To study the prevalence of tuberculous urinary tract and urogenital TB and urogenital symptoms in pulmonary and extra-pulmonary in young girls.

Out of 1484 young girls with TB with pulmonary (982) and extra-pulmonary (502) TB over last 5 years were enrolled in this study. All girls were enquired about detailed history especially urogenital and urinary symptoms. Those with urogenital symptoms were investigated to look for urogenital TB by performing ultrasound or Computed Axial Tomography of abdomen and pelvis for any tubo-ovarian mass, renal or bladder involvement. Early morning urine was subjected to microscopy, pyogenic culture, AFB microscopy, CBNAAT and liquid culture (MGIT) for TB.

A total of 9 girls (0.61%) had renal or bladder tuberculous. 6(0.61%) had concomitant Pulmonary TB and 3(0.59%) were from EPTB group. The age of urogenital TB cases ranged from 10 to 14 with mean being 11.8 years. Out of 9 girls only one had normal menstruation, 6 had not started menstruation yet, two had scanty menses. The urogenital symptoms were increased frequency (100%), dysuria in 7 (77.75%), pyuria in 2 (22.4%), haematuria in 3 (33%), abdominal pain in 5 (50.7%), pelvic pain in 3 (33.5%). 
On ultrasound, renal enlargement was seen in 5 cases (55.5%), (right in 2, left in 2 and bilateral in 1 case). Bladder involvement was seen in 4 (44.4%) cases. IUP showed beaded appearance, confirmed on CT showing ureteric wall strictures and dilatation. Two patients had irregular bladder wall, all 9 (100%) patients had sterile pyuria.
However AFB could only be identified in only 2 (22.2%) cases in urine of patients by CBNAAT and liquid culture (MGIT). All patients were treated with category I anti-tubercular therapy on using rifampicine, isoniazid, Pyrazinamide and ethambutol daily for 2 months (intensive phase) followed by rifampicin, isoniazid and ethambutol daily for 4 months (continuation phase). Most patients responded to medical treatment with their renal and bladder lesions disappeared on ATT.                    In one case, drainage of pyonephracy had to be done surgically.

A total of 9 girls (0.61%) had renal or bladder tuberculous. 6(0.61%) had concomitant Pulmonary TB and 3(0.59%) were from EPTB group. The age of urogenital TB cases ranged from 10 to 14 with mean being 11.8 years. Out of 9 girls only one had normal menstruation, 6 had not started menstruation yet, two had scanty menses. The urogenital symptoms were increased frequency (100%), dysuria in 7 (77.75%), pyuria in 2 (22.4%), haematuria in 3 (33%), abdominal pain in 5 (50.7%), pelvic pain in 3 (33.5%). 
On ultrasound, renal enlargement was seen in 5 cases (55.5%), (right in 2, left in 2 and bilateral in 1 case). Bladder involvement was seen in 4 (44.4%) cases. IUP showed beaded appearance, confirmed on CT showing ureteric wall strictures and dilatation. Two patients had irregular bladder wall, all 9 (100%) patients had sterile pyuria.
However AFB could only be identified in only 2 (22.2%) cases in urine of patients by CBNAAT and liquid culture (MGIT). All patients were treated with category I anti-tubercular therapy on using rifampicine, isoniazid, Pyrazinamide and ethambutol daily for 2 months (intensive phase) followed by rifampicin, isoniazid and ethambutol daily for 4 months (continuation phase). Most patients responded to medical treatment with their renal and bladder lesions disappeared on ATT.                    In one case, drainage of pyonephracy had to be done surgically.

Urogenital tuberculosis is a rare form of tuberculosis which can complicate with pulmonary or EPTB and should be looked for in all cases of TB especially with urogenital symptoms to detect urogenital TB in early stage to avoid permanent damage to the kidney and urinary and genital system.