Earliest and often the only presentation of TB kidneys is:

Genitourinary TB may involve any poion of the genitourinary tract. Local symptoms :- Urinary frequency, dysuria, nocturia, hematuria, and flank or abdominal pain is common presentations. However, patients may be asymptomatic. Urinalysis - pyuria and hematuria. Culture-negative pyuria in acidic urine raises the suspicion of TB. IV pyelography, abdominal CT, or MRI may show deformities and obstructions, and calcifications and ureteral strictures are suggestive findings. Culture (of three morning urine specimens) yields a definitive diagnosis in nearly 90% of cases.