European Journal of Cardiovascular Medicine

Objectives: Tuberculosis of the prostate is an extremely rare disease. Even most of the urologists are not familiar with it. But in backdrop of covid pandemic, we have encountered 5 such cases in last 3 years which are reported here and the literature reviewed in this context. Methods: This was a retrospective study carried out in a tertiary care centre from December 2021 to December 2023. Results: All the patients were in their fourth or fifth decade of life. Irritative voiding (100%) followed by haematospermia (50%) were the common presenting symptoms. A history of pulmonary tuberculosis was absent in 4 cases. All patients had positive history of Covid 19 infection in last 6 months. 80% (4 out 5) had a suspicious prostate on the digital rectal examination. PSA assays were slightly elevated with a mean of 8.35 ng/ml. Urine analysis revealed sterile pyuria in all patients, and the urine culture was negative. The urine and seminal fluid positivity rate was 40% for the microscopy of AFB , 80% for the M. tuberculosis culture test, and 100% for PCR. The transrectal ultrasonogram showed hypoechoic areas with irregular outlines in 3 cases (60%) and calcification in 3 cases (60%). All patients were scheduled to receive 6 months of chemotherapy with Isoniazid, Rifampicin, and Ethambutol or Pyrazinamide. Conclusion: A high index of suspicion of Tuberculosis of prostate is required in patients presenting with haematospermia. An upsurge in cases may been seen after covid pandemic and therefore a wide range of investigations may be required to achieve a complete diagnosis of prostatic tuberculosis. Although short-term multi-drug chemotherapy is the mainstay of treatment and it has excellent outcome.