Remarks to the reasons of urogenital tuberculosis late detection

Kul'chavenya E.V., Shaderkin I.A., Krasnov V.A., Shevchenko S.Yu., Baranchukova A.A., Shaderkina V.A.

The aim of the study was to evaluate the knowledge of the physicians from different specialties (urologists, gynecologists, internists, phthisiatricians) in the urogenital tuberculosis. The testing was carried out among the specialists attending the professional education courses in the tuberculosis clinic of NGMU (261 physician) and also among the specialists distantly at the uroweb.ru portal using a specially developed software (14 physicians).

The results are outlined in this article. Nobody answered correctly all questions. Only a fourth of the specialists was aware, that mycobacterium detection is the most effective, when the daily portion of the urine is cultured, ideally – several times during one day. The difficulties have also arisen in the area of clinical and laboratory signs of urotuberculosis. Almost all respondents have found it difficult to answer, which outcomes are typical for renal tuberculosis and which criteria could be used for the recovery.

The difference in the quality of answers was not significant among different specialists: urologists, gynecologists and internists had given the right answers in 59.2%-63.7% of questions; as it was expected phthysiatricians showed the better results and were correct in 77.2% of cases. The insufficient awareness is a ground for the late detection of urotuberculsosis at the stage of the severe and irreversible complications. We demonstrate this using the clinical case of the male patient with generalized urogenital tuberculosis, polycavernous tuberculosis of the right kidney followed by renal shrinkage, tuberculous papillitis of the left kidney, tuberculosis of the both ureters, urinary bladder, urethra, prostate. This patient was also diagnosed with the tuberculous epididymitis and tuberculosis of the intestine. The clinical tactic was analyzed in this patients, the mistakes are discussed.

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