Hysteroscopic findings in women with primary and secondary infertility due to genital tuberculosis

Sharma, Jai Bhagwan; Roy, Kallol Kumar; Mohanraj, P.; Kumar, Sunesh

doi:10.1016/j.ijgo.2008.08.019

Cited by 40 publications

(34 citation statements)

References 19 publications

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“…More often, however, the endometrium is pale looking, and the cavity is partially or completely obliterated by adhesions of varying grade (grade 1 to grade 4) often involving ostia as observed by us (Fig. 2) [34]. There may be a small shrunken cavity.…”

Section: Role Of Endoscopy In Fgtb Hysteroscopymentioning

confidence: 56%

Current Diagnosis and Management of Female Genital Tuberculosis

Sharma

2015

J Obstet Gynecol India

123

145

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Female genital tuberculosis (FGTB) is an important cause of significant morbidity, short-and longterm sequelae especially infertility whose incidence varies from 3 to 16 % cases in India. Mycobacterium tuberculosis is the etiological agent for tuberculosis. The fallopian tubes are involved in 90-100 % cases, endometrium is involved in 50-80 % cases, ovaries are involved in 20-30 % cases, and cervix is involved in 5-15 % cases of genital TB. Tuberculosis of vagina and vulva is rare (1-2 %). The diagnosis is made by detection of acid-fast bacilli on microscopy or culture on endometrial biopsy or on histopathological detection of epithelioid granuloma on biopsy. Polymerase chain reaction may be false positive and alone is not sufficient to make the diagnosis. Laparoscopy and hysteroscopy can diagnose genital tuberculosis by various findings. Treatment is by giving daily therapy of rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) for 2 months followed by daily 4 month therapy of rifampicin (R) and isoniazid (H). Alternatively 2 months intensive phase of RHZE can be daily followed by alternate day combination phase (RH) of 4 months. Three weekly dosing throughout therapy (RHZE thrice weekly for 2 months followed by RH thrice weekly for 4 months) can be given as directly observed treatment short-course. Surgery is rarely required only as drainage of abscesses. There is a role of in vitro fertilization and embryo transfer in women whose fallopian tubes are damaged but endometrium is healthy. Surrogacy or adoption is needed for women whose endometrium is also damaged.

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Section: Role Of Endoscopy In Fgtb Hysteroscopymentioning

confidence: 56%

Current Diagnosis and Management of Female Genital Tuberculosis

Sharma

2015

J Obstet Gynecol India

123

145

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“…8 Hysteroscopy is useful in endometrial disease and may show pale looking endometrium with endometrial cavity being partially or completely obliterated by adhesions of varying grade which may involve ostia. 9 Total destruction of endometrium may result in Asherman's syndrome resulting in amenorrhea secondary to end organ failure. However, laparoscopy is the most reliable tool to diagnose FGTB, especially for tubal, ovarian, and peritoneal disease.…”

Section: Discussionmentioning

confidence: 99%

Female genital tuberculosis and ndash; still a common cause of primary amenorrhea in developing countries

Bettaiah¹,

Daksha²,

Ghanti³

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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“…The most common finding of TB affecting the endometrium is adhesions that may be firm and agglutinated and occluding the ostia (14). Treatment of intrauterine adhesions, from any etiology, for the purpose of improving fertility outcomes usually involves hysteroscopic adhesiolysis (15).…”

Section: Discussionmentioning

confidence: 99%