12 / 15
Page 57
allied
academies
Res Rep Gynaecol Obstet 2017 | Volume 1 Issue 4
November 02-03, 2017 | Chicago, USA
Embryology and In vitro Fertilization
World Congress on
Introduction:
The paucisymptomatic presentation and the
insidious evolution of genitourinary tuberculosis in humans
induce diagnostic difficulties especially in the context of male
infertility. We report two cases of urogenital tuberculosis
discovered during the exploration of infertile men.
Observations & Methods:
Observation 1- 40-year-old
patient living in urban area was explored for primary four
years infertility. Repeated spermograms were carried out
according to WHO method showed severe necrospermia
(vitality10-15%) with low motility (total motility<5%) and
normal sperm count. Moreover, the patient presented
urogenital symptomatology with dysuria, pollakiuria and
post-ejaculatory pains. Spermocultures were negative.
Ultrasound exploration showed a right epididymal cyst
and a left epididymal nodule. Urogenital tuberculosis was
suspected in a latter manifestation of fever and detection
of cervical adenopathy. Observation 2- 37-year-old
patient living in rural area and was explored for two years
primary infertility. He reported urogenital symptomatology
with painful urination, severe dysuria and recurrent
hemospermia. Spermogram showed necrospermia (38%
vitality), asthenospermia (total mobility 25%), leucospermia
(1.6 ×10
6
leucocytes/ml) and hemospermia. The evolution
was marked by the persistence of hemospermia and the
alteration of sperm parameters despite the prescription of
antibiotherapy leading to suspicion of tuberculosis.
Results & Conclusion:
The diagnosis of urogenital
tuberculosis was confirmed in both patients by identification
of
Mycobacterium tuberculosis
respectively at the lymph
node biopsy and the urine culture. The diagnosis of
urogenital tuberculosis remains difficult outside an evocative
context. Its serious risk related to male infertility is linked to
possibility of caseous melting of the testis and to the often
irreversible damage of epididymis.
e:
sellamiafifa@yahoo.frMale infertility as a circumstance of discovery of genitourinary tuberculosis
Afifa Sellami
1
, Salima Daoud
1
, Nozha Chakroun
1
, Dorra Lahieni
2
, Mounir Ben Jemaa
2
and
Tarek Rebai
1
1
Medical School of Sfax, Tunisia
2
Hedi Chaker Academic Hospital, Tunisia