Tuberculosis primaria de la próstata. Reporte de un caso

Background

Tuberculosis is one of the diseases in which poverty, overcrowding, and malnutrition result in a poor immunologic state. Genitourinary tuberculosis is the most common extra-pulmonary site of tuberculosis, but involvement of the prostate gland is observed in only 2.6% of the cases.

Aim

To present a case of tuberculosis of the prostate and its medical and surgical management.

Case presentation A 63-year-old man had a history of intense smoking and occasional drinking and he sought medical attention for acute urinary retention. He had a prostate-specific antigen level of 1.36 ng/ml. Examination identified a 3 × 3 cm, hard, irregular prostate that was not painful upon palpation. Malignancy was suspected and the patient underwent a prostate biopsy that reported chronic granulomatous prostatitis. Studies for pulmonary or genitourinary disease were negative. Immunofluorescence corroborated the diagnosis of tuberculosis of the prostate. Anti-tuberculosis treatment was begun and continued for 6 months, after which transurethral resection of the prostate was performed.

Discussion

Primary tuberculosis of the prostate resembles different pathologies, such as prostate cancer and acute or chronic prostatitis, and therefore ultrasound-guided transrectal biopsy is indicated. The definitive diagnosis is made through histopathologic confirmation of the bacillus to differentiate it from nonspecific granulomatous prostatitis. Endourologic surgery is not contraindicated for this pathology.