Genitourinary tuberculosis in a medical center in southern Taiwan: an eleven-year experience.
OBJECTIVE
Genitourinary tuberculosis is the second most common disease form of extrapulmonary tuberculosis. This study analyzed the clinical characteristics and outcome in 31 patients with genitourinary tuberculosis treated between 1994 and 2004 at a tertiary medical center in southern Taiwan.


METHODS
Data were collected by chart review. Diagnosis was based on microbiological or histological proof plus compatible radiographic findings and clinical presentation.


RESULTS
This study included 14 men (45%) and 17 women (55%). Their ages ranged from 31 to 81 years (mean, 58.1 years). Genitourinary symptoms (83.9%) were more frequent than constitutional symptoms (35.5%). Pyuria plus hematuria with sterile culture (51.6%) was the most common finding. Only 25.8% of patients had a known history of pulmonary tuberculosis. Diagnosis was based on microbiological findings in 11 patients (35.5%), and by histological findings in 20 (64.5%) patients. Intravenous pyelography revealed abnormalities in 94% of patients and renal ultrasonography in 79.2%. Imaging studies were characteristic of advanced stage in most patients. Twenty-five percent of patients were classified as having treatment failure after at least 6 months of therapy. The treatment failure rate was higher in patients with positive microbiological findings (71.4%) than in those with histological findings alone (5.9%, p=0.003).


CONCLUSIONS
The high rate of treatment failure and advanced stage of disease at diagnosis are indicative of the challenge in the care of patients with genitourinary tuberculosis in Taiwan.
Hsieh
Hsiao-Cheng
HC
Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Lu
Po-Liang
PL
Chen
Yen-Hsu
YH
Chen
Tun-Chieh
TC
Tsai
Jih-Jin
JJ
Chang
Ko
K
Chen
Tyen-Po
TP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006417:Hematuria / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011776:Pyuria / Q000473:pathology; D012189:Retrospective Studies; D013624:Taiwan; D014397:Tuberculosis, Pulmonary / Q000150:complications; D014401:Tuberculosis, Urogenital / Q000150:complications / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*
D000995:Antitubercular Agents