Uncommon Presentation of Testicular Anomaly: An Insight into Tuberculous Orchitis Diagnostic Challenges in Rural Settings

Syarif Syarif; Jefry Sondang Kembaren; Jeffry Yandhi

doi:10.11594/bjurology.2026.006.03.2

Authors

Syarif Syarif Division of Urology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia, 90245
Jefry Sondang Kembaren Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia, 90245
Jeffry Yandhi Faculty of Medicine, Hasanuddin University, Makassar, Indonesia, 90245

DOI:

https://doi.org/10.11594/bjurology.2026.006.03.2

Keywords:

orchiectomy, testicular tuberculosis, testicular tumor, tuberculous orchitis

Abstract

Introduction. Testicular tuberculosis is very rare, accounting for only 3% of genital tuberculosis cases. Diagnosing testicular tuberculosis is challenging and often only confirmed through post-surgical histopathological findings after an orchiectomy.

Case. A 59-year-old male patient came in complaining of a painless, gradually developing expansion in his left testicle. The patient did not have a history of tuberculosis or any related symptoms, including fever, appetite loss, respiratory issues, or significant weight loss. Physical examination and ultrasound suggested a testicular tumor. Due to the absence of definite preoperative diagnostic methods in our settings, we diagnosed the patient with a testicular tumor. Consequently, a left orchiectomy was performed, and the pathologic examination revealed tuberculous orchitis.

Conclusion. Given the limited diagnostic tools available and the elusiveness of similar cases encountered, surgery followed by histopathological findings for both treatment and diagnosis might be unavoidable in many cases.

References

Hadiansyah H, Wahyudi I, Rasyid N. Management of tuberculous epididymal-orchitis: a literature review. Indones J Biomed Sci. 2021;15(2):185-192. doi: 10.15562/ijbs.v15i2.341.

Rajabi MH, Gharaei HA, ArabAhmadi A, Yarmohammadi M. Isolated tuberculosis of testis: A case report. Casp J Intern Med. 2021;12(1):111-114. doi: 10.22088/cjim.12.1.111.

Pattiselanno YA, Pattiselanno LL, Leo B, Hadi C, Angel SH. Epididymo-Orchitis: A Rare Manifestation of Tuberculosis Infection. J Respirasi. 2024;10(2):155–160. doi: 10.20473/jr.v10-I.2.2024.155-160.

Das A, Batabyal S, Bhattacharjee S, Sengupta A. A rare case of isolated testicular tuberculosis and review of literature. J Fam Med Prim Care. 2016;5(2):468-470. doi: 10.4103/2249-4863.192334.

Kharbach Y, Retal Y, Khallouk A. Is orchiectomy avoidable in testicular tuberculosis mimicking malignancy? A case report. African J Urol. 2021;27:144. doi: 10.1186/s12301-021-00244-9.

Al-Hashimi KA, Said UN. Unilateral Testicular Tuberculosis: An Extra-Pulmonary Manifestation. Cureus. 2021;13(10):1-6. doi: 10.7759/cureus.18896.

Surya PA, Faadilah AH, Indarjadi I, Wirjopranoto S, Jamhari MAH, Azmi YA. Tuberculosis Testis In Middle-Aged Male As A Rare Case Of Genitourinary Tuberculosis: A Case Report. Medicra (Journal Med Lab Sci). 2023;6(2):74-78. doi: 10.21070/medicra.v6i2.1720.

Huang Y, Chen B, Cao D, Chen Z, Li J, Guo J, et al. Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up. BMC Infect Dis. 2021;21(1):1068. doi: 10.1186/s12879-021-06753-w.

World Health Organization. Treatment of tuberculosis: guidelines. Geneva: World Health Organization; 2010 [cited 2026 Jan 24]. Available from: https://www.who.int.

European Association of Urology. EAU guidelines on urogenital tuberculosis. Arnhem: EAU Guidelines Office; 2023 [cited 2026 Jan 24]. Available from: https://uroweb.org/guidelines.

Figueiredo AA, Lucon AM. Urogenital tuberculosis: update and review of 8961 cases from the world literature. Rev Urol. 2008;10(3):207–217.