The genitourologic aspects of leprosy are reviewed. (1) Renal complications are widespread and clinically significant. Amyloid degeneration is common in leprosy, particularly in the West. (2) Adrenal involvement is also seen. Clinical consequences, although not thoroughly evaluated, do not seem significant. (3) Testicular and epididymal involvement, universal in lepromatous leprosy, is of diagnostic and therapeutic importance, particularly in association with lepromatous gynecomastia, a clinical model of ‘acquired Klinefelter’s syndrome’. (4) The existence of venereal leprosy, postulated through the ages in folklore, is not borne out by scientific investigation. (5) The external genitalia are generally spared, although occasional involvement has been reported. (6) The ureters, bladder, and urethra are spared as are the prostate and seminal vesicles. (7) Abnormal urinalyses, reflecting renal impairment, are frequently seen. The frequency and significance of mycobacteriuria remain unsettled.

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