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Case Reports in Obstetrics and Gynecology
Volume 2014, Article ID 985682, 4 pages
http://dx.doi.org/10.1155/2014/985682
Case Report

Genitourinary Tuberculosis: A Rare Cause of Obstructive Uropathy in Pregnancy

Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9032, USA

Received 23 April 2014; Accepted 4 June 2014; Published 22 June 2014

Academic Editor: Svein Rasmussen

Copyright © 2014 Emily H. Adhikari et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. A rare but morbid form of extrapulmonary tuberculosis (TB), genitourinary TB is an important cause of obstructive uropathy and is likely underdiagnosed in pregnancy. Case. A 30-year-old primigravida undergoing treatment for active pulmonary TB presented with anuria at 13-14-weeks gestation. Bilateral ureteral strictures above the level of the ureterovesicular junctions were seen on imaging studies. Given her pulmonary disease, her obstructive uropathy was attributed to genitourinary TB. Bilateral percutaneous nephrostomy tubes were placed during pregnancy with successful ureteral reimplantation postpartum. Conclusion. Genitourinary TB should be considered as an etiology of urinary tract pathology during pregnancy, especially in foreign-born and immunocompromised persons. Early recognition resulting in prompt treatment can prevent further deterioration of maternal renal function and optimize pregnancy outcomes.