Surgical treatment of urethral tuberculosis in men – history and present (literature review)
https://doi.org/10.29413/ABS.2021-6.4.20
Abstract
The literature review provides data on tuberculosis of the urethra in men. This disease is rarely recorded, as a rule, at the stage of formation of the urethral stricture, which can develop many years after the onset of the disease. Urethral tuberculosis is usually secondary to other localizations of extrapulmonary tuberculosis, such as tuberculosis of the prostate, penis, kidney, and bladder, but there are also isolated forms of this disease. The most common symptoms of urethral tuberculosis are the presence of strictures, skin-urethral and recto-prostatic fistulas, and purulent urethritis. Almost always, with this disease, conservative specific therapy was carried out, which in some cases made it possible to completely eliminate the symptoms and ensure the patient’s clinical recovery. Tuberculous urethral strictures are operated on according to generally accepted rules, but there is no single algorithm for the surgical treatment of strictures of this etiology, often limiting itself only to urine diversion or urethral dilation. Of the urethroplasty, the most commonly used end-to-end urethral anastomosis. In our opinion, a promising direction is the use of various grafts for the surgical treatment of this disease.
About the Authors
A. A. Volkov
Moscow Research and Clinical Center for TB Control, Moscow Healthcare Department
Russian Federation
Russian Federation
Cand. Sc. (Med.), Research Officer at the Clinical Research Department
Stromynka str. 10, Moscow 107014, Russian Federation
O. N. Zuban
Moscow Research and Clinical Center for TB Control, Moscow Healthcare Department
Russian Federation
Russian Federation
Dr. Sc. (Med.), Professor, Deputy Chief Physician
Stromynka str. 10, Moscow 107014, Russian Federation
M. N. Reshetnikov
Moscow Research and Clinical Center for TB Control, Moscow Healthcare Department
Russian Federation
Russian Federation
Cand. Sc. (Med.), Surgeon at the Tuberculosis Pulmonary Department No. 4 (COVID)
Stromynka str. 10, Moscow 107014, Russian Federation
D. V. Plotkin
Moscow Research and Clinical Center for TB Control, Moscow Healthcare Department
Russian Federation
Russian Federation
Cand. Sc. (Med.), Docent, Surgeon at the Tuberculosis Surgical Department
Stromynka str. 10, Moscow 107014, Russian Federation
E. M. Bogorodskaya
Moscow Research and Clinical Center for TB Control, Moscow Healthcare Department
Russian Federation
Russian Federation
Dr. Sc. (Med.), Professor, Director
Stromynka str. 10, Moscow 107014, Russian Federation
References
1. Muneer A, Macrae B, Krishnamoorthy S, Zumla A. Urogenital tuberculosis – epidemiology, pathogenesis and clinical features. Nat Rev Urol. 2019; 16(10): 573-598. doi: 10.1038/s41585-019-0228-9
2. Dje K, Yao B, D’Horpock FA, Tchimou J. La tuberculose urogénitale: difficultés diagnostiques à propos de 5 observations [Urogenital tuberculosis: Diagnostic difficulties in 5 cases]. Ann Urol (Paris). 2003; 37(5): 233-235. doi: 10.1016/s0003-4401(03)00091-3
3. Yadav S, Singh P, Hemal A, Kumar R. Genital tuberculosis: Current status of diagnosis and management. Transl Androl Urol. 2017; 6(2): 222-233. doi: 10.21037/tau.2016.12.04
4. Mittal A, Ranjan S, Narain T, Panwar V. Surgical management of genitourinary tuberculosis: our experience and review of literature. Pol Przegl Chir. 2020; 92(6): 1-6. doi: 10.5604/01.3001.0014.3669
5. Wejse C. Medical treatment for urogenital tuberculosis (UGTB). GMS Infect Dis. 2018; 6: Doc04. doi: 10.3205/id000039
6. Zuban ON, Volkov AA, Muravyov AN, Sushchiy EA. Surgical tuberculosis of the urinary and male genital organs. Problems of Tuberculosis and Lung Diseases. 2008; 12: 57-60. (In Russ.).
7. All-Russian United Organization “Russian Association of Phthisiologists”. Federal clinical guidelines for the diagnosis and treatment of urogenital tuberculosis. Moscow; 2015: 24. (In Russ.).
8. Kerr WK, Gale GL, Peterson KS. Reconstructive surgery for genitourinary tuberculosis. J Urol. 1969; 101(3): 254-266. doi: 10.1016/s0022-5347(17)62324-3
9. Figueiredo AA, Lucon AM, Srougi M. Urogenital tuberculosis. Microbiol Spectr. 2017; 5(1). doi: 10.1128/microbiolspec.TNMI7-0015-2016
10. Wise GJ, Shteynshlyuger A. An update on lower urinary tract tuberculosis. Curr Urol Rep. 2008; 9(4): 305-313. doi: 10.1007/s11934-008-0053-9
11. Burrill J, Williams CJ, Bain G, Conder G, Hine AL, Misra RR. Tuberculosis: A radiologic review. Radiographics. 2007; 27(5): 1255-1273. doi: 10.1148/rg.275065176
12. Gupta N, Mandal AK, Singh SK. Tuberculosis of the prostate and urethra: A review. Indian J Urol. 2008; 24(3): 388-391. doi: 10.4103/0970-1591.42623
13. Porter MF. III. Uro-genital tuberculosis in the male. Ann Surg. 1894; 20(4): 396-405. doi: 10.1097/00000658-189407000-00052
14. Chute AL. Urethral tuberculosis, with repor t of a case. Boston Med Surg J. 1903; 149: 361-365. doi: 10.1056/NEJM190310011491401
15. Ross JC. Renal tuberculosis. Br J Urol. 1953; 25(4): 277-315. doi: 10.1111/j.1464-410x.1953.tb09279.x
16. Bianco A. IV. L’Uretrite tubercolare. Urologia Journal. 1975; 42(2): 101-119. doi: 10.1177/039156037504200201
17. Mochalova T.P. Tuberculosis of the urinary tract (diagnosis, clinic, treatment). Tashkent: Medicine of the Uzbek SSR; 1976: 182. (In Russ.).
18. Mba B, Lucas BP, Houchens N, Seares JM, Joshi U. All in the stream. J Hosp Med. 2019; 14(12): 777-781. doi: 10.12788/jhm.3286
19. Mizuno S, Ito N, Kobayashi KI, Kubo K, Komiya N. Urethral tuberculosis: A forgotten cause of urethral stricture. Urology. 2021; S0090-4295(21)00424-6. doi: 10.1016/j.urology.2021.05.016
20. Psihramis KE, Donahoe PK. Primary genitourinary tuberculosis: Rapid progression and tissue destruction during treatment. J Urol. 1986; 135(5): 1033-1036. doi: 10.1016/s0022-5347(17)45970-2
21. Skutil V, Payer J. Enterocystoplasty and two-stage urethroplasty in urogenital tuberculosis. A case report. Eur Urol. 1979; 5(2): 146-148. doi: 10.1159/000473088
22. Raghavaiah NV. Tuberculosis of the male urethra. J Urol. 1979; 122(3): 417-418. doi: 10.1016/s0022-5347(17)56440-x
23. Freidovich AI. Clinical phthisiourology. Moscow: Medicine; 2002: 302. (In Russ.).
24. Indudhara R, Vaidyanathan S, Radotra BD. Urethral tuberculosis. Urol Int. 1992; 48(4): 436-438. doi: 10.1159/000282372
25. Shevchenko SYu, Kulchavenya EV, Holtobin DP, Khomyakov VT, Brizhatyuk EV. A case of severe widespread extrapulmonary tuberculosis. Tuberculosis and Lung Diseases. 2016; 94(10): 73-76. (In Russ.). doi: 10.21292/2075-1230-2016-94-10-73-76
26. Symes JM, Blandy JP. Tuberculosis of the male urethra. Br J Urol. 1973; 45(4): 432-436. doi: 10.1111/j.1464-410x.1973.tb12184.x
27. Ozawa H, Kumon H, Nasu Y, Ohmori H, Arakawa K. [Chronic perianal pyoderma with urethrocutaneous fistula: A case report]. Hinyokika Kiyo. 1998; 44(2): 125-127. (In Japanese)
28. Mayilvaganan KR, Naren Satya Srinivas M, Reddy VN, Singh RK. Tuberculosis penis with ‘watering can penis’ appearance: Report of a rare case with retrograde urethrography and voiding cystourethrography findings. Pol J Radiol. 2016; 81: 454-457. doi: 10.12659/PJR.897943
29. Uteshev MS, Parpieva NN, Mukhamedov KS, Dzhurabaeva MKh. Background diseases and “masks” of tuberculosis of the genitourinary system. Medico-biological, clinical and social issues of health and human pathology: Proceedings of the IV All-Russian scientific conference of students and young scientists with international participation. Ivanovo; 2018: 320-321. (In Russ.).
30. Bouchikhi AA, Amiroune D, Tazi MF, Mellas S, Elammari JE, El Fassi MJ, et al. Isolated urethral tuberculosis in a middle-aged man: A case report. J Med Case Rep. 2013; 7: 97. doi: 10.1186/1752-1947-7-97
31. Mukherjee S, Sinha RK, Mandal SN, Tan WS. Primary urethral tuberculosis with urethrocutaneous fistula in association with balanitis xerotica obliterans. Urology. 2020; 141: e20-e21. doi: 10.1016/j.urology.2020.04.035
32. Prakash G, Singh V, Sinha RJ, Babu S, Jhanwar A, Mehrotra CN. Primary tuberculosis of urethra presenting as stricture urethra and watering can perineum: A rarity. Urol Ann. 2016; 8(4): 493-495. doi: 10.4103/0974-7796.192093
33. Bouchikhi AA, Khallouk A, El Fassi MJ, Farih MH. Atypical isolated urethral tuberculosis associated with inflammatory stenosis and fistulas. Urol Ann. 2014; 6(3): 270-271. doi: 10.4103/0974-7796.134307
34. Zajaczkowski T. Genitourinary tuberculosis: Historical and basic science review: Past and present. Cent European J Urol. 2012; 65(4): 182-187. doi: 10.5173/ceju.2012.04.art1
35. Bispen AV, Zuban ON, Yagafarova RK. Fournier’s disease and tuberculosis of the genital organs. Tuberculosis and Lung Diseases. 1999; 6: 57-58. (In Russ.).
36. Karthikeyan K, Thappa DM, Shivaswamy KN. “Water can” penis caused by tuberculosis. Sex Transm Infect. 2004; 80(1): 75. doi: 10.1136/sti.2003.007203
37. Bhari N, Jangid BL, Singh S, Mittal S, Ali F, Yadav S. Urethrocutaneous fistula: A rare presentation of penile tuberculosis. Int J STD AIDS. 2017; 28(1): 97-99. doi: 10.1177/0956462416647624
38. Aytekin S, Göktay F, Yasar Ş, Ferhatoğlu ZA, Güneş P. Penile tuberculosis: A case report. Indian J Dermatol Venereol Leprol. 2017; 83(3): 357-359. doi: 10.4103/ijdvl.IJDVL_301_16
39. Bell GM, De Klerk JN. Tuberkulose van die penis (corpora cavernosa) [Tuberculosis of the penis (corpora cavernosa)]. S Afr Med J. 1976; 50(38): 1489-1490. (In Afrikaans).
40. Pathak N, Keshavamurthy M, Rao K, Tabrez S, Ashwathaiya MB, Krishnappa P. A rare case of tubercular recto-prostatic urethral fistula with tuberculous orchitis. Urol Case Rep. 2020; 33: 101355. doi: 10.1016/j.eucr.2020.101355
41. Pal DK, Mondal S, Roy S. An unusual case of tubercular recto-prostatic urethral fistula. Sch J Med Case Rep. 2016; 4(12): 939-941. doi: 10.21276/sjmcr.2016.4.12.19
42. Okaneya T, Ogawa A, Wajiki M. Tuberculous rectourethral fistula. Urology. 1988; 31(5): 424-426. doi: 10.1016/0090-4295(88)90741-8
43. Suton S, Shiraishi Y, Sasaki T. Tuberculous rectourethral fistula: A case report of two cases. Med J Aomor 1974; 20: 151.
44. Okaneya T, Ogawa A, Wajiki M. Tuberculous rectourethral fistula. Urology. 1988; 31(5): 424-426. doi: 10.1016/0090-4295(88)90741-8
45. Kumar S, Kekre NS, Gopalakrishnan G. Diagnosis and conservative treatment of tubercular rectoprostatic fistula. Ann R Coll Surg Engl. 2006; 88(1): 26. doi: 10.1308/147870806x83242
46. Karimbaev KK. Modern methods of treatment of extended and complicated urethral strictures: Abstract of the Dissertation Thesis of the Dr. Sc. (Med.). Moscow; 2002: 35. (In Russ.).
47. Mukanbaev K. Emergency operations for tuberculosis of the genitourinary system. International Journal of Applied and Fundamental Research. 2017; 8(2): 272-275. (In Russ.).
48. Singh O, Gupta SS, Arvind NK. A case of extensive genitourinary tuberculosis: combined augmentation ileo-cystoplasty, ureteric ileal replacement and buccal mucosal graft urethroplasty. Updates Surg. 2013; 65(3): 245-248. doi: 10.1007/s13304-012-0141-8
49. Volkov AA, Zuban ON, Budnik NV, Saenko GI, Gavrilenko IV. Urethral strictures and obliteration as an outcome of urethral tuberculosis in men. Urology. 2020; S5: 42. (In Russ.)
Review
For citations:
Volkov A.A., Zuban O.N., Reshetnikov M.N., Plotkin D.V., Bogorodskaya E.M. Surgical treatment of urethral tuberculosis in men – history and present (literature review). Acta Biomedica Scientifica. 2021;6(4):220-229. (In Russ.) https://doi.org/10.29413/ABS.2021-6.4.20
Views:
1077
.png)
Email this article 
