Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Indian J Med Res. 2017 Apr;145(4):425-436. doi: 10.4103/ijmr.IJMR_1550_15.
The morbidity and mortality due to tuberculosis (TB) is high worldwide, and the burden of disease among women is significant, especially in developing countries. Mycobacterium tuberculosis bacilli reach the genital tract primarily by haematogenous spread and dissemination from foci outside the genitalia with lungs as the common primary focus. Genital TB in females is a chronic disease with low-grade symptoms. The fallopian tubes are affected in almost all cases of genital TB, and along with endometrial involvement, it causes infertility in patients. Many women present with atypical symptoms which mimic other gynaecological conditions. A combination of investigations is needed to establish the diagnosis of female genital TB (FGTB). Multidrug anti-TB treatment is the mainstay of management and surgery may be required in advanced cases. Conception rates are low among infertile women with genital TB even after multidrug therapy for TB, and the risk of complications such as ectopic pregnancy and miscarriage is high. More research is needed on the changing trends in the prevalence and on the appropriate methods for diagnosis of FGTB.
全球范围内,结核病(TB)的发病率和死亡率很高,女性的疾病负担巨大,尤其是在发展中国家。结核分枝杆菌杆菌主要通过血行播散和从生殖器外的病灶传播到达生殖道,肺部是常见的原发性病灶。女性生殖器结核是一种慢性疾病,症状较轻。几乎所有生殖器结核病例都会累及输卵管,同时累及子宫内膜,导致患者不孕。许多女性的症状不典型,类似于其他妇科疾病。需要综合多种检查来确诊女性生殖器结核(FGTB)。多药抗结核治疗是主要治疗方法,在晚期病例可能需要手术。即使经过多药治疗结核病,患有生殖器结核的不孕女性的受孕率仍然较低,并且异位妊娠和流产等并发症的风险较高。需要对 FGTB 的患病率变化趋势以及适当的诊断方法进行更多研究。