Current Therapy and Surgery for Urogenital Tuberculosis

Current Therapy and Surgery for Urogenital Tuberculosis

Ekaterina Kulchavenya Current Therapy and Surgery for Urogenital Tuberculosis

Ekaterina Kulchavenya Research TB Institute Novosibirsk Medical University Novosibirsk, Russia ISBN 978-3-319-28288-6 DOI 10.1007/978-3-319-28290-9 ISBN 978-3-319-28290-9 (ebook) Library of Congress Control Number: 2015959924 Springer International Publishing Switzerland 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by SpringerNature The registered company is Springer International Publishing AG Switzerland.

Contents 1 Enigmatic Tendency of Epidemiology of Extrapulmonary Tuberculosis... 1 1.1 Introduction... 1 1.2 Transmission of Mtb... 2 1.3 Enigmas of Extrapulmonary Tuberculosis... 3 1.3.1 First Enigma is Incomparable Epidemiologic Data on EPTB... 3 1.3.2 Second Enigma A Different Part of EPTB Among TB as a Whole in Different Times and in Different Regions... 4 1.3.3 Third Enigma Different Spectrum of EPTB in Different Regions and in Different Time... 4 1.3.4 Fourth Enigma is a Non-stable Spectrum of EPTB During a Time Period... 5 1.3.5 Fifth Enigma is the Different Prevalence of EPTB in Neighboring Regions... 6 1.3.6 Sixth Enigma What Does UGTB Mean (Misunderstanding in Definitions)... 6 1.3.7 Seventh Enigma Different Sex and Age Ration in UGTB... 6 1.4 Rare Cases of Extrapulmonary Tuberculosis... 7 1.5 Conclusion... 10 References... 10 2 Pathogenesis of Urogenital Tuberculosis... 13 2.1 Introduction... 13 2.2 Unrequited Questions on TB... 14 2.3 Innate Human Resistance to Tuberculosis... 14 2.3.1 Lubeck Disaster... 15 v

vi Contents 2.4 Acquired Human Resistance to Tuberculosis... 15 2.4.1 The Role of Humoral Immunity... 16 2.4.2 The Role of Polymorphonuclear Neutrophils... 16 2.4.3 The Role of Macrophages... 16 2.4.4 The Role of Apoptosis... 17 2.4.5 The Role of Proteins... 18 2.4.6 The Role of Granulysin... 19 2.4.7 The Role of Chemokines... 19 2.4.8 The Role of Nitric Oxide... 19 2.5 Other Factors of the Immune Response... 20 2.6 Is Urine Bactericidal for Uropathogens (M. tuberculosis and E. coli)?... 20 2.7 How Mycobacteria Defends Itself?... 21 2.8 Development of TB Infection... 21 2.9 Pathogenesis of UGTB... 22 2.10 Outcomes of Kidney TB... 23 2.11 Vaccines Against TB Infection... 25 2.12 Conclusion... 27 References... 27 3 Urogenital Tuberculosis Definition and Classification... 31 3.1 Introduction... 31 3.2 Terms and Definitions... 32 3.3 Classifications of UGTB... 32 3.3.1 Kidney Tuberculosis... 32 3.3.2 Urinary Tract TB... 32 3.3.3 Male Genital Tuberculosis (MGTB)... 33 3.4 Clinical Features... 33 3.4.1 Clinical Features of Kidney TB... 33 3.4.2 Clinical Features of Urinary Tract TB... 36 3.4.3 Clinical Features of Male Genital Tuberculosis (MGTB)... 41 References... 48 4 Chemotherapy for Urogenital Tuberculosis... 51 4.1 History (Before Antibacterial Era)... 52 4.2 Antibacterial Era... 53 4.2.1 MDR Period... 53 4.2.2 Persistence of Mtb... 54 4.2.3 Resistance of Mtb... 54 4.2.4 How to Get Good Results in the Therapy for UGTB in MDR Period?... 55 4.2.5 How to Improve an Adherence and Compliance... 56

Contents vii 4.2.6 How Can We Prevent Drug Resistance and Improve Results of the Therapy for UGTB?... 57 4.2.7 Tuberculosis and Cancer... 57 4.2.8 Antituberculous Drugs... 61 4.3 Adverse Effect of Chemotherapy for UGTB... 66 4.4 Important Drug Interactions... 67 4.5 How to Improve Tolerance of the Therapy for Kidney Tuberculosis... 68 References... 69 5 Regimens of the Chemotherapy for Urogenital Tuberculosis... 73 5.1 Introduction... 73 5.2 Principles of the Chemotherapy for UGTB... 74 5.3 How to Choose the Optimal Anti-TB Drugs... 75 5.4 How to Choose the Optimal Administration of Anti-TB Drugs... 76 5.5 Etiotropic Therapy for UGTB... 77 5.5.1 Doses of Anti-TB Drugs... 77 5.5.2 Intravenous Administration... 78 5.6 Etiotropic Therapy for Prostate Tuberculosis... 80 5.7 Can We Predict the Outcome of the Therapy?... 82 5.8 Pathogenetic Therapy... 82 5.8.1 Vitamin D in the Complex Anti-TB Therapy... 83 References... 83 6 Surgery for UGTB... 85 6.1 Introduction... 85 6.2 Indication for Surgery for UGTB Patients... 86 6.2.1 Surgery for Kidney TB... 86 6.2.2 Endoscopic Surgery for Kidney TB... 87 6.2.3 Surgery for UGTB in Co-Morbidity with Urolithiasis... 87 6.2.4 Surgery for Urinary Tract TB... 89 6.3 Conclusion... 94 References... 96

Abbreviations AIDS ART BCG EPTB ETTB FGTB FNAC gugtb HCV HIV IGRA INH IVU KTB LTBI MDR MGM MGTB Mtb PCR PTB TB TST UGTB UTI UTTB WHO Acquired immunodeficiency syndrome Antiretroviral therapy Bacillus Calmette Guérin Extrapulmonary tuberculosis Extrathoracal tuberculosis Female genital tuberculosis Fine needle aspiration cytology Generalized urogenital tuberculosis Hepatitis C virus Human immunodeficiency virus interferon-gamma release assay Isonicotinic acid hydrazide/isoniazid Intravenous urography Kidney tuberculosis Latent tuberculosis infection Multidrug-resistant (TB, resistant to at least isoniazid and rifampicin) Molecular genetic methods Male genital tuberculosis Mycobacterium tuberculosis Polymerase chain reaction Pulmonary tuberculosis Tuberculosis Tuberculin skin test Urogenital tuberculosis Urogenital tract infection Urinary tract tuberculosis World Health Organization ix

x XDR Z-N Abbreviations Extensively drug-resistant TB (defined as resistance to at least rifampicin and isoniazid from among the first-line anti-tb drugs, in addition to resistance to any fluoroquinolone, and to at least one of three injectable second-line anti-tb drugs used in TB treatment) (capreomycin, kanamicin and amikacin) Ziehl Neelsen