Reasons for suspicion of prostate tuberculosis

Abstract

Prostate tuberculosis (PTB) is often underdiagnosed disease, although 77% men died from TB had PTB. We retrospectively analyzed history cases of 72 patients with PTB to evaluate the reasons for suspicion of TB. Four patients (5.6%) underwent transurethral resection of prostate due to low urinary tract symptoms and enlarged prostate, that was estimated like benign prostatic hyperplasia; histology revealed prostate TB. Thirty patients (41.7%) for a long time were managed as prostatitis patients. Diagnosis was confirmed by bacteriology in 17 (56.7%), by X-ray - in 9 (30.0%), and by histology - in 4 patients (13.3%). In 9 patients with pulmonary TB PTB was diagnosed as they had low urinary tract symptoms; in ejaculate M.tuberculosis was found. Nine patients (12.5%) had relapses of epididymitis, and six patients (8.3%) addressed to the doctor as they had scrotal fistula. In six patients (8.3%) with kidney TB also PTB was revealed. Four patients (5.6%) were sent to TB-urologists as they had hematuria, another 4 patients (5.6%) had hemospermia (fig1). Chronic prostatitis and chronic epididymitis, resistant to standard therapy, were most common reasons for suspicion of prostate TB – 62.5% altogether. In 20.8% PTB was diagnosed in patients with pulmonary and kidney TB. Hematuria and hemospermia are the real reason for suspicion of PTB. In 5.6% the disease was found occasionally.