Symptoms Of Urinary Tract Tuberculosis: Causes And Treatment

Tuberculosis is one of the main causes of mortality and morbidity due to communicable disease. This infectious disease is common all over the world, but its prevalence is more in developing countries. Tuberculosis is primarily a disease of lungs. The microorganism that causes tuberculosis is a bacterium known as mycobacterium tuberculosis. It can then spread to other organs of the body through blood and lymph including the genitourinary tract. Kidney is the main site in urinary tuberculosis.

The incidence pulmonary and extra pulmonary tuberculosis is on rise in many countries. The resurgence is mainly due to HIV infection as well as other factors such as poverty, illicit drug use and inadequate health care.

Diagnosis of urinary tuberculosis is often difficult because it has various clinical manifestations. The symptoms mimic many other diseases of urinary tract. Early detection and timely initiation of treatment is vital to prevent destruction of kidney and reducing the mortality risk.

What Causes Tuberculosis Of Urinary Tract?

Urinary tuberculosis involves the kidney and other organs of the urinary tract. The disease is caused by mycobacterium tuberculosis bacteria. Kidney is the main organ that is involved. The disease than can spread downwards involving the ureter and bladder. In majority of cases the primary focus of infection is lungs.

Tuberculosis infection is spread from droplets released in air by an infected patient during the act of coughing. The bacteria than enters into the lungs of a healthy person through breathing. The exposure to TB germs may or may not cause an active infection in lungs. It may depend of the immunity of the person. From the primary site, TB germs can travel though the bloodstream and lodge in different organs which may also include kidney.

The infection can develop as sequelae of the primary infection in lungs that may have occurred long time ago. After reactivation the bacteria starts destroying the renal parenchyma. In advanced stage of the disease, scarring may develop which can result in loss of kidney function. Although, TB germ afflicts both the kidney, the disease mostly is unilateral affecting only one side of the urinary system.

Signs And Symptoms Of Urinary Tuberculosis

The onset of urinary tuberculosis is sudden but it often does not manifest specific symptoms. The clinical picture may be confusing as it may mimic many other urinary tract conditions. This may lead to difficulty and delay in diagnosis of the disease. Majority of patients suffering from urinary tuberculosis present with following symptoms;

  • Blood in urine.
  • Burning pain while passing urine.
  • Pain in flanks and back.
  • Abscess can develop in thigh when the infection from kidney spreads to the psoas muscle. This muscle originates from the lower back and has its insertion in the front part of thigh.
  • Patient may have general systemic symptoms such as weight loss, mild fever, loss of appetite, and feeling of tiredness.

Diagnosis And Treatment Of Urinary Tuberculosis

When the doctor suspects urinary tuberculosis from the symptoms and medical history, he recommends the patient for certain tests that help to detect the disease. These tests include urine culture, blood tests, sonography of genitourinary tract, mantoux test, intravenous urography, CT scan of urinary system.

Once the disease is confirmed to be urinary tuberculosis, the standard anti-tuberculosis treatment is started. This includes three to four anti tuberculosis drugs. The treatment is continued for 9 to 12 months depending on the severity of the disease and outcome of the urine culture. During this period patient is advised to eat nutritious food so that his immune system becomes strong.