Tuberculosis of Kidneys and Genital Glands

The tuberculosis of kidneys, testicles or ovaries (genital glands) is always secondary to primary lesion in the lungs, lymph glands or bones. The tuberculosis of kidneys may occur in early adult life. In the beginning it is commonly confined to one kidney but can spread to second kidney if chemotherapy is delayed. If the disease is not detected and treated well in time, it may spread to urinary bladder. In addition to low grade fever in the evening, feeling of general weakness and loss of appetite, it has three additional symptoms: increased frequency of urination, painless hematuria or passage of red blood cells or blood in the urine and a feeling of dull pain in the lower back or region of loin. The 'tubercular toxemia' is there. The treatment with anti-tubercular drugs is must to avoid surgical nephrectomy.

The tuberculosis of testicles or ovaries (genital glands) is also a serious manifestation of pulmonary tuberculosis. Initially there is swelling of one testicle in the male patient which can be easily felt. Later on it may transform into 'cold abscess' and a sinus is produced. Such patients show highly reactive 'tuberculin test'. The diagnosis is not difficult in a case of 'tuberculosis of ovary'. The swelling of the ovary can be palpated by experienced gynaecologist or can be detected by abdominal ultrasonography. The diagnosis can be confirmed easily by 'fine needle aspiration cytology' (FNAC). The signs and symptoms of 'tubercular toxemia' are there as stated in the case of tuberculosis of kidneys. The treatment with anti-tubercular drugs is must to avoid surgical removal of testicle or ovary.

The treatment begins with active anti-tubercular therapy by the use of at least three drugs and a longer course of treatment may be required in these cases. Surgical treatment will be required if the medical treatment alone is not capable of controlling the disease. If the disease is unilateral in one kidney or one testicle and there is no arrest of the disease with medical treatment, these organs would have to be removed surgically with informed consent of the patient.

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