Tuberculosis of the urinary bladder: a literature review. Part 1

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Abstract

Tuberculosis remains a significant public health issue worldwide. In 2022, over 45 000 new tuberculosis cases were registered in Russia, corresponding to an incidence rate of 31.0 per 100 000 population. Among genitourinary tuberculosis, bladder involvement accounts for 10.6-52.3%. The clinical presentation of tuberculous cystitis mimics that of typical cystitis. Lack of specific symptoms, combined with insufficient clinical suspicion among phthisiatrists, often leads to delayed diagnosis and treatment, so that irreversible morphological changes have occurred in the bladder wall. This process manifests as persistent impairments of both the storage and voiding phases and significantly diminishes quality of life. The so-called small contracted bladder represents the end-stage of bladder involvement and is universally considered an indication for surgical intervention.

A literature search was carried out in Elibrary.ru, PubMed, and Google Scholar to compile data on tuberculous bladder involvement leading to the development of a small, contracted bladder. This review covers the etiology, pathogenesis, and classification of bladder tuberculosis, and summarizes current diagnostic approaches.

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About the authors

Vladimir V. Protoshchak

FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Email: protoshakurology@mail.ru
ORCID iD: 0000-0002-4996-2927

Ph.D., MD, professor, Head of the Department of Urology

Russian Federation, 194044, St. Petersburg, Academician Lebedev Street, 6Zh

Konstantin Kh. Chibirov

FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Email: 4chibirov@mail.ru
ORCID iD: 0009-0002-1724-6106

urologist, Department of Urology

Russian Federation, 194044, St. Petersburg, Academician Lebedev Street, 6Zh

Evgeniy G. Karpushchenko

FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Email: z_karpushe@mail.ru
ORCID iD: 0000-0001-7464-5926

Ph.D., Senior Lecturer of the Department of Urology 

Russian Federation, 194044, St. Petersburg, Academician Lebedev Street, 6Zh

Mikhail V. Paronnikov

FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Email: paronnikov@mail.ru
ORCID iD: 0009-0005-1762-6100

Ph.D., MD, Deputy Head of the Department of Urology 

Russian Federation, 194044, St. Petersburg, Academician Lebedev Street, 6Zh

Pavel A. Babkin

FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Email: galiukurolog@mail.ru
ORCID iD: 0000-0003-0829-2661

Ph.D., MD, professor, professor of the Department of Urology 

Russian Federation, 194044, St. Petersburg, Academician Lebedev Street, 6Zh

Nikolay P. Kushnirenko

FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Email: nikolaj.kushnirenko@yandex.ru
ORCID iD: 0009-0004-1960-4696

Ph.D., MD, Associate associate professor, associate professor of the Department of Urology 

Russian Federation, 194044, St. Petersburg, Academician Lebedev Street, 6Zh

Anna A. Gorelova

FGBOU VO Saint-Petersburg State University

Email: gorelova_a@yahoo.com
ORCID iD: 0000-0002-7010-7562

Ph.D., associate professor, associate professor of the Department of Urology

Russian Federation, 199034, Saint Petersburg, Universitetskaya nab., 7-9

Dmitry A. Galyuk

FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation

Author for correspondence.
Email: galiukurolog@mail.ru
ORCID iD: 0009-0000-8986-999X

resident of the Department of Urology

Russian Federation, 194044, Saint Petersburg, Academician Lebedev Street, 6Zh

References

  1. World Health Organization‎. Global tuberculosis report 2023 [Электронный ресурс], 2023. Geneva. Режим доступа: https://iris.who.int/handle/10665/373828. License: CC BY-NC-SA 3.0 IGO. P.57.
  2. Federal State Budgetary Institution «National Medical Research Center of Phthisiopulmonology and Infectious Diseases» of the Ministry of Health of the Russian Federation. The epidemic situation of tuberculosis in 2022 [Electronic resource], 2023. Access mode: https://nmrc.ru/for_specialists/main-directions/tuberculosis. Russian (ФГБУ «НМИЦ ФПИ» Минздрава России. Эпидемическая ситуация по туберкулезу в 2022 г. [Электронный ресурс], 2023. Режим доступа: https://nmrc.ru/for_specialists/main-directions/tuberculosis).
  3. Furin J., Cox H., Pai M. Tuberculosis. Lancet. 2019;393(10181):1642-1656. doi: 10.1016/S0140-6736(19)30308-3.
  4. Zhang H., Xu Y., Liu R. A rare case of prostatic tuberculosis accompanied by prostate cancer BJU Int. – 2010. doi: 10.1002/BJUIw-2010-038-web.
  5. Figueiredo A.A., Lucon A.M., Junior R.F., Srougi M. Epidemiology of urogenital tuberculosis worldwide. Int J Urol. 2008;15(9):827-32. doi: 10.1111/j.1442-2042.2008.02099.x.
  6. Figueiredo A.A., Lucon A.M. Urogenital tuberculosis: update and review of 8961 cases from the world literature. Rev Urol. 2008;10(3):207-17. PMID: 18836557.
  7. Figueiredo A.A., Lucon A.M., Srougi M. Urogenital Tuberculosis. Microbiol Spectr. 2017;5(1). doi: 10.1128/microbiolspec.
  8. Muneer A., Macrae B., Krishnamoorthy S., Zumla A. Urogenital tuberculosis – epidemiology, pathogenesis and clinical features. Nat Rev Urol. 2019;16(10):573-598. doi: 10.1038/s41585-019-0228-9.
  9. Kulchavenya E., Naber K., Johansen T.E.B. Urogenital tuberculosis: classification, diagnosis, and treatment. European Urology Supplements. 2016;15(4):112-121. https://doi.org/10.1016/j.eursup.2016.04.001.
  10. Adhikari S., Basnyat B. Extrapulmonary tuberculosis: a debilitating and often neglected public health problem. BMJ Case Rep. 2018;11(1):e226098. doi: 10.1136/bcr-2018-226098.
  11. Sourial M.W., Brimo F., Horn R., Andonian S. Genitourinary tuberculosis in North America: A rare clinical entity. Can Urol Assoc J. 2015;9(7-8):484-489. doi: 10.5489/cuaj.2643.
  12. Nakane K., Yasuda M., Deguchi T., Takahashi S., Tanaka K., Hayami H., Hamasuna R., Yamamoto S., Arakawa S., Matsumoto T. Nationwide survey of urogenital tuberculosis in Japan. Int J Urol. 2014;21(11):1171-1177. doi: 10.1111/iju.12549.
  13. Kul’chaveniya E.V., Krasnov V.A., Skornyakov S.N., Mukanbaev K., Zuban’ O.N., Holtobin D.P. Current in the epidemic situation of extrathoracic tuberculosis. Tuberkulez i bolezni legkih. 2013;12:34–38. Russian (Кульчавения Е.В., Краснов В.А., Скорняков С.Н., Муканбаев К., Зубань О.Н., Холтобин Д.П. Современные тенденции эпидемиологической ситуации по внелегочному туберкулезу. Туберкулез и болезни легких. 2013;12:34–38).
  14. Chotchaev R.M., Zuban’ O.N., Bogorodskaya E.M., Rodchenkov A.V., Sinicyn M.V., Abu-Arkub T.I. Clinic, laboratory and radiological features of urogenital tuberculosis in HIV-patients. Tuberkulez i social’no znachimye zabolevaniya. 2018;4:53–60. Russian (Чотчаев Р.М., Зубань О.Н., Богородская Е.М., Родченков А.В., Синицын М.В., Абу-Аркуб Т.И. Клинико-лабораторно-рентгенологические особенности туберкулеза мочеполовой системы у больных вич-инфекцией. Туберкулез и социально значимые заболевания. 2018;4:53–60).
  15. Shah H.N., Badlani G.H. Genitourinary Tuberculosis; An Update. Curr Bladder Dysfunct Rep. 2013;8(3):186–196. doi: 10.1007/s11884-013-0197-4
  16. Gow J. G., Barbosa S. Genitourinary tuberculosis: a study of 1,117 cases over a period of 34 years. Br J Urol. 1984;56(5):449–455.
  17. Liu Y., Lu J., Huang Y., Ma L. Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer. J Oncol. 2019;2019:6230409. doi: 10.1155/2019/6230409.
  18. Zuban’ O.N., Komyakov B.K., Yagafarova R.K., Bispen A.V., Novikov A.I, Semchenko A.F. Surgical treatment of patients with micro-cystitis of tuberculous and other etiology. Tuberculosis problems. 2006:(11):50–54. Russian (Зубань О.Н., Комяков Б.К., Ягафарова Р.К., Биспен А.В., Новиков А.И, Семченко А.Ф. Оперативное лечение больных с микроцистисом туберкулезной и иной этиологии. Проблемы туберкулеза. 2006;11:50–54).
  19. Holtobin D.P., Kul’chavenya E.V., Homyakov V.T. Bladder tuberculosis stage 4: how to restore urination? Urologiia. 2014;5:26–29. Russian (Холтобин Д.П., Кульчавеня Е.В., Хомяков В.Т. Туберкулез мочевого пузыря 4-й стадии: как восстановить мочеиспускание? Урология. 2014;5:26–29).
  20. Jayarajah U., Gunawardene M., Willaraarachchi M., Chandrasiri S., Udayakumaran P., Sosai C., Abeygunasekera A. Clinical characteristics and outcome of genitourinary tuberculosis in Sri Lanka: an observational study. BMC Infect Dis. 2021;21(1):1279. doi: 10.1186/s12879-021-06990-z.
  21. Singh J.P., Priyadarshi V., Kundu A.K, Vijay M.K., Bera M.K., Pal D.K. Genito-urinary tuberculosis revisited-13 years’ experience of a single centre. Indian J Tuberc. 2013;60(1):15-22. PMID: 23540084.
  22. Gupta N.P., Kumar R., Mundada O.P., Aron M., Hemal A.K., Dogra P.N., Seth A. Reconstructive surgery for the management of genitourinary tuberculosis: a single center experience. J Urol. 2006;175(6):2150-2154. doi: 10.1016/S0022-5347(06)00310-7.
  23. Krishnamoorthy S., Palaniyandi V., Kumaresan N., Govindaraju S., Rajasekaran J., Murugappan I., Ramanan V., Krishnan M.N. Aspects of Evolving Genito Urinary Tuberculosis-A Profile of Genito Urinary Tuberculosis (GUTB) in 110 Patients. J Clin Diagn Res. 2017;11(9):PC01-PC05. doi: 10.7860/JCDR/2017/25882.10557.
  24. Kul’chavenya E.V., Holtobin D.P. Diagnosis of tuberculosis of bladder. Urologiia. 2014;6:36–40. Russian (Кульчавеня Е.В., Холтобин Д.П. Диагностика туберкулеза мочевого пузыря. Урология. 2014;6:36–40).
  25. Cantu H., Maarof S.N.M., Hashim H. The Inflammatory Contracted Bladder. Current Bladder Dysfunction Reports. 2019;14:67–74. doi.org/10.1007/s11884-019-00507-w
  26. Zuban’ O.N., Komyakov B.K. Surgical correction of the small bladder. St. Petersburg: Stiks 2011;227 p. Russian (Зубань О.Н., Комяков Б.К. Хирургическая коррекция малого мочевого пузыря. СПб.: Стикс. 2011;227 с.).
  27. Kulchavenya E.V. Basic concepts and clinical manifestations of urogenital tuberculosis. Urologiia. 2015;1:104–107. Russian (Кульчавеня Е.В. Основные понятия и клинические проявления урогенитального туберкулеза. Урология. 2015;1:104–107).
  28. Reyblat P., Ginsberg D.A. Augmentation cystoplasty: what are the indications? Curr Urol Rep. 2008;9(6):452–458. doi: 10.1007/s11934-008-0078-0.
  29. Altintepe L., Tonbul H.Z., Ozbey I., Guney I., Odabas A.R., Cetinkaya R., Piskin M.M., Selcuk Y. Urinary tuberculosis: ten years’ experience. Ren Fail. 2005;27(6):657–661. doi: 10.1080/08860220500234857.
  30. Kulchavenya E., Kholtobin D., Shevchenko S. Challenges in urogenital tuberculosis. World J Urol. 2020;38(1):89–94. doi: 10.1007/s00345-019-02767-x.
  31. Wise G.J., Shteynshlyuger A. An update on lower urinary tract tuberculosis. Curr Urol Rep. 2008;9(4):305–313. doi: 10.1007/s11934-008-0053-9.
  32. Chawla A., Chawla K., Reddy S., Arora N., Bairy I., Rao S., Hegde P., Thomas J. Can tissue PCR augment the diagnostic accuracy in genitourinary tract tuberculosis? Urol Int. 2012;88(1):34–38. doi: 10.1159/000327039.
  33. Sun L., Yuan Q., Feng J.M., Yang C.M., Yao L., Fan Q.L., Liu L.L., Ma J.F., Wang L.N. Rapid diagnosis in early stage renal tuberculosis by real-time polymerase chain reaction on renal biopsy specimens. Int J Tuberc Lung Dis. 2010;14(3):341–346. PMID: 20132626.
  34. Mert A., Guzelburc V., Guven S. Urinary tuberculosis: still a challenge. World J Urol. 2020;38(11):2693–2698. doi: 10.1007/s00345-020-03146-7.
  35. Shammaa M.Z., Hadidy S., al-Asfari R., Siragel-Din M.N. Urinary tuberculosis: experience of a teaching hospital in Syria. Int Urol Nephrol. 1992;24(5):471–480. doi: 10.1007/BF02550113.
  36. Walzl G., McNerney R., du Plessis N., Bates M., McHugh T.D., Chegou N.N., Zumla A. Tuberculosis: advances and challenges in development of new diagnostics and biomarkers. Lancet Infect Dis. 2018;18(7):e199–e210. doi: 10.1016/S1473-3099(18)30111-7.
  37. Visweswaran R.K., Bhat S. Tuberculosis of the Urinary Tract. In: Comprehensive Clinical Nephrology: 6th Edition, Section X, Chapter 52. Elsevier. 2019:641–648.
  38. Singh D.D., Vogel M., Müller-Stöver I., El Scheich T., Winzer M., Göbels S., Hüttig F., Heinrich S., Mackenzie C., Jensen B., Reuter S., Häussinger D., Richter J. TB or not TB? Difficulties in the diagnosis of tuberculosis in HIV-negative immigrants to Germany. Eur J Med Res. 2011;16(9):381–384. doi: 10.1186/2047-783x-16-9-381.
  39. Bansal P., Bansal N. The surgical management of urogenital tuberculosis our experience and long-term follow-up. Urol Ann. 2015;7(1):49–52. doi: 10.4103/0974-7796.148606.
  40. Ali M. Y., Fattah S.A., Islam M.M., Haque M.M., Biswas A.K., Hossain M.A. Urinary Bladder Tuberculosis – A Case Report. Faridpur Med. Coll. J. 2010;5(2):66–68.
  41. D’Ancona C., Haylen B., Oelke M., Abranches-Monteiro L., Arnold E., Goldman H., Hamid R., Homma Y., Marcelissen T., Rademakers K., Schizas A., Singla A., Soto I., Tse V., de Wachter S., Herschorn S. Standardisation Steering Committee ICS and the ICS Working Group on Terminology for Male Lower Urinary Tract & Pelvic Floor Symptoms and Dysfunction. The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol Urodyn. 2019;38(2):433–477. doi: 10.1002/nau.23897.
  42. Singh O., Gupta S.S., Arvind N.K. A case of extensive genitourinary tuberculosis: combined augmentation ileo-cystoplasty, ureteric ileal replacement and buccal mucosal graft urethroplasty. Updates Surg. 2013;65(3):245–48. doi: 10.1007/s13304-012-0141-8.
  43. Dogra P.N., Regmi S.K., Singh P., Bora G., Saini A.K., Aggarwal S. Robot-assisted laparoscopic augmentation ileocystoplasty in a tubercular bladder. Urol Ann. 2014;6(2):152–155. doi: 10.4103/0974-7796.130647.
  44. Gupta R., Dorairajan L.N., Muruganandham K., Manikandan R., Kumar A., Kumar S. Laparoscopic ablative and reconstructive surgeries in genitourinary tuberculosis. JSLS. 2014;18(3):e2014.00203. doi: 10.4293/JSLS.2014.00203.
  45. Abel B.J., Gow J.G. Results of caecocystoplasty for tuberculous bladder contracture. Br J Urol. 1978;50(7):511–516. doi: 10.1111/j.1464-410x.1978.tb06202.x.
  46. Resina R.G., Ruiz B.C., López R.A., Romero F.J. Reconstrucción vésico-ureteral completa con íleon en un caso de tuberculosis genitourinaria [Complete vesico-ureteral reconstruction with ileum in a case of genitourinary tuberculosis]. Actas Urol Esp. 2009;33(6):706–711. Spanish. doi: 10.1016/s0210-4806(09)74213-5.

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