Tuberculosis still remains a significant global concern despite there is decline of this communicable disease in developed countries. The percentage of tuberculosis patients is more in developing countries. Tuberculosis is caused by bacterium called mycobacterium tuberculosis. Tuberculosis (TB) is a disease primarily affecting the lungs. The germs can then sometime spread to other parts of body through blood and lymph channel.
What Causes Urinary Tuberculosis?
Urinary tuberculosis is caused by mycobacterium tuberculosis. It is a type of bacteria belonging to mycobacterium family.
Symptoms of Urinary Tuberculosis
The symptoms of urinary tuberculosis are sudden in onset. However, because the symptoms are similar to several other diseases of urinary tract, it is difficult to pin point the disease. Due to this confusion, many times the disease is not detected in its early stage. The presenting symptoms of urinary tract TB are as follows:
- Red urine due to passage of blood in urine.
- Pain in the renal angle and in lower abdomen.
- Burning in urine with increased frequency
- Weight loss
- Loss of appetite
- Mild fever
- Tiredness all the time
- A cold abscess may develop in thigh. It develops when the infection spreads to the psoas muscle which has its origin in the lower back and its insertion in the thigh region.
Diagnosis and Treatment of Urinary Tuberculosis:
As mentioned earlier, diagnosis of TB initially is difficult because the symptoms are similar to urinary tract infection. However, the gold standard for diagnosis of urinary tract TB is presence of TB bacteria in at least out of 3 to 6 early morning urine specimens. The method used for detection is called Ziehl-Neelson Acid fast staining. Urine PCR for mycobacteria tuberculosis is far more sensitive test used nowadays. Presence of bacteria is known within 48 hours of the test. Urine culture is also useful test to detect the disease. Aside from the urine test, other methods used to determine urinary Tb are sonography of urinary tract, Mantoux test, blood ESR, intravenous pyelography, and CT scan of kidney, ureter and bladder.
Once the disease has been diagnosed, the treatment module is similar to that for pulmonary tuberculosis. Patient is prescribed 3 to 4 anti tuberculosis medicines initially. This medicine has to be continued for at least 6 to 9 months period depending on the severity of disease and response to the drug. After first 3 months, certain medicines are withdrawn out of the 4 and rest important medicines are continued for a period of 6 months. The treatment is discontinued once urine culture is negative after 9 months of treatment. Patient during this period of time is advised to eat healthy food to strengthen the immune system. In addition to the medical therapy, if the kidney is completely damaged and dysfunctional, nephrectomy may be reserved choice. In case if there is several strictures present in ureter, artificial implantation of ureter may be thought of if dilatation is not successful.