Genitourinary Tuberculosis Ganesh Gopalakrishnan, Sujata Patwardhan
INDEX
Page numbers followed by f refer to figure, fc refer to flowchart, and t refer to table.
A
Abdomen 156
plain 52
Abdominal wall, posterior 64f, 118f
Abscess
developing 113f, 117f
multiple 115f, 116f, 119f
perinephric 56, 64f
perirenal extension of 118f
thick-walled 117f
tuberculous 82f
wall of 113f, 114f
Absolute neutrophils count 23
Acid-fast bacilli 38f, 45, 49
Adherence monitoring system, mobile-based 3
Adnexa, oblique scan of 89f
Airborne infection control 12
Air-filled tract 74
Alanine aminotransferase 23
Amenorrhea 87
Amikacin 22, 47, 94
Aminosalicylic acid 94
Amoxicillin 9, 9f, 22
Anal canal 77f
Anorexia 98, 155
Antegrade nephrostogram 107f
Anti-Koch treatment 47
Antiretroviral therapy 10
Antitubercular therapy 6
Anti-tuberculosis drugs 22t
classes of 21
newer 14, 21
Anti-tuberculous
first-line drugs 94t
second-line drugs 94t
Appetite, decreased 114
Ascites 87
Aspartate aminotransferase 23
Asymmetric caliectasis 69f
Augmentation cystoplasty 108
Autonephrectomy 56, 74f
Autopsy 39
B
Bacillus Calmette-Guérin vaccine 13
Bacterial pyelonephritis, acute 54
Bacteriological monitoring 27
Balloon dilatation 95
Bedaquiline 14, 22, 23, 94
Bladder 99, 102
augmentation 102, 107
MCU-full 135f
MCU-small 156f
small
capacity 139f, 142f, 180f
contracted 157f
surgery 96
thickened 120f, 157f, 165f
wall of 123f, 132f, 146f
tuberculosis of 41
urine 46
Boari flap 106
Bowel segment 102
Brucellosis 43
Buccal mucosa 108f
Bulbar urethra 120f
Bulbomemberanous junction 169f, 180f
C
Calcified kidney 95, 183f
Calcium, milk of 67f
Calicorrhaphy 102
Calyceal infundibular stenosis, left superior 149f
Calyces
lower 69f
mucosal thickening of 64f
thick-walled 122f
Calyectasis, evaluation of 57
Calyx
focal caliectasis of minor 68f
lower pole 62f
middle 69f
selectively, left upper 162f
Capreomycin 22, 94
Caseating granulomas, multiple 39f
Caseous necrosis 37
large area of 37f
Catholic Bishops’ conference 11
Catholic Church healthcare facilities 11
Cavernotomy 100
Central caseous necrosis 36f, 37
Central tuberculosis division 4
Cerebrospinal fluid 7
Chemotherapy 98
Cilastatin 22
Clarithromycin 9, 94
Clavulanate 22
Clavulanic acid 9
Clofazimine 9, 9f, 22
Complete blood count 92
Computed tomography scan 54
Co-trimoxazole preventive therapy 10
Crohn's disease 102
CT urography 185, 185f, 187f
Cutaneous fistula 167f
Cycloserine 9, 22, 94
Cystectomy 96
Cystoplasty, complications of 108
D
Delamanid 22
Dense chunky calcification 186f
Dense perinephric adhesions 112
Deoxyribonucleic acid 47
Diabetes 93
mellitus 10, 48
Diethylenetriamine pentaacetate 104
scan 179, 181f, 182
Diffusion-weighted imaging 57
Directly observed treatment short-course 33
strategy 1
Disseminated infection 39
Distorted calyces 131f
Distorted pelvicalyceal system 131f
Distorting calyx 62f
District Tuberculosis Center 4, 19
District Tuberculosis Officer 4
DMSA renogram 134, 140
Dormant bacteria 92
Double J stent 99
Drug-resistance
diagnostic technology choice 18
tests 17
Drug-resistant tuberculosis 1, 20
center 16
classification of 14, 15
diagnostic algorithm guidelines 2019 20fc
management of 14, 24, 28, 29
programmatic 8, 9, 15, 20
Drug-susceptibility testing 17, 20, 29
methods for 14, 16
Drugs, new grouping of 22
Duodenal repair 112
Duodenum 55
Dystrophic calcifications 75f
Dysuria 186
E
Ectopia, cross-fused 144f
Eggshell calcification 122f
Ejaculatory ducts 78f, 79f
Endometrial osseous metaplasia 87
Endometrial polyp 87
Endometrial tuberculosis 87
Endometrium 90f, 91f
irregular contour of 87
E-NIKSHAY 32
role of 33
Epididymal cysts, multiple 79f
Epididymal tuberculosis 74
Epididymis 75, 78f, 79f, 84
head of 81f
tail of 81f83f
tuberculosis of 42
tuberculous lesion of tail of 82f
Epithelioid cells 36
Epithelioid granuloma 36, 36f
multiple 43
Epithelioid macrophages 37
Escherichia coli 43, 112
Ethambutol 9, 22, 47, 94
Ethionamide 9, 22, 94
Ethylene dicysteine 104
Extensive drug resistance 6, 15
Extensively drug-resistant tuberculosis, diagnosis of 9
Extrapulmonary tuberculosis, sequelae of 7
F
Fallopian tube 84, 90f
floating 87
Fibrotic bladder 109f
Fibrous tissue 37
First-line line probe assay 20
Fistulas 55
multiple 166f
persistent 95
rectal opening of 167f
Flank pain, bilateral 185
Fluid distended fallopian tube, thick-walled 90f
Fluid samples 46
Fluoroquinolone 20, 22
Focal calyectasis 147
Focal nodular heterogeneous lesion 83f
Food and Drug Administration 21
Fungal infections 36, 40
G
Gas-filled fistulous tract 77f
Gatifloxacin 22
GeneXpert 50
detection 140
Genital surgery 97
Genital tract
male 74
tuberculosis, female 84
Genitourinary physicians and surgeons 110
Genitourinary tract 36, 38
Genitourinary tuberculosis 14, 43, 45, 48, 52, 93
diagnosis of 45, 47, 48
disease 93
management of 45
sample collection for 45
Gerota's fascia 57, 114f
Giant hydrocalyx 103
Gömöri methenamine silver 42
Granuloma 36f, 37, 57
healing of 75f
multiple 126
noncaseating 40f
resection 41
Granulomatous disease, types of 36
Granulomatous infection 134
Granulomatous inflammation 40, 41
Granulomatous orchitis 43
Granulomatous prostatitis, nonspecific 42
Growth indicator tube 46
H
Heart failure 23
Hematological investigations 118
Hematuria 96, 140
Heminephrectomy 100, 104
Hemoglobin 23
Hepatitis
B 92
C 92
Heterogeneous hypoechoic
nodules 75
texture 84f
High-resolution ultrasonography 60, 66f
Hilar lymph nodes 122f
Histoplasma capsulatum 43
Homogeneous hypoechoic
epididymis, diffusely enlarged 81f
nodules 75
Homogenous consolidation, large 141f
Horse shoe kidney 144f
Human immunodeficiency virus 1, 9, 43, 48, 92
testing 32
Hydrocalycosis, left superior 149f
Hydrocele 84f
chronic 83f
Hydronephrosis 66, 66f
evaluation of 57
left 157f
right 139f
moderate 134f, 135f
with left upper ureteric 146f
Hydronephrotic kidney 73f
calcified walls of 74f
right 152f
Hydrosalpinx 90f
Hydroureteronephrosis
bilateral 129f
proximal 146f, 148f
Hypodensities, multiple 127f
Hypoechoic epididymis 80f
Hypoechoic masses, multiple 160f
Hypoechoic nodules, multiple small 84f
Hypokalemia 23, 107
Hysteroscopic biopsy 87
I
Idiopathic granulomatous orchitis 43
Ileal conduits 109
Ileocalicostomy 101f
Imipenem 22
Immune reconstitution inflammatory syndrome 27
Indian Academy of Pediatrics 10
Infection control measures 14, 33
Infundibular stenosis 149f
multiple 136f
Infundibuloplasty 101f, 104
Infundibulum
fibrosis of 68f
surgery for 96
Injectable agents, second-line 22
Institute of Leprosy and other Mycobacterial Diseases 4
Intensive case finding 2
Interstitial nephritis 39
drug-induced 40
Intestine, distal small 158
Intrarenal pelvis 164f
Intravenous pyelogram 53
nephrogram phase of 149f
Intravenous pyelography 105f, 140, 142f, 143, 148, 150f, 153, 156
normal 154f
Intravenous urography 52, 104
Irritative voiding symptoms 84
Isoniazid 6, 9, 47, 94
high-dose 9f, 22
preventive therapy 10, 13
J
Jan Dhan Yojana 3
Joint Secretary of Health 4
K
Kanamycin 22, 94
Kaplan-Meier survival estimator 111
Kerr's kink 66
Kidney 38, 120f
cement 40
coronal scan of 64f, 65f, 67f, 69f, 70f
cut surface of 184f
disease epidemiology collaboration, chronic 104
extensive calcification of 73f
high-resolution ultrasonography image of 60f63f
interstitium of 40f
material inside 138
nonfunctioning 95
nonvisualization of 56
transverse scan of 64f, 65f, 70f
tuberculosis of 38, 39f
underwent nephrectomy 106
Koch's contact 133, 151, 153
L
Langhans giant cells 36, 37
Langhans type 37f
Laparoscopic nephrectomy 95
Laparotomy, exploratory 158
Latent tuberculosis infection treatment 12
Left kidney 131f, 144f, 179
lower pole of 148f
nonfunctioning 139f, 180f
normal 183f
parenchymal calcification in 134f, 135f
region of 186f
upper pole of 67f
Left lower ureter 132f
stricture 121f, 132f, 142f
Left ureteric
calculus 145, 145f
dilatation 131f
wall calcification 123f
Leprosy 36, 43
Leukemia, acute 13
Levofloxacin 9, 22, 94
Line probe assay 9, 17
Linezolid 9, 9f, 22, 94
Lipoarabinomannan 51
Lithuria 140
Liver 55
disease, chronic 58
function test 92
Lobar caseation 56
Lung field, right 141f
Lymph nodes 39f
retroperitoneal 120f
Lymphadenopathy, abdominal 144f
Lymphocytes 37
M
Magnetic resonance urography 57
Malaria 11
Mass lesion 39
MCU/RGU prostatic-rectal fistula 167f
MCU-bilateral reflux 164f
MCU-bladder 160f
Medical Officer-Tuberculosis Control 4
Medically resistant hypertension 95
Medication event reminder monitor system 30
Medullary cavity
irregular 63f
large 62f
Meropenem 22
Micturating cystogram 130f
Micturating cystourethrogram 132f, 135, 139, 142, 155
Midureter
high-resolution ultrasonography image of 67f
oblique scan of 71f
Midureteric strictures, bilateral 137f
Miliary tuberculosis 5
Millennium development goal 2
Minimally invasive management 95
Moxifloxacin 9, 22, 94
Multidetector computed tomography 54
Multidrug-resistant
pulmonary tuberculosis 25
tuberculosis 22
diagnosis of 9
Multinucleated giant cells 37f
Multiple drug therapy 92
Mycobacteria 38, 39
infections, atypical 56
Mycobacterium 47
avium-intracellulare 38
smegmatis 49
tuberculosis 5, 17, 45, 50, 92, 140
Mycolic acid 38
N
Nadir serum creatinine 108
Narrow pelvis, parenchymal calcification with 135f
National AIDS Control Programme 2
National Expert Technical Working Group 15
National Framework for Joint TB-HIV Collaborative Activities 2, 10
National Health Mission 2
National Institute for Research in Tuberculosis 4
National Japanese Leprosy Mission for Asia 4
National Reference Laboratory 8
National Strategic Plan for Tuberculosis Elimination 2
National Technical Working Group 11
National Tuberculosis Control Programme
free of cost 47
objectives of revised 33
revised 1, 10, 14, 15, 29, 34
National Tuberculosis Institute 4
National Tuberculosis Programme 1
surveillance system 32
Nausea 114
Nephrectomy 95, 98
after 139f
before 139f
partial 100, 101f, 104
specimen 184f
Nephrocutaneous fistula 62
Nephrostogram 101f
Nephrotic syndrome 13
Newer information and communication technology solutions 30
NIKSHAY 3, 14, 32
scheme 92
Nocturia 96
Nodular lesion 154f
Nucleic acid
amplification test 17, 50
cartridge based 7, 20, 47, 92
O
Omental flap 108f
Orchidectomy 97
Orthotopic bladder 102
Orthotopic substitution 109
P
P-aminosalicylic acid 22
Papillary necrosis 69
Para-aminosalicylic acid 9
Parenchyma 55, 152f
Parenchymal calcification 131f, 145f, 152f, 164f
left 124f
Parenchymal cavity 60, 64f
large irregular 61f
multiple 70f
Parenchymal cyst, small 67f
Parenchymal mass 60f, 61f
Parenchymal nodules 54
Parenchymal tuberculomas 53
Parietal wall 87
Paucibacillary disease 45
Pelvic brim 148f
level of 71f
Pelvic infundibular strictures 56
Pelvic stricture 54, 69f, 96
Pelvic tuberculosis, dry type of 90f
Pelvicalyceal anatomy of kidney 101f
Pelvicalyceal system 53, 96, 127
dilated 181f
left 156f
left 156
normal 137f, 168f
right 156f
right 164f
distorted 146f
Pelvis 96, 156
left small 136f
mucosal thickening of 64f
nonvisualized 181f
sagittal scan of 88f
tuberculosis of 41
Pelviureteric junction 64, 66, 105f
obstruction, lower moiety 144f
stenosis of 66f
Penis, ventral surface of 154f
Percutaneous nephrostomy 95, 99, 105f, 106, 109
obstruction 121, 121f, 132, 132f, 133, 133f, 136, 136f, 139, 142
Perinephric fat stranding 57, 112, 113f, 114f
Periodic acid-Schiff 42
Periodic ureteric dilatation 103
Peripheral Health Institution 5, 18
Perirenal fat stranding 117f
Peritoneum, thickening of 88f
Phantom calyx, left upper 162f
Phenotypic drug susceptibility testing, growth-based 17
Plasma cells 37
Pleura 55
Pleural fluid adenosine deaminase activity 7
Polymerase chain reaction 6, 47, 50
Post-ileocalicostomy nephrostogram 102f
Pott's spine, old healed 122f
Prostate 74, 86f, 99, 102
axial scan of 76f, 77f
gland 74
longitudinal scan of 76f
tuberculosis of 41
involvement of 41
Prostatectomy 166
Prostatic architecture, destroyed 168f
Prostatic substitution 102
Prothionamide 22
Pseudomonas aeruginosa 133, 140
Pseudotumor 39
Psoas
abscess 114f
right 119f
and adjacent abdominal wall 116f
involvement of 114f
muscle 127f
left 185
Public finance management system 3
Pulmonary Koch's 133, 151, 153
Pulmonary tuberculosis 5, 14, 48
active 141f
drug-sensitive 25
mono-drug resistant 26
poly-drug resistant 26
Punctuate calcification 56
Putty kidney 40, 53, 69, 73f, 186
left 125f
Putty-like calcification 68
Pyelo fistulae 55
Pyelography, retrograde 53
Pyelolysis 101f, 104
Pyelonephritis 39, 107
Pyeloureteric anastomosis 102
Pyogenic epididymo orchitis 43
Pyonephrosis 40, 70f
Pyosalpingitis 87
Pyrazinamide 22, 92, 94
Q
QT syndrome, long 23
R
Radionucleotide scintigraphy 106
Rat tail anastomosis 97
Reconstructive surgery 99, 103
Reconstructive surgical procedures 99
indications for 100
Regional Medical Research Centre 4
Renal abscess 55, 64f, 117f
Renal area, coronal scan of 73f, 74f
Renal calcification, left 122f
Renal calculus, right multiple 146f
Renal disease, end-stage 52
Renal failure, chronic 106
Renal fistulae 55
Renal function 99
global 102
preservation of 99, 110
test 92
Renal infundibuloplasty 102
Renal lobes 98
Renal nuclear scintigraphy 104
Renal parenchyma 37f, 54, 57, 60
calcification, left 122f
left 186
Renal pelvis 69f
dilatation 66
extensive calcification of wall of 73f
kinking of 70f
Renal tuberculosis, localized 39
Renal unit
damage, obstruction related 98
function
assessment 111
opposite 111
Renocutaneous fistula 55
Respiratory infections, acute 12
Rifabutin 94
Rifampicin 6, 47, 50
Rifampin 94
Right kidney 124f, 144f
calcified lower pole of 120f
destroyed 183f
middle pole of 152f
nonfunctioning 120f
nonvisualized 142f
normal
functioning 144f
hypertrophied 187f
Right renal
abscess 127f
calculus 145f
parenchyma 125f, 127f
calcification 183f
pelvis 164f
S
Sarcoidosis 36, 40
Scarred cavity 87
Scars 166f
Scrotal abscess formation 42
Scrotum
empty 166f
scan of 83f
Seminal vesicle 74, 84, 85f, 86f
tuberculosis of 80
Senior Tuberculosis Laboratory Supervisor 4
Senior Tuberculosis Treatment Supervisor 4
Serum
creatinine 109, 134, 166
continues 164
electrolytes 134, 152
Shrunken bladder, small 139f
Shrunken kidney, left 125f
Sinus 182f
tract 55, 128f
thick-walled 128f
Sonolucent tract 63f
Speleotomy 100, 103
procedure 100f
Spermatic cord 85f
State tuberculosis cells 4
State Tuberculosis Officer 4
State tuberculosis training and demonstration centre 4
Status simultaneous ureteropyelostomy 105f
Steroids, role of 93
Streptomycin 22, 47, 94
Stress incontinence 109
Synechia 87, 90f
Syphilis 36
Systemic infection 98
T
Terizidone 22
Testicular tuberculosis 74
Testis 75, 80, 84f
diffusely enlarged 84f
enlarged 84f
enlargement of 79
scan of 79f
tuberculosis of 42
Thiacetazone 9
Thioacetazone 22
Tifampicin-susceptible tuberculosis 20
Tissue 92
samples 46
Transplanted kidney, tuberculosis in 58
Transport box, technical specifications of 19f
Transureteroureterostomies 106
Transurethral resection 108
Treponema pallidum 42
Trigone area, Mucosal thickening of 71f
TRUS-prostate gland measures 160f
Tubercular urethral involvement 109
Tuberculoma, wall of 124f
Tuberculosis 911, 20, 36, 41, 43, 45, 74, 85f, 89f, 90f, 96, 98, 136
adhesive type 87
algorithm, integrated drug-resistant 14, 19, 21fc, 24
childhood 10
culture 50
diagnosis of 47
molecular approaches for 47
disease 1
dry type 87
epidemiology 1
etiology 119
extrapulmonary 5, 20, 27, 48
gastrointestinal 96
granulomas 52
infection 12
pathology of 36
pediatric 27
poly-drug resistant 15
recurrent 6
rifampicin
resistant 15, 20, 22
susceptible 20
sputum 140
strictures 95
treatment of 92
drug-resistant 14, 21
extensively drug-resistant 9
history of 5
multidrug-resistant 9
unit level 4
wet type 87
Tuberculous contracture 108
Tuberculous epididymitis 42, 74, 80f
Tuberculous epididymo-orchitis 43f
Tuberculous granulomatous interstitial nephritis 40f
Tuberculous interstitial nephritis 40
Tuberculous orchitis, isolated 42
Tuberculous perinephric abscess 64f
Tuberculous pyelonephritis 40
Tuberculous ulceration 95
Tubes, enlargement of 87
Tubo-ovarian abscess 89f
formation 87
Tunica vaginalis, calcification of 83f
U
Ulcerative colitis 102
Unhealthy bladder 158f
Upper calyx 69f
Upper ureteric stricture
buccal mucosa augmentation of 107
repair 108f
Ureter 95, 156f
color Doppler image of 71f
dilated 128f, 146f
left 119f
proximal 66f, 71f
thickened right 125f
ileal
replacement of 102
substitution of 107
narrow, right lower 156f
oblique scan of 71f
right 148f
lower 155
thick 116f
walled distal 146f
tuberculosis of 41
with thick walls, dilated right 124f
Ureteral urine samples 147
Ureteric calcification, bilateral 137f
Ureteric dilatation 103
efficacy of 103
mild 142f
Ureteric procedures, lower 104
Ureteric reimplant 105f, 106
surgical procedures of 106
Ureteric stricture 96
bilateral 138f
buccal mucosal grafting augmentation of 102
lower 139f
multiple left 133f
right distal 136f
Ureteric wall calcification and thickening 117f
Ureterocalicostomy 96, 102, 105, 106
Ureterogram, retrograde 108f
Ureteroneocystostomy 102, 106
Ureteropyelostomy 104
Ureteroureterostomy 106
Ureterovesical junction 95
obstruction, right 180f
Ureters with calcification, bilateral thickened 181f
Urethra 99
and anus, posterior 169f
gas outlining 77f
nonvisualization of posterior 180f
posterior 180f
procedures for 103
Urethral fistula excision 166
Urethral stricture 109
Urethroplasty 103, 109
Urinary bladder 68, 72f, 73f, 86f
and vagina 156f
fibrosis of walls of 73f
oblique scan of 71f
small capacity 142f
transverse scan of 72f
Urinary conduits, obstruction of 98
Urinary tuberculosis 49, 49t, 60, 69, 98, 110
context of 98
sonographic features of 60
Urine
acid-fast staining 49
analysis 179
collection, method of 45
samples 45
Urodynamic study 143
Uterus, longitudinal scan of 91f
V
Vagina, contrast in 157f
Vas deferens 86f
hypoechoic mass of 85f
Vasa deferentia 80
Vesicoureteric junction 130f
obstruction 129f
right 125f
stricture 133f, 139f
left 142f
Vesicoureteric reflux 71f
bilateral 132f
Vesicourethral anastomosis 166
Vesicovaginal fistula 96
large 158f
Vomiting 114
W
Weight loss 98
World Health Organization 1
World Health Organization Global Tuberculosis Report 8
X
Xanthogranulomatous pyelonephritis 40
Z
Ziehl-Neelsen
smear 49
stain 38, 38f, 42, 46
×
Chapter Notes

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_FM_1Genitourinary Tuberculosis_FM_2
_FM_3Genitourinary Tuberculosis
Editors Ganesh Gopalakrishnan MS MCh Urology Ex HOD, CMC Vellore Consultant Urologist Vedanayagam Hospital Coimbatore, Tamil Nadu, India Sujata Patwardhan MS MCh Urology Professor and Head Department of Urology Seth GS Medical College and KEM Hospital Mumbai, Maharashtra, India Foreword P Venugopal
_FM_4
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Genitourinary Tuberculosis / Ganesh Gopalakrishnan, Sujata Patwardhan
First Edition: 2020
9789389776683
Printed at
_FM_5CONTRIBUTORS
Editors
Co-Editors
Contributing Authors
_FM_7FOREWORD
Tuberculosis continues to be a public health problem in most countries around the globe and it is more so in India.
Tuberculosis of urinary and genital organs is ancient but it continues to remain as an unsolved problem. Clinical features are flexible and genitourinary tuberculosis (GUTB) presentations are so varied that it can mimic many other conditions. Approximate 8,000 articles are available in the literature but there is probably no study encompassing all aspects of the disease. Most of them are quite superficial addressing some aspect of this disease. Hence to compile all aspects of the disease, even as a textbook, is well-nigh impossible.
The main issue attached to the problem is that delay in diagnosis and proper initiation of early treatment very often result in progress of disease leading to eventual renal functional deterioration. In many, the old statement that “Bladder is the Vocal cord of Kidney” is true as many present with varying bladder symptoms. This adds to the confusion as to the diagnosis of urinary tuberculosis.
The sequelae following proper treatment resulting in functional changes have to be borne in mind and need very frequent follow-ups and evaluation even after commencing treatment.
It has been noticed that though there are several diagnostic tests now available, the overall efficacy of detecting GUTB is being questioned by some. Hence, the question asked is whether one will have to wait for the results of diagnostic tests prior to initiation of treatment by drugs. Can the treatment be initiated on high index of suspicion? Professor HS Bhat (Doyen of Urology in India) often used to mention that “Urologists should be able to sniff GUTB”. According to him, even diagnosing by bacteriological tests and radiology is often too late. This view is now being questioned by many and mentions that the condition should be diagnosed beyond doubt to commence treatment.
Ganesh and Sujata have to be complemented for bringing out this book on time covering most aspects that we have to know and understand. The 26 cases illustrated provide more than adequate representation on all aspects of GUTB that we frequently encounter. Such a compiling adds considerable value for the book.
I am sure this book is a must read for all urologists across the globe and even for those countries where GUTB may not be under much consideration.
P Venugopal MBBS MS MCh (Urology)
Retired Professor Urology, KMC
Manipal, Karnataka, India_FM_8
_FM_9PREFACE
India accounts for 23% of the global burden of tuberculosis. In 2014 of a total of 9.6 million cases worldwide, 2.2 million cases of tuberculosis were estimated to have occurred in India. Renal tuberculosis is the most common site of extrapulmonary genitourinary tuberculosis (GUTB) comprising of 20% of all extrapulmonary tuberculosis (EPTB).
In 2014, the Central TB Division and Directorate General of Health Services of the Ministry of Health and Family Welfare, Government of India, recognized the need to develop evidence-informed guidelines for EPTB. This was aimed to run concurrently with those for pulmonary tuberculosis from the Revised National TB Control Programme (RNTCP). Unfortunately, evidence-based guidelines for treatment of GUTB are lacking. Should a 6-month regimen be sufficient or should it be 9 months.
While there are individual chapters in various textbooks relating to different aspects of GUTB, a single book devoted to renal tuberculosis is lacking. We, the editors felt that the vast experience in our country by individual physicians should be collated in a comprehensive book which would help urologists enhance their knowledge and also serve to manage our patients effectively.
This has been possible only because of the commitment of the authors who themselves have felt such a need and the untiring efforts of Drs Umesh Shelke and Yash Pamecha both ex-residents of the Urology Department, KEM Hospital, Mumbai.
Ganesh Gopalakrishnan
Sujata Patwardhan_FM_10
_FM_11ACKNOWLEDGMENTS
We would like to thank Drs Umesh Shelke, Yash Pamecha, Rishikesh Velhal, Nikhar Jain, ex and present staff of the Department of Urology, KEM Hospital, Mumbai for their untiring effort. We would like to especially appreciate Dr Rupali Sable, Department of Preventive and Social Medicine, KEM Hospital, for providing us the source material for this publication.
Last but not the least, we would like to thank Mr Padmanabhan and his team from Dr Reddy's Laboratories for supporting this venture.
We also want to acknowledge the sincere efforts and enthusiasm of Shri Jitendar P Vij, Mr Sabarish Menon, Dr Richa Saxena, Dr Nidhi Sood and their team from Jaypee Brothers Medical Publishers (P) Ltd for carrying out the process of publication swiftly and completing the book in short span of time._FM_12
_FM_13ABBREVIATIONS AKT
Anti-Kock treatment
BDQ
Bedaquiline
C-DST
Culture and drug susceptibility testing
c/o
Complaint of
CAT 1
Category 1
CBNAAT
Cartridges based nucleic acid amplification test
CSIC
Clean self intermittent catheterization
CT
Computed tomography
DDR-TBC
District Drug Resistant Tuberculosis Centre
DMC
Designated Microscopy Centre
DM
Diabetes mellitus
DR-TB
Drug-resistant tuberculosis
DST
Drug Susceptibility Testing
DVDMS
Drug Vaccine Distribution Management System
e/o
Evidence of
EPDR-TB
Extrapulmonary drug-resistant tuberculosis
EP
Extrapulmonary
EPTB
Extrapulmonary tuberculosis
ESRD
End-stage renal disease
FL-LPA
First line probe assay
GUTB
Genitourinary tuberculosis
h/o
History of
HIV
Human immunodeficiency syndrome
IVP
Intravenous pyelography
k/c/o
Known complaint of
LPA
Line probe assay
LUTS
Lower urinary tract symptoms
MDR-TB
Multidrug resistant tuberculosis
MRI
Magnetic resonance imaging
MR-TB
Mono-resistant tuberculosis
PDR-TB
Poly-drug resistant tuberculosis
PMDT
Programmatic management of drug-resistant tuberculosis
PTB
Pulmonary tuberculosis
r/o
Resident of
RNTCP
Revised National Tuberculosis Control Program
RRTB
Rifampicin-resistant tuberculosis
s/o
suggestive of
TBC
Tuberculosis contact
TB
Tuberculosis
WHO
World Health Organization
XDR-TB
Extensively drug-resistant tuberculosis