B90.1

Clinical Causes: Incomplete or inadequate treatment of initial genitourinary TB infection Delayed diagnosis leading to prolonged bacterial presence and tissue damage Reactivation of latent TB bacteria within the genitourinary organs Progressive tissue destruction due to immune response to residual bacteria Structural damage resulting from granulomatous inflammation during active TB infection

Key Symptoms: Chronic pain or discomfort in the lower back or pelvic area Persistent or recurrent urinary issues such as hematuria (blood in urine) or dysuria (painful urination) Reduced kidney function or signs of renal insufficiency Possible urinary leakage or incontinence due to structural damage Fever or general malaise in some cases Pelvic or testicular masses in cases involving reproductive organs

Diagnosis Path: Detailed medical history focusing on previous TB infection and treatment Urinalysis to detect abnormalities such as blood, protein, or bacteria Imaging studies like ultrasound, CT scan, or MRI to visualize structural damage Cystoscopy for direct visualization of the bladder and urethra Laboratory tests including urine PCR or culture to detect TB bacteria, though these may be less sensitive after treatment Blood tests to evaluate kidney function and check for ongoing inflammation

Treatment Protocols: Supportive care with analgesics for pain management Antibiotic therapy targeting residual or recurrent TB if active disease is detected Surgical interventions for structural repair, such as resection of damaged tissue or reconstructive procedures Dialysis or kidney transplantation in cases of severe renal failure Regular monitoring of kidney function and urinary tract health Management of complications like urinary incontinence or obstructions