After the lungs, the organs most often affected by tuberculosis are the genitourinary organs. Tuberculosis is a multisystem disease that can manifest itself symptomatically in a different way. The manifestation of the disease depends on the affected organ and the degree of the disorder. The most common causative agent of genitourinary tuberculosis is Mycobacterium tuberculosis. It accounts for 20% of all forms of extrapulmonary tuberculosis. From 2% to 20% of patients with a history of pulmonary tuberculosis may have genitourinary involvement 5 to 25 years later. The incidence of renal tuberculosis is not precisely determined because of the lack of radiological findings. The diagnosis in this case can be made by urine culture. Genital tuberculosis is most often secondary and may occur as a result of renal tuberculosis infection. In the early stages of the disease, it is possible to observe normal imaging findings. Renal and urological tuberculosis most often affect the renal pelvis, calyces, ureter and bladder, less often the renal parenchyma is affected. Genital tuberculosis, on the other hand, affects the epididymis, testicles, urethra and prostate in men, while in women the fallopian tubes, endometrium and ovaries are affected. In affected kidneys, the disease may be latent for more than 20 years after the primary infection, until urinary tract symptoms such as hematuria and stone disease appear. The main method for diagnosing tuberculosis of the kidneys, ureters and bladder is intravenous urography. However, tuberculosis of the urinary tract can also be observed with the help of ultrasound, computed tomography or nuclear magnetic resonance. Through computed tomography, in addition to making a diagnosis, kidney function and the severity of the disease can be assessed. Moreover, in cases where other abdominal organs are also affected, it can be established. In patients with renal tuberculosis, treatment includes antituberculosis drugs with surgical excision as an adjunct to antituberculosis therapy. Urine can be cleared of microorganisms in less than 72 hours, but anatomical changes could progress during the healing process. Women with genital tuberculosis often suffer from infertility, menstrual disorders and pain. When pregnancy occurs, a miscarriage or ectopic pregnancy usually occurs. Due to the lack of clinical features, diagnosing genital tuberculosis in general can be a very difficult process. References: https://emedicine.medscape.com/