title: [Investigation and management of genito-urinary tuberculosis].
abstract: Genito-urinary tuberculosis is the fourth most common manifestation of the disease, but it is often underestimated by clinicians because of few and non-specific symptoms and insidious disease course. The most common urinary findings are multiple ureteral stenosis. The most common genital involvement is an epididymal nodule for men and a chronic salpingitis for women. The definite diagnosis of genito-urinary tuberculosis is obtained on the basis of culture studies. Due to the paucibacillary nature of the disease, especially of genital location in woman, a probable or presumptive diagnosis is frequently considered with several parameters including radiological imaging (abdominal CT-scan, pelvic ultrasound, pelvic MRI). Endoscopic and surgical procedures are frequently required to obtain specimens for histopathologic and bacteriological studies. Medical treatment is the method of choice, with a combination of four drugs, namely isoniazid, rifampicin, ethambutol and pyrazinamide, followed by a two-drug regimen, for a total of six month duration. Surgery might be indicated in complicated genito-urinary tuberculosis (decreased renal function, infertility, urologic complaints).
authors.affiliation: Département d'infectiologie, CHU de Dijon, 14, rue Gaffarel, BP 77908, 21079 Dijon cedex, France. Electronic address: aurelie.fillion@chu-dijon.fr.
authors.forename: A
authors.initials: A
authors.lastname: Fillion
authors.affiliation: Service d'urologie, CHU de Dijon, 14, rue Gaffarel, BP 77908, 21079 Dijon cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Koutlidis
authors.affiliation: Service de médecine interne, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94010 Créteil cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Froissart
authors.affiliation: Service de médecine interne, hôpital Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France.
authors.forename: B
authors.initials: B
authors.lastname: Fantin
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D003952:Diagnostic Imaging; D004359:Drug Therapy, Combination; D006801:Humans; D014401:Tuberculosis, Urogenital / Q000175:diagnosis* / Q000188:drug therapy*; D016482:Urinalysis
chemical_list: D000995:Antitubercular Agents
keywords: Epididymal nodule; Genito-urinary tuberculosis; Infertility; Infertilité; Multiple ureteral stenosis; Mycobacterium tuberculosis; Nodule épididymaire; Sténoses urétérales étagées; Tuberculose urogénitale