diagnosis of pseudotumoral renal tuberculosis. Conclusions The pseudotumoral form of urinary tuberculosis can be difficult to diagnose. Only bacteriological or histological confirmation allows diagnosis for adequate treatment.

Introduction Tuberculosis affects commonly the lungs, but any other organs can be affected as well. Urogenital tuberculosis is usually misdiagnosed. In this perspective, we aimed to give an update on the epidemiological, clinical and evolutionary features of urogenital tuberculosis in Southern Tunisia. Methods We conducted a retrospective study including all patients with extrapulmonary tuberculosis notified during the period from 1992 to 2017 in Southern Tunisia. We specified the particularities of urogenital tuberculosis cases, and we compared them with other extrapulmonary tuberculosis cases. Results Overall, we analyzed 240 cases with urogenital tuberculosis, among 1702 patients with extrapulmonary tuberculosis (14.1%). There were 121 women (50.4%). The mean age was 49±17 years. Multifocal tuberculosis was noted in 29 cases (12.1%). There were 169 cases with urinary tract tuberculosis (70.4%). Chronological trends analysis showed that the median age at diagnosis increased significantly (Rho=0.41; p=0.039) and the number of urogenital tuberculosis declined during the study period, without a statistical significance (Rho = -0.07; p=0.721). Compared to other extrapulmonary tuberculosis sites, patients aged 60 years and above (OR=2.7; p<0.001) and coming from rural areas (OR=1.4; p=0.021) were more frequently diagnosed with urogenital tuberculosis. Treatment duration was significantly longer in patients with urogenital tuberculosis (10.13±3.79 vs 9.20±3.77 months; p<0.001). As for the disease evolution, relapse was significantly more frequent in patients with urogenital tuberculosis (OR=4.1; p=0.045). Conclusions Although decreasing trends over time were noted, the prognosis of urogenital tuberculosis was more severe compared to other extrapulmonary tuberculosis sites. [ABSTRACT FROM AUTHOR]

• The second common presentation of extra pulmonary tuberculosis is urogenital tuberculosis. • Most patients present with general symptoms, rarely they present like RCC. • Suspicion of Tb is crucial to avoid missing UGTB for RCC particularly in epidemic countries. • Renal cell carcinoma and genitourinary tuberculosis can coexist. Renal tuberculosis (RTB) has no specific presentation and symptoms can be absent in up to 8% of cases in developing countries. Most patients present with symptoms like fever, burning micturition, pyuria, weight loss, and loin pain. In very rare occasions RTB can present as a renal mass mimicking renal cell carcinoma RCC. We report a case that was initially diagnosed as renal cell carcinoma and histopathology revealed renal tuberculosis. Tuberculosis is more common than renal cell carcinoma, the WHO states that 1 in every three individuals have TB worldwide, but something to keep in mind is that the incidence of RCC is increasing by the rate of 1% since the year 2006. Hence uncommon presentations of common diseases are more common than common presentations of uncommon diseases, then when doctors encounter a patient who is presenting with renal mass especially in countries that are endemic with TB a probability of uncommon presentation of UGTB should be considered to avoid missing the chance of treating a medically curable condition. Most of the reported cases in the literature about pseudo tumor presentation of UGTB indicate that most of the cases presented with unilateral mass mimicking RCC and TB is detected after radical nephrectomy. RTB can mimics RCC clinically and radiologically, which creates a diagnostic challenge. The chance of diagnosing renal TB in a patient presenting with renal mass is extremely lower than the chance of missing it for RCC, this because of the lack of evidence-based diagnostic approaches. [ABSTRACT FROM AUTHOR]

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• Low accuracy of conventional testing complicates clinical management of urogenital tuberculosis. • Xpert demonstrates promising diagnostic efficiency for urogenital tuberculosis. • Xpert performance may not be affected by differing characteristics of included studies. • Integrating traditional tests with Xpert assay may increase likelihood of urogenital tuberculosis detection. Effective methods for diagnosing urogenital tuberculosis (UGTB) are important for its clinical management. Therefore, we undertook a systematic review to assess the performance of the urine-based Xpert MTB/RIF assay for UGTB. PubMed, Embase, Web of Science, the Cochrane library, and Scopus were systematically searched up to July 30, 2019. A hierarchical summary receiver operating characteristic (HSROC) was applied to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and odds ratio (OR) for the diagnostic accuracy of the Xpert test. Our search identified 858 unique articles from which 69 studies were selected for full-text revision, with 12 studies meeting the inclusion criteria. Eleven studies comprising 1202 samples compared Xpert with mycobacterial culture, while 924 samples from eight studies compared it with a composite reference standard (CRS). The values for pooled sensitivity, specificity, PLR, NLR, and OR were 0.89, 0.95, 20.1, 0.18, and 159.53, respectively, when compared with the mycobacterial culture. Likewise, when compared with a CRS, the respective pooled sensitivity, specificity, PLR, NLR, and OR values were 0.55, 0.99, 40.67, 0.43, and 166.17, thereby suggesting a high level of accuracy for diagnosing UGTB. A meta-regression and sub-group analysis of TB-burden countries, study design, decontamination, concentration, and reference standard could not explain the heterogeneity (p > 0.05) in the diagnostic efficiency. Our results suggested that Xpert is a promising diagnostic tool for the diagnosis of UGTB via urine specimen. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is an important worldwide health problem. It can be divided into pulmonary and extrapulonary forms, with the genitourinary tract being a common site of extrapulmonary TB. Renal impairment may be due to the hematogenous spread of infection or localized genitourinary disease. Objective: To describe a case report of an adult female patient with renal failure due to renal tuberculosis undergoing hemodialysis. Case report: A 57-year-old female patient, 30 years ago presented with urinary symptoms, evening fever and weight loss, already being treated for recurrent urinary tract infections, without improvement. It was requested urinalysis, which presented intense pyuria and negative urine culture. Excretory urography was performed, which revealed parenchymal destruction, hydronephrosis with signs of structural distortion of the kidney and spastic bladder. In addition, a positive Bacillus Alcohol-Acid Resistance (BAAR) study was carried out in the urine, establishing a diagnosis of tuberculosis in the urinary tract. It was initiated therapy with Rifampicin, Isoniazid and Pyrazinamide, with symptomatic improvement. However, left nephrectomy was performed to correct refractory arterial hypertension, progressing to renal failure requiring hemodialysis. Conclusion: Renal tuberculosis presents a challenging diagnosis for the various medical specialties, since its manifestation and severity diverge individually. The typical symptoms of pulmonary tuberculosis are not frequent when there is renal involvement. Therefore, early diagnosis allows intervention in the evolution of the disease, avoiding possible complications. [ABSTRACT FROM AUTHOR]

Background: Urogenital tuberculosis (TB) is rare in children and usually develops due to reactivation of the foci in the genitourinary tract after the latency period following initial infection. Urogenital TB in children has no pathognomonic clinical features that can result in overlooking or misdiagnosing this clinical entity. Here, we report important findings regarding the pathogenesis and transmission of TB by using genotyping and whole-genome sequencing (WGS) in a study of renal TB case in a child.Case Presentation: A 13-year-old boy was admitted to the hospital because of high fever, severe dry cough, flank pain and painful urination. Abdominal ultrasonography and CT revealed an 8 mm calculus in the kidney, and clinical findings were initially interpreted as nephrolithiasis. Nevertheless, due to the atypical clinical presentation of kidney stone disease, additional investigations for possible TB were performed. The QuantiFERON®-TB Gold Plus test was positive, and the Mantoux test resulted in 15 mm of induration, confirming infection with Mycobacterium tuberculosis (Mtb). Chest X-ray was normal. Chest CT revealed calcified intrathoracic lymph nodes. The urine sample tested positive for acid-fast bacilli, and Mtb cultures were obtained from urine and bronchial aspirate samples, resulting in a final diagnosis of intrathoracic lymph node and renal TB. Contact investigation revealed that the child's father was diagnosed with TB when the child was 1 year old. Genotyping and WGS analysis of Mtb isolates of the child and his father confirmed the epidemiological link and pointed to the latency of infection in the child.Conclusions: This case report confirmed the development of active TB from calcified lesions in adolescent after 12 years of exposure, demonstrated the absence of microevolutionary changes in the Mtb genome during the period of latency, and proved the importance of appropriate evaluation and management to prevent the progression of TB infection to active TB disease. The use of WGS provided the ultimate resolution for the detection of TB transmission and reactivation events. [ABSTRACT FROM AUTHOR]

Purpose: For better understanding of urogenital tuberculosis (UGTB), its clinical spectrum and characteristic features need to be evaluated. Materials and methods: One hundred and forty-two cases of UGTB patients were analyzed retrospectively. We considered age, gender, symptoms, and diagnostic procedures. Results: The total of 142 patients were divided into group A (consisted of 93 patients with only urinary TB), group B (consisted of 13 male patients with generalized UGTB, including urinary TB and male genital TB (MGTB). Group C consisted of 36 patients with MGTB. Sixty patients in groups A and B 56.6% had kidney TB third-to-fourth stages, which are incurable for anti-TB therapy and require surgery. The urinary tract was involved in 48 patients (45.3%): 25 (23.6%) had ureteral TB and 23 (21.7%) had also bladder TB. The most common symptom for kidney TB was flank pain (69.8%) followed by dysuria (47.2%). Perineal pain and dysuria were most common symptoms for prostate TB and were found in 87.5% (14 patients) and 56.3% (9 patients), respectively. Of total, in only 58 UGTB patients (40.8%), the culture for Mycobacterium tuberculosis (Mtb) was positive. Conclusion: Of 142 patients with UGTB, 106 (74.7%) had kidney TB and 13 (9.2%) of them had kidney TB in combination with MGTB. Only MGTB (prostate, scrotal, or generalized) was diagnosed in 49 (34.5%) patients. The most common symptoms were flank pain and dysuria. Identification of Mtb in UGTB is difficult. Therefore, the most advanced microbiological technology should be used to establish the correct diagnosis. [ABSTRACT FROM AUTHOR]