Introduction: The aim of this study was to evaluate diagnostic value of
urinary polymerase chain reaction (PCR) in urogenital tuberculosis (UTB).
Materials and Methods: In 33 patients with confirmed diagnosis of UTB
by urine culture and/or acid-fast staining, clinical symptoms and laboratory
and radiological findings were evaluated. For each patient, 3 consecutive
urine samples were examined by PCR for Mycobacterium tuberculosis and
the results were compared with the standard microbiological methods and
radiological findings.
Results: The mean interval between the appearance of the symptoms and
the diagnosis was 12.3 ± 12.2 months. Symptoms were irritative bladder
symptoms such as dysuria and diurnal or nocturnal frequency (51.5%), flank
pain (27.3%), microscopic hematuria (18.2%), gross hematuria (9.1%), and
suprapubic pain (9.1%). The laboratory findings included hematuria (27.3%),
pyuria (12.1%), and hematuria with pyuria (48.5%). Diagnosis of UTB was
made in 19 patients by positive urine culture for MT in 19 patients (57.6%),
positive acid-fast staining in 6 (18.2%), and both in 8 (24.2%). Intravenous
urography showed abnormal findings in 16 patients (61.5%), including
pyelocaliceal dilatation (26.9%), ureteral stricture and hydroureter (23.1%),
multiple small caliceal deformities (15.4%), severe parenchymal destruction
(11.5%), autonephrectomy (11.5%), and calcification (7.7%). Urinary PCR
was positive in 16 patients (48.5%) and in 10 (62.5%) with abnormal findings
on intravenous urography.
Conclusion: A high index of suspicion is necessary for diagnosis of UTB even
in patients with nonspecific manifestations. Urinary PCR is recommended
for instant diagnosis and screening before further examinations, but it cannot
be the sole diagnostic modality for diagnosis of UTB
