Genitourinary tuberculosis in Nigeria; a review of thirty-one cases.

OBJECTIVE: To report and discuss the characteristics of genitourinary tuberculosis as observed in a sub-Saharan African setting, where reports suggest its rarity despite reported high incidence and prevalence of pulmonary tuberculosis.

PATIENTS AND METHOD: Thirty one consecutive patients with discharge diagnoses of genitourinary tuberculosis seen in a small community-based hospital over a five-year period were retrospectively studied.

RESULT: There were 28 males and three females, with a mean age of 37.6 (SD 11.5) years. Forty- three sites were involved in seven organs: epididymis 25 (58.1%), kidney 7 (16.3%), testis 4 (9.3%), bladder 3 (7.0%), ureter 2 (4.7%), prostate 1 (2.3%), and cord of the testis 1 (2.3%). The commonest presenting features were scrotal/testicular mass with or without pain/tenderness (80.6%), fever/headache (51.6%), and dysuria (22.6%). Other common features were back, loin, or abdominal pain/tenderness. hydrocoele, scrotal abscess, and haematuria. 26.9% had evidence of concurrent or previous pulmonary tuberculosis, and 9.1% were positive on HIV 1 & 11 screening.

CONCLUSION: With the prevailing conditions in sub-Saharan Africa and most of the developing world and the slightly different characteristics of the disease in our environment, diagnosis of genito-urinary tuberculosis may be difficult. It is advised that patients with unexplained symptoms in the urinary tract should be investigated for tuberculosis.