Tuberculosis in Sex Accessory Organs

Lee, Hee Seock; Lee, Sang Kon

Abstract

PURPOSE: The incidence of genitourinary tuberculosis(tbc) has consistently declined as results of effective chemotherapy and health care. But it still has significant associated morbidity. The pathogenesis of prostatic and epididymal tbc remains obscure. To assess the progress of tuberculous infection in sex accessory organs including prostate, epididymis and testis, prospective clinical study was performed.
MATERIALS AND METHODS
Of the 58 male patients with genitourinary tbc during a 8-year period(1989-1996), 23 patients (39.7%) had tuberculosis in sex accessory organs. Thirty patients who demonstrated tuberculosis in at least one organ amomg prostate, epididymis, testis and bladder were evaluated. The conclusive diagnosis was made on the basis of isolation of Mycobacterium tuberculosis, histopathology. A patients with organ confined tbc was considered to be caused by metastatic spread of infection.
RESULTS
In 12(40%) of 30 patients tubercle bacilli were detected in urine. 14(87.5%) of the 16 patients with tuberculous epididymitis and 10(76.9%) of the 13 patients with tuberculous prostatitis were considered to have an infection extended through the metastatic spread. Three(25%) patients had tuberculous cystitis directly extended from the tuberculous prostatitis. All three tuberculous orchitis were secondary to the tuberculous epididymitis.
CONCLUSIONS
The results suggest that the route of infection of tuberculosis in the prostate and the epididymis are mainly through the hematogenous spread and direct extension of infection is likely deveploped by descending spread.