Urogenital Tuberculosis (Tb), a Rare Manifestation of Extrapulmonary Tb, a Retrospective Study

Abstract

Introduction Urogenital tuberculosis (TB) is a rare manifestation of extrapulmonary TB. Globally it is thought to account for 10% of extrapulmonary TB cases. It is often associated with disseminated spread of TB from another site. Methods a retrospective study of patients diagnosed with urogenital TB at a large London NHS Trust, between 2018 and 2023 was conducted. Cases were identified from the London TB Registry, with additional clinical information gathered from electronic notes. Results Of 796 patients identified as having EPTB, 14 (1.8%) patients were diagnosed with urogenital TB. The cohort of urogenital TB included seven patients with renal TB, two with testicular TB, one endometrial, one bladder wall/renal/epidymo- orchitis, one extra-testicular epididium, and one lymph node with renal TB. The median age at diagnosis was 34.5 years (IQR 20). Ten (71%) urogenital TB patients were male. Ten of fourteen were born outside of the UK, from Bangladesh, India, Pakistan, Somalia and Sri Lanka. Five patients had pre-existing renal disease and one a diagnosis of HIV. Table 1 summarises patients presenting signs and symptoms, with the most common presentation being acute kidney injury or deterioration in renal function. Median time from symptom onset to date of presentation was 135 days (IQR 161 days). Patients were diagnosed at a median of 61 days (IQR 93 days) from presentation. One patient presented to the TB service initially whilst others were referred to renal (six), urology (five), gynaecology (one), and general surgery (one) departments. Eleven patients underwent cross-sectional imaging (CT, PET-CT or MRI) which facilitated diagnosis. All fourteen patients underwent biopsy of lesions however only five were AFB culture positive. All patients successfully completed antitubercular treatment for six months or longer. Conclusion Although urogenital TB is rare, biopsies of urogenital lesions in patients from high TB incidence countries should always be sent for TB culture. (Table Presented).