Tuberculosis of male genital system--myth or reality in 21st century.

To review literature and our clinical experience with tuberculosis (TBC) of male genital tract. To analyze the localization of the specific process, association with other forms of TBC and its impact on fertility. The study comprises 69 male patients, average age 40.32 +/- 1.64 years who were diagnosed to have TBC of genital system. All laboratory, imaging, immunological and biological methods for detection of TBC were used as well as sperm count in patients with fertile problems. Time to set up of the diagnosis was 1 day to 19 years (median 26.82 +/- 6.76 months). TBC of the epididymis was found to be present in 78.26% of all cases. In 68.12%, unilateral affection was evident and involvement of left and right sites were similar. In 40.58% of patients, different grade of sperm quality alterations were diagnosed. Almost one-third of cases showed co-morbidity and 36.24% association with TBC of other organs and systems. TBC of male genital tract has a considerable impact on fertility and still remains a challenging medical problem. There is a growing body of evidence that regardless of all measures we should ring the bell about the possibility of a new widespread of TBC. Strong efforts are mandatory especially in developing countries and countries in transition like Eastern European Countries. Management of the disease should involve measures in health promotion programs, medical education health policy makers, and international cooperation.