Kesharwani Himanshi, Mohammad Shazia, Pathak Pranav
Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 Sep 2;14(9):e28708. doi: 10.7759/cureus.28708. eCollection 2022 Sep.
Genitourinary tuberculosis (GUTB) is caused by bacilli and is typically secondary to tuberculosis (TB) of the lungs. The spread largely occurs through the haematogenous route. complex infections frequently cause the symptoms by reactivation of previously dormant tuberculous bacilli. Particularly in underdeveloped nations, female genital TB (FGTB) continues to be a key contributor to tubal blockage and infertility. It damages genital organs, which results in abnormal menstruation and infertility. FGTB is a chronic condition that manifests as mild symptoms. Almost all cases of genital TB include the fallopian tubes, which, together with endometrial involvement, render patients infertile. There may be asymptomatic cases. In order to save women from invasive surgery, it is vital to keep in mind the extremely rare but critical role of FGTB in the differential diagnosis of any malignancy. A thorough physical examination, careful history collection, and careful use of tests are done to arrive at a diagnosis. Hysterosalpingography has been recognised as the most accurate method for detecting FGTB and as the gold standard screening test for determining tubal infertility. Recently, there have been numerous improvements and modifications to FGTB management. The primary treatment for TB is a multidrug anti-TB regimen, while surgery may be necessary in more severe cases. Even after receiving multimodal therapy for TB, infertile women with genital TB have low conception rates and a significant risk of complications like ectopic pregnancy and loss.
泌尿生殖系统结核(GUTB)由杆菌引起,通常继发于肺部结核(TB)。其传播主要通过血行途径。复杂感染常因先前潜伏的结核杆菌重新激活而引发症状。特别是在欠发达国家,女性生殖器结核(FGTB)仍然是输卵管阻塞和不孕的主要原因。它会损害生殖器官,导致月经异常和不孕。FGTB是一种表现为轻微症状的慢性疾病。几乎所有生殖器结核病例都累及输卵管,再加上子宫内膜受累,会导致患者不孕。可能存在无症状病例。为了使女性避免接受侵入性手术,必须牢记FGTB在任何恶性肿瘤鉴别诊断中极其罕见但至关重要的作用。通过全面的体格检查、仔细的病史收集以及谨慎地使用检查来做出诊断。子宫输卵管造影已被公认为检测FGTB最准确的方法,也是确定输卵管性不孕的金标准筛查试验。最近,FGTB的管理有了许多改进和调整。结核病的主要治疗方法是多药抗结核方案,而在更严重的情况下可能需要手术。即使接受了针对结核病的多模式治疗,患有生殖器结核的不孕女性受孕率仍然很低,并且有异位妊娠和流产等并发症的重大风险。