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Tuberculosis

What is genital tuberculosis?

Genital TB is mostly secondary to pulmonary TB or extrapulmonary foci such as kidneys, brain, skeletal system and gastrointestinal system. TB bacilli infect the genital tract by four routes – blood transmission (with lungs as the common primary focus), descending direct spread, lymphatic spread and rarely as primary infection of the genitalia through sexual transmission. The genital organs affected by Mycobacterium tuberculosis (in descending order of frequency) are as follows: fallopian tubes (95-100%), uterine endometrium (50-60%), ovaries (20-30%), cervix (5-15%), uterine myometrium (2.5%) and vagina/vulva (1%).

What are the symptoms?

  • Mostly asymptomatic
  • Infertility
  • Irregular periods in terms of flow, frequency and duration
  • Pelvic pain
  • Abnormal vaginal discharge

When to visit a gynecologist?

Please see your gynecologist if you are bothered with abnormal periods, pelvic pain, infertility, unexplained weight loss with low grade fever. We at Queen's Gynecology offers detailed examination and the best treatment for genital tuberculosis in Delhi

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Why do you have all these symptoms in pelvic with genital tuberculosis?

Genital tuberculosis changes the normal tubo-ovarian anatomy which is the main cause of infertility. Tubercular endometritis causes ulceration, necrosis and haemorrhage which can destroy the endometrium and thus hinder implantation of a healthy embryo. Adhesions may occur between ovaries and adjacent pelvic organs resulting in adnexal mass, causing pelvic pain. Intrauterine adhesions if occur can result in partial obliteration of the uterine cavity, causing the symptoms of menstrual abnormalities.

Complications of genital tuberculosis:

  • Infertility ( endometrial damage)
  • Pelvic pain
  • Menstrual irregularities (disturbed ovarian function)
  • Tubo-ovarian masses
  • Frozen pelvis
Management

Diagnosis & Treatment

Demonstration of mycobacterium tuberculosis is not possible in all the cases, a high index of suspicion is required. The diagnostic dilemma arises due to varied clinical presentation, diverse results on imaging and endoscopy and availability of series of bacteriological, serological and histopathological tests which are often required to get to evidence of genital TB . The diagnostic approach used is family history of TB or history of antituberculous therapy (ATT) in a close family member or a past history of tuberculosis or anti-tubercular treatment in the patient may show recrudescence of tuberculosis in the genital region. We at Queen’s Gynecology provide best genital tuberculosis treatment in Delhi after a detailed analysis. Also, we always screen for tuberculosis in all our infertility patients.

Treatment for Tuberculosis:

  • Medical treatment includes multidrug regimes categorized under DOTS (Directly Observed Treatment Short-Course) Strategy Treatment.
  • Treatment of Chronic Cases, Drug Resistant and Multidrug Resistant (MDR).
  • Surgical treatment- There are much higher chances of complications during surgery in women with genital TB in hysteroscopy, laparoscopy, vaginal hysterectomy and laparotomy.
  • IVF (IN VITRO FERTILIZATION) in case of infertility.

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