Urinary tuberculosis: still a challenge
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TOPIC PAPER
Urinary tuberculosis: still a challenge Ali Mert1 · Vahit Guzelburc2 · Selcuk Guven2 Received: 19 August 2019 / Accepted: 25 February 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Urinary tuberculosis (TB) is a challenging disease to cope with, as there has been no noticeable difference in basic diagnostic and therapeutic options in clinical practice over time. Purpose The aim of the current review was the critical assessment and evaluation of TB, which remains a major global health problem. Methods The available literature regarding TB in the PubMed database was extensively searched. Results New interdisciplinary team approaches such as next-generation sequencing are promising for the diagnosis and treatment of the disease. The epidemiology of the disease is changing with globalization and increasing migration events; however, the knowledge here is limited. Despite ongoing destruction, kidney functions need to be preserved as much as possible, and relatively rapid development of minimally invasive techniques relieved the surgeons in this regard. Experience is increasing in minimally invasive techniques that provide better comfort for patients compared to extensive radical surgeries. Conclusions Knowing the pathogenesis of urinary TB is essential for understanding the range of clinical manifestations. The onset of the disease is usually insidious. Despite modern TB drugs, reconstructive surgery, and minimally invasive procedures, progression cannot be prevented in some patients, and patient selection is essential, but we still do not have sufficient information and objective parameters to predict progression. Keywords Mycobacterium tuberculosis · Urinary · Endoscopic · Reconstructive or ablative surgical interventions
Introduction and epidemiology Even after the discovery of Mycobacterium tuberculosis by Robert Koch ~ 1.5 centuries ago in 1882, tuberculosis (TB) still remains a major health problem. In 2014, one-quarter (~ 1.7 billion people) of the world’s population was estimated to have latent TB (LTBI) infection [1]. The lifetime risk of LTBI to progress to active TB in an individual is predicted to be ~ 10% [2]. According to the World Health Organization (WHO), TB affected 10 million people and caused the death of 1.3 million people in 2017 [3]. In 2014, WHO set a goal to end tuberculosis by 2035, recognizing that success depends on the development of better preventive, diagnostic, and therapeutic interventions [3]. Although * Ali Mert [email protected] 1
Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey
Department of Urology, Istanbul Medipol University, Istanbul, Turkey
2
the number of TB deaths has decreased during the past decades, TB was still the 1 0th leading cause of death worldwide in 2016. M. tuberculosis is the second most common infectious cause of death (after Human Immunodeficiency Virus) in adults worldwide [5]. Human Immunodeficiency Virus (HIV) infection is a ma
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