FEATURES OF PROSTATE TUBERCULOSIS IN A 60-YEAR-OLD MALE PATIENT

Introduction. Tuberculosis of the prostate is a rare disease that can mimic chronic prostatitis, prostate cancer, and benign prostatic hyperplasia for a long period of time. Prostate tuberculosis becomes evident only with the development of destruction, massive fibrosis, and loss of organ function, where treatment is only possible through complex, often multi-stage reconstructive surgical interventions. In this article, we describe a case of isolated prostatic tuberculosis in a 60-year-old male patient. Six years passed from the onset of the first symptoms to the diagnosis of the tuberculosis etiology of the disease. Aim. To analyze the clinical case of prostate tuberculosis in a 60-year-old man. Materials and Methods. This article describes the clinical case of a 60-year-old male patient with tuberculosis affecting the prostate. The patient underwent a comprehensive diagnosis for tuberculosis, such as luminescent microscopy of sputum; detection of Mycobacterium tuberculosis DNA by polymerase chain reaction in urine and ejaculate; recombinant tuberculosis allergen test; and chest X-ray. His prostate bioptate was examined pathomorphologically, along with ultrasound and magnetic resonance imaging of the prostate, and measurement of prostate-specific antigen in the blood. Results and Discussion. A 60-year-old man first sought medical attention in 2018 with complaints of difficult urination with blood. A transrectal ultrasound of the prostate and prostate-specific antigen level measurement were performed. He had self-medicated with furazidin for a month, after which his condition normalized. In early November 2023, he experienced persistent weakness and periodic evening fever reaching 37.3 degrees Celsius. Repeated transrectal ultrasound and MRI examinations confirmed the focal findings from the previous ultrasound. A prostate biopsy revealed the proliferation of fibrous tissue and productive chronic inflammation with granulomas and giant Langhans cells in the prostate bioptate. Antituberculosis therapy was initiated, during which the patient’s condition improved, and leukocyturia decreased. Conclusions. Thus, six years elapsed from the onset of the first symptoms to the diagnosis of the tuberculosis etiology of the disease. This example represents a reminder to clinicians to consider excluding specific processes, especially in cases of prolonged and recurrent inflammatory processes. Prostatic tuberculosis can occur without confirmation using bacteriological, molecular-genetic, or immunological methods. Given this, prostate biopsy is an important technique for the differential diagnosis of prostate diseases. Any case of active urogenital inflammation should be regarded as potentially of tuberculous etiology.