A Hospital Based Study on Female Genital Tuberculosis in Central India

  • Dr Swati Patel Assistant Professor, Department of Pathology, R. D. Gardi Medical College, Ujjain, M.P, India
  • Dr P. L. Dhand Professor Head , Department of Pathology, R. D. Gardi Medical College, Ujjain, M.P, India
Keywords: Tuberculosis (TB), Female genital tuberculosis (FGTB), Female infertility, Histopathology

Abstract

Introduction: In developing countries like India tuberculosis (TB) is common and still a major cause of infertility. Female genital tuberculosis is one form of extra pulmonary TB. Genital TB may be asymptomatic and diagnosis requires a high index of suspicion. Early diagnosis may improve the outcome before permanent tissue damage get established. The objective of this study was to evaluate the prevelance and clinico-pathological aspects and diagnosis of female genital tuberculosis (FGTB).

Method: A total of 21 cases of female genital tuberculosis were diagnosed from 1672 patients over a period of 2 years, studied from January 2013 to December 2015. The diagnostic procedure used were endometrial curettage and biopsy, histopathological examination, culture, stain for Acid fast bacilli in correlation with clinical presentation ,organ involvement, hysterosalpingography(HSG), Ultrasonography (USG)and laparoscopy. Most of the specimens received were endometrial curettage and biopsies.

Result: Female genital TB accounted for 1.25% of all tuberculosis patients in this study. The highest incidence was between 21-30 years of ages, but the patient ranged from 18-60 years. FGTB involves the endometrium (16 ), fallopian tube (4),cervix (1). Out of all cases, 7 demonstrate typical epitheloid granuloma and rest with atypical tuberculous lesion, acid-fast bacilli in tissue section were detected in 3 cases of endometrium, 1 case of fallopian tube and culture positive in 3 cases of endometrium, 1 case of fallopian tube.

Conclusion: Female genital tuberculosis is not uncommon in developing countries like India and indicates a strong relation between genital TB and infertility. The diagnosis of FGTB is challenging. Therefore, if possible genital TB is to be frequently diagnosed and considered in differential diagnosis of causes of infertility, in correlation with clinical and other diagnostic modalities.

Downloads

Download data is not yet available.

References

1. Schaefer G. Tuberculosis of the female genital tract. Clin Obstet Gynecol. 1970 Dec;13(4):965-98. [PubMed]

2. Roya R, Sreenivasagari R, Cheruvu N R :Evaluation of women with infertility and genital tuberculosis. J Obstet Gynecol India 2006; 56: 423-426.

3. Nwachokor FN, Thomas JO. Tuberculosis in Ibadan, Nigeria--a 30 year review. Cent Afr J Med. 2000 Nov;46(11):287-92. [PubMed]

4. Namavar Jahromi B, Parsanezhad ME, Ghane-Shirazi R. Female genital tuberculosis and infertility. Int J Gynaecol Obstet. 2001 Dec;75(3):269-72. [PubMed]

5. Gupta N, Sharma JB, Mittal S, Singh N, Misra R, Kukreja M. Genital tuberculosis in Indian infertility patients. Int J Gynaecol Obstet. 2007 May;97(2):135-8. Epub 2007 Mar 23. [PubMed]

6. Winfred J. Female genital tuberculosis. J Obstet Gynecol 1977; 63:418-28.

7. Arora VK, Gupta R, Arora R. Female genital tuberculosis: need for more research .Indian J Tuberc 2003;50(9): 9-11. [PubMed]

8. Chakraborty S, Chakraborty AK, Patra SP, Bhattacharya SK. Demonstration of acid-fast bacilli in tissues and evaluation of atypical tuberculous lesions. J Indian Med Assoc. 1993 Feb;91(2):30-3. [PubMed]

9. Agarwal J, Gupta JK. Female genital tuberculosis--a retrospective clinico-pathologic study of 501 cases. Indian J Pathol Microbiol. 1993 Oct;36(4):389-97.

10. Prasad S, Singhal M, Negi SS, Gupta S, Singh S, Rawat DS, Rai A. Targeted detection of 65 kDa heat shock protein gene in endometrial biopsies for reliable diagnosis of genital tuberculosis. Eur J Obs Gynecol Reprod Biol 2012; 160: 215-218.

11. Mondal SK. Histopathologic analysis of female genital tuberculosis: a fifteen-year retrospective study of 110 cases in eastern India. Turk Patoloji Derg. 2013;29(1):41-5.

12. Srinivas Rao MS, Pavani K, Uma M, Krishna K, Vinayaraj EV, Dass M.. To evaluate the prevalence of female genital tuberculosis in Hyderabad . Int J Res Med Sci. 2013 Nov;1(4):421-423.

13. Muechler E, Minkowitz S. Postmenopausal endometrial tuberculosis. Obstet Gynecol. 1971 Nov;38(5):768-70. [PubMed]

14. Carter JR. Unusual presentations of genital tract tuberculosis. Int J Gynaecol Obstet. 1990 Oct;33(2):171-6. [PubMed]

15. Shukla S, Acharya N, Acharya S, Rajput DP, Vagha S. Fictitious pseudo Meig’s syndrome: A medical emergency. J College Med Sci-Nepal 2011; 7: 57-64.

16. Varma TR. Genital tuberculosis and subsequent fertility. Int J Gynaecol Obstet. 1991 May;35(1):1-11. [PubMed]

17. Abdulhakim A Al, Ahmed S A, Abdelrahman H A H Genital tuberculosis is common among females with tubal factor infertility: Observational study, . Alexandria Journal of Medicine 2015; 51:321-324.

18. Roy A, Mukherjee S, Bhattacharya S, Adhya S, Chakraborty P. Tuberculous endometritis in hills of Darjeeling: a clinicopathological and bacteriological study. Indian J Pathol Microbiol. 1993 Oct;36(4):361-9. [PubMed]

19. Jindal UN. An algorithmic approach to female genital tuberculosis causing infertility. Int J Tuberc Lung Dis. 2006 Sep;10(9):1045-50. [PubMed]

20. Kashyap B, Kaur T, Jhamb R, Kaur IR Evaluating the utility of menstural blood versus endometrial biopsy as a clinical sample in the diagnosis of female genital tuberculosis. Am J Med Res 2012; 1(2):45-49.

21. Matthys H B, Frederick H, Vander M. Female genital tuberculosis : CPD S Afr Fam Pract 2008; 50(5):12-16.

22. Mukta K, Kher A., Sharma K.D. Tuberculosis of endometrium - A histopathological study of 385 cases; Ind. J. Pathol Microbiol, 1997; 20: 39.

23. Devi P.D. Genital tuberculosis in the female; JTMA, 1962; 38:164. [PubMed]

24. Sammel K.C, Gupta P. Tuberculous endometritis. J Obstet Gynae India, 1967; 17: 14.
A Hospital Based Study on Female Genital Tuberculosis in Central India
CITATION
DOI: 10.17511/ijmrr.2016.i02.017
Published: 2016-02-29
How to Cite
1.
Patel S, Dhand PL. A Hospital Based Study on Female Genital Tuberculosis in Central India. Int J Med Res Rev [Internet]. 2016Feb.29 [cited 2024Apr.27];4(2):227-32. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/463
Section
Original Article