Namavar Jahromi B, Parsanezhad M E, Ghane-Shirazi R
Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
Int J Gynaecol Obstet. 2001 Dec;75(3):269-72. doi: 10.1016/s0020-7292(01)00494-5.
This study was performed to evaluate the rate of diagnosed female genital tuberculosis and its presentational symptoms and methods of diagnosis.
A total of 3088 cases of tuberculosis (TB) who had been registered and treated in the Health Center of Fars Province from 1989 to 1999 were retrospectively studied. From this group, 46 women were diagnosed as having genital TB. The diagnosis in 41 cases was based on the standard pathological criteria of tissue specimens. The other five cases were excluded from this study due to the lack of classical diagnostic criteria. Statistical analysis was performed using the Z-test.
The mean age of the patients at the time of diagnosis was 30.4 years. Seven patients presented with abdominal or pelvic pain (17.07%). In this group three cases underwent laparatomy due to abdominal mass and four patients for tubo-ovarian abscess, which led to the diagnosis. Abnormal uterine bleeding was the cause of diagnostic dilatation and curettage in three other patients (7.31%). However, in 31 cases (75.6%) TB was diagnosed during studies performed to evaluate the cause of their infertility, and the most common diagnostic procedure was endometrial curettage (25 cases). Female genital TB accounted for 1.32% of all tuberculous patients in this study. Of these, 75.6% were infertile by definition (Z=12.13 P<0.0001). TB endometritis was detected in 72.03%, tubal involvement in 34.03%, ovarian TB in 12.9% and cervical TB in 2.4% of the patients.
This study confirms the presence of a strong relationship between genital TB and infertility; therefore genital TB would be more frequently diagnosed if this possibility was considered in the evaluation of every infertile patient in areas where tuberculosis is endemic.
本研究旨在评估女性生殖器结核的诊断率、临床表现症状及诊断方法。
对1989年至1999年在法尔斯省健康中心登记治疗的3088例结核病患者进行回顾性研究。该组中，46名女性被诊断为生殖器结核。41例的诊断基于组织标本的标准病理标准。另外5例因缺乏经典诊断标准而被排除在本研究之外。采用Z检验进行统计分析。
诊断时患者的平均年龄为30.4岁。7例患者出现腹痛或盆腔痛（17.07%）。该组中，3例因腹部肿块接受剖腹手术，4例因输卵管卵巢脓肿接受手术，从而得以确诊。另外3例患者（7.31%）因异常子宫出血而行诊断性刮宫。然而，31例（75.6%）患者在评估不孕原因的检查过程中被诊断为结核病，最常见的诊断方法是子宫内膜刮宫术（25例）。本研究中，女性生殖器结核占所有结核病患者的1.32%。其中，根据定义75.6%的患者不孕（Z=12.13，P<0.0001）。72.03%的患者检测出结核性子宫内膜炎，34.03%的患者输卵管受累，12.9%的患者患有卵巢结核，2.4%的患者患有宫颈结核。
本研究证实生殖器结核与不孕之间存在密切关系；因此，在结核病流行地区，若在评估每例不孕患者时考虑到这种可能性，生殖器结核将更常被诊断出来。
