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  • MSU - a sterile pyuria, unless secondary bacterial infection has occurred
  • collect 3 early morning specimens of urine (EMUS) on consecutive days:
    • microscopy for acid-fast bacilli with Ziehl-Nielsen stain
    • culture on Lowenstein-Jensen medium; takes 6 weeks
  • tuberculin skin test - often positive in affected patients
  • IVU / ultrasound - to assess extent of disease
  • CXR - to exclude active pulmonary TB
  • cystoscopy:
    • in acute disease, reveals generalised cystitis and superficial granulations around ureteric orifices
    • in chronic disease, fibrosis of the bladder results in bladder shrinkage and "golf-hole" ureteric orifices

Last reviewed 01/2018