S.A. Vozianov, S.N. Shamrayev, P.I. Stepanov

The evolution of methods of diagnostics of male genitals tuberculosis

The goal of the given research is to study the evolution of methods of mycobacterium tuberculosis (MG TB) diagnostics in the last decades.

Material and methods. An examination of 467 men with MG TB aged 16 to 82 years took place (average age was 49±14 years). Symptomatology, anamnesis, clinical, biochemical analyses, bacteriological examination, polymerase chain reaction to verify DNA mycobacterium tuberculosis, radio-diagnostics (sonographic, X-ray, multi-spiral X-ray computer-tomography, magnetic resonance imaging, radionuclide) and endoscopic examination methods data were evaluated.

Results. From 372 (79,7%) patients were diagnosed of the scrotum organs tuberculosis, prostate tuberculosis was detected in 305 (65,3%) and vesicle tuberculosis in 280 (59,9%) men. 94 (20,3%) were diagnosed inner pelvic genitals tuberculosis without involving of scrotum organs in the process, tuberculosis prostatitis was detected in 93(19,9%) and vesiculitis - in 74 (15,8) men. Two (2,2%) patients had penis tuberculosis. The algorithm of diagnostics of male genitals tuberculosis has undergone modifications in the past decades: instead of purified tuberculin, applied recombinant tuberculous allergen. From immunological methods, the following are used: detection of anti-tuberculous antibodies in blood by monoclonal antibodies to mycobacterium tuberculosis by means of ELISA and methods of immunophenotyping with determination of the number of CD4, CD8 cells. Also examination of other surface Т markers of lymphocytes with patients having a combination of tuberculosis and HIV/AIDS. The leading place for examination of male genitals anatomy was occupied by safe sonographic examinations with performing targeted aspiration of biological materials and tissues biopsy. The first place amongst methods of verification of mycobacterium tuberculosis was occupied by molecular-genetic examinations of biological materials by PCR. Research on tissues bioptates is not only performed using classical histology, but also using tissues miscroscopy on acido-resistant bacteria and molecularogenetic examinations. Fibreurethrocystoscopy with catheterisation of ejaculatory duct and seminal vesicles is applied as well.

Conclusions. These evolutional modifications of methods of diagnostics have enabled to examine all male genitals faster, safer and more precisely, and to detect their affection by tuberculosis.