Genitourinary Tuberculosis
Genitourinary TB is the great mimic — it seeds the kidney by the blood, then creeps down the urinary tract and into the genitals over years, scarring everything it touches.
The big picture
Genitourinary TB is the great mimic — it seeds the kidney by the blood, then creeps down the urinary tract and into the genitals over years, scarring everything it touches. By the time it declares itself, the damage (ureteric strictures, a shrunken bladder, an infertile man) is often structural. The board-relevant heart of it is the pattern of spread, the classic sites it strictures, and the tell-tale signs — sterile pyuria, calcification, a "beaded" ureter, a "thimble" bladder.
The framework: haematogenous seeding of the kidney → descending spread to ureter, bladder, and genitals → fibrosis/stricture/calcification → diagnosis (sterile pyuria, imaging, culture) → anti-TB drugs + managing the structural damage.
Mechanism pathway
Tap any step to see why it happens.
Diagnostic algorithm
Each step answers one question. Tap to expand.
Board traps
Kidney is the first/commonest site (~80%); epididymis is second (10–55%).
Classic ureteric stricture is of the DISTAL THIRD of the ureter and the UVJ — "beaded corkscrew" ureter; scarring causes obstruction and reflux.
Thimble bladder (<20 mL) → orthotopic substitution/augmentation.
Sterile pyuria/haematuria in >90% — the signature clue; confirm with AFB/culture/PCR.
GU TB calcifies (kidney, distal ureters).
Prostate/seminal vesicles 22–49%; vas/epididymis involvement → infertility.