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女性生殖器结核与子宫内膜异位症并存。

Concomitant female genital tuberculosis and endometriosis.

作者信息

Sharma Jai Bhagwan, Goyal Manu, Kumar Sunesh, Roy Kallol Kumar, Sharma Eshani, Arora Raksha

机构信息

Professor, Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

Senior Resident, Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

出版信息

Indian J Tuberc. 2017 Jul;64(3):173-177. doi: 10.1016/j.ijtb.2017.01.006. Epub 2017 Feb 22.

Abstract

AIMS

To demonstrate an association between female genital tuberculosis (FGTB) and endometriosis.

METHODS

A total of 16 women who underwent laparoscopy (12 cases) or laparotomy (4 cases) and were found to have female genital tuberculosis and endometriosis were enrolled in this retrospective study.

RESULTS

The mean age and parity were 28.2 years and 0.2, respectively. Past history of tuberculosis was present in 75% of the women (pulmonary in 50%). Menstrual dysfunction (especially oligomenorrhoea and dysmenorrhoea), constitutional symptoms, infertility, abdominal pain and lump were the main complaints. Diagnosis of FGTB was made by positive acid-fast bacilli (AFB) on microscopy, culture of endometrial aspirate, positive polymerase chain reaction (PCR), histopathological finding of epitheliod granuloma or findings of TB on laparoscopy or laparotomy. Diagnosis of endometriosis was made by laparoscopy or laparotomy. Pelvic adhesions were seen in all women, whereas frozen pelvis was seen in 7 (43.7%) women. Surgery was performed, which was laparoscopic adhesiolysis in 12 (75%), drainage of endometrioma in 12 (75%), cystectomy in 8 (50%), and total abdominal hysterectomy with bilateral salpingo-oophorectomy in 4 (25%) cases. With more then one type of (surgery in many cases).

DISCUSSION

Female genital tuberculosis and endometriosis may have similar manifestations and can co-exist.

摘要

目的

证实女性生殖器结核(FGTB)与子宫内膜异位症之间的关联。

方法

本回顾性研究纳入了16例接受腹腔镜检查(12例)或剖腹手术(4例)且被发现患有女性生殖器结核和子宫内膜异位症的女性。

结果

平均年龄和产次分别为28.2岁和0.2。75%的女性有结核病史(50%为肺结核)。月经功能障碍(尤其是月经过少和痛经)、全身症状、不孕、腹痛和肿块是主要症状。通过显微镜下抗酸杆菌(AFB)阳性、子宫内膜抽吸物培养、聚合酶链反应(PCR)阳性、上皮样肉芽肿的组织病理学发现或腹腔镜检查或剖腹手术时的结核表现来诊断FGTB。通过腹腔镜检查或剖腹手术诊断子宫内膜异位症。所有女性均可见盆腔粘连,7例(43.7%)女性可见冰冻骨盆。进行了手术,其中12例(75%)为腹腔镜粘连松解术,12例(75%)为子宫内膜瘤引流术,8例(50%)为囊肿切除术,4例(25%)为全腹子宫切除术加双侧输卵管卵巢切除术。(许多情况下有不止一种手术方式)

讨论

女性生殖器结核和子宫内膜异位症可能有相似的表现且可同时存在。

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