Abstract
BackgroundNowadays, most studies of tuberculous epididymo-orchitis (TBEO) are case reports or small sample cohort series. Our study is aimed to present the largest series of TBEO with our management experiences and long-term follow-up outcomes.MethodsPatients diagnosed with TBEO after surgical procedures at Department of Urology, West China Hospital from 2008 to 2019 were included. All clinical features, auxiliary examination results, treatment and histopathological findings were extracted if available.ResultsEighty-one patients (mean age 50.77 ± 16.1 years) were included. Scrotal swelling (N = 47, 58.0%) and pain (N = 29, 35.8%) were the most common presenting complaint. Pyuria and microscopic hematuria were observed in twenty-two (27.2%) and eight patients (9.9%), respectively. Urine acid fast bacilli cultures were available in 16 patients and all were negative. The mean duration between the onset of symptoms and the definite diagnosis was 6.42 ± 7.0 months. TBEO was considered in 30 (37.0%), tumors in 28 (34.6%) and nonspecific bacterial epididymo-orchitis in 23 (28.4%) patients. All patients received triple therapy of chemotherapy-surgery-pharmacotherapy and definite diagnosis was confirmed through histopathology of surgical specimens. Fifty-five patients were followed up regularly (mean follow-up 82.35 ± 36.6 months). One patient (1.2%) died from liver cirrhosis and no recurrence was observed. Postoperative complications included erectile dysfunction in 4 patients (4.9%), premature ejaculation in 5 patients (6.2%) and sterility in 7 patients (8.6%).ConclusionsWe recommend patients with advanced TBEO to receive triple therapy of chemotherapy-surgery-pharmacotherapy. Physicians should pay more attention to patients’ sexual function and fertility during follow up after treatment completed.
Highlights
Nowadays, most studies of tuberculous epididymo-orchitis (TBEO) are case reports or small sample cohort series
Compared with renal TB, male genital TB is a rare subtype of the urogenital TB, which can be classified as TB epididymitis, TB orchitis, TB of the prostate, TB of the seminal vesicles, and TB of the penis [2, 3]
Setting and study design From January 2008 to May 2019, patients diagnosed with TBEO after surgical procedures at Department of Urology, West China Hospital were included in our retrospective observational study
Summary
Most studies of tuberculous epididymo-orchitis (TBEO) are case reports or small sample cohort series. Our study is aimed to present the largest series of TBEO with our management experiences and longterm follow-up outcomes. Huang et al BMC Infect Dis (2021) 21:1068 affect people of both sexes in all age groups but the highest burden is in men (aged ≥ 15 years), who accounted for 57% of all TB cases, while women and children (aged < 15 years) accounted for 32% and 11%, respectively. China is the second highest TB-burden country after India, accounting for 9% of global TB cases in 2018 [1]. In addition to lymphatic involvement, urogenital TB is the most common manifestation of extrapulmonary TB and is more frequent in middle-aged men, which accounts for 33.7–45.5% of the extrapulmonary TB worldwide [2]. Compared with renal TB, male genital TB is a rare subtype of the urogenital TB, which can be classified as TB epididymitis, TB orchitis, TB of the prostate, TB of the seminal vesicles, and TB of the penis [2, 3]
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