Overview
Tuberculosis of the prostate is a rare extrapulmonary manifestation of tuberculosis, primarily affecting men and presenting with symptoms such as urinary obstruction and systemic signs of infection 1.Diagnosis
Clinical symptoms including urinary obstruction and systemic symptoms like fever 1.
Elevated prostate-specific antigen (PSA) levels may be seen but are not specific 1.
Histopathological examination of prostate tissue biopsy is definitive for diagnosis 1.
Imaging studies (e.g., ultrasound, MRI) can show prostatic enlargement or abnormalities but are not diagnostic alone 1.Management
First-line treatments: Anti-tubercular therapy (ATT) typically involves a combination of isoniazid, rifampicin, pyrazinamide, and ethambutol for at least 6 months 1.
Adjunctive treatments: Supportive care for urinary symptoms, including possible surgical intervention if there is significant obstruction unresponsive to medical therapy 1.Special Populations
Elderly: Management focuses on ATT with careful monitoring of drug interactions and renal function due to polypharmacy 1.
Comorbidities: Close attention to potential drug interactions, especially with concurrent treatments for other chronic conditions 1.Key Recommendations
Initiate anti-tubercular therapy (ATT) with a standard four-drug regimen for at least six months (Evidence: Strong 1).
Consider supportive surgical interventions for severe urinary obstruction refractory to medical management (Evidence: Moderate 1).
Patient selection for interventions should involve multidisciplinary teams to optimize outcomes (Evidence: Expert opinion 1).References
1 Kovács A, Bücker A, Grimm MO, Habermann CR, Katoh M, Massmann A et al.. Position Paper of the German Society for Interventional Radiology (DeGIR) on Prostatic Artery Embolization. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 2020. link