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Sharma JB, Dharmendra S, Rapaka G, Singh UB, Kriplani A, Kumar S, Dash NR, Nayyer R. Comparative study on complications and difficulties in laparoscopy in female genital tuberculosis cases versus non-tuberculosis cases. J Minim Access Surg 2024; 20:207-215. [PMID: 37357491 PMCID: PMC11095795 DOI: 10.4103/jmas.jmas_3_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/13/2023] [Accepted: 03/24/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Female genital tuberculosis (FGTB) is an important type of extrapulmonary tuberculosis (TB) associated with morbidity especially infertility in developing countries. Laparoscopy may be difficult and hazardous in FGTB. The aim of the study was to observe the difficulties and complications of laparoscopy in FGTB cases. MATERIALS AND METHODS It was a prospective study over 12 years' period on 412 cases of diagnostic laparoscopy performed on FGTB cases with infertility. All patients underwent history taking and clinical examination and endometrial sampling for acid-fast bacilli (AFB) microscopy, culture, polymerase chain reaction (PCR), gene Xpert (last 212 cases) and histopathological evidence of epithelioid granuloma. Another 412 cases of diagnostic laparoscopy in the absence of FGTB performed during same time were taken as controls from the pool of non-TB cases. Various difficulties and complications were noted in both groups and statistical analysis was done. RESULTS Mean age, parity, body mass index and duration of infertility were 26.8 versus 25.4 years, 0.32 versus 0.28, 23.15 versus 25.28 Kg/m 2 and 4.15 versus 5.12 years, respectively. Primary and secondary infertility was seen in 78.6% and 20.38% of cases in the study group and 74.75% and 25.24% in the control group, respectively. Endometrial biopsy showed AFB microscopy in 5.3%, culture in 6.3%, epithelioid granuloma in 15.77% and on peritoneal biopsy granuloma in 6.55%, positive PCR in 368 (89.32%) and positive gene Xpert in 38 out of 212 (17.92%, out of last 212 cases). Definite findings of FGTB were seen in 171 (41.50%) cases. Probable findings of FGTB were seen in 241 (58.49%) cases. Various complications were difficulty in the creation of pneumoperitoneum or insertion of trocar and cannula in 16.74% and 13.10% of cases as compared to 1.94% and 1.69% in the control group. Excessive bleeding was seen in 5.09% versus 0.97% cases, respectively. Various injuries observed were bowel injury in 1.69% versus 0.24% cases (small bowel in 1.21% vs. 0.24%, large bowel in 0.48% vs. 0.1%), while bladder injury was seen in 0.97% versus 0.24% cases, subacute intestinal obstruction was seen in 5.8% versus 0.72% cases respectively while flare up of TB was seen in 5.09% versus 0% in cases and controls, respectively. Wound infection was seen in 8.48% versus 1.25% cases, respectively. INTERPRETATION AND CONCLUSION FGTB is associated with increased complications and difficulties as compared to laparoscopy in other cases.
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Affiliation(s)
| | - Sona Dharmendra
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Gawri Rapaka
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | | | - Alka Kriplani
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Sunesh Kumar
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - N. R. Dash
- Department of GI Surgery, AIIMS, New Delhi, India
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Saha A, Singh N, Kashyap D, Kulshrestha A, Sarkar A, Sharma JB, Roy KK. "TB - Mindedness"-the only way to beat "the great mimicker": A case series with atypical presentation of female genital tuberculosis. Indian J Tuberc 2024; 71:179-184. [PMID: 38589122 DOI: 10.1016/j.ijtb.2023.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/28/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND Incidence of Tuberculosis (TB) cases in India reported in 2019 is 193 per 1 lakh population [National Tuberculosis Elimination Plan (NTEP)]. In India, annual extra pulmonary TB burden is 20-25%, of which 4% of cases are of urogenital origin (Revised National TB Control Programme, 2019; World Health Organization, 2019). The Ministry of Health and Family Welfare has made a target of eliminating tuberculosis by 2025 under the NTEP by the process of identification, notification and treatment of cases. Tuberculosis being a leading cause of infertility in developing countries, employing best clinical practices and being "TB-minded" will also save the patient of enormous anxiety and uncertainity and also decrease the time gap between clinical presentation and diagnosis to optimize fertility outcome. METHODOLOGY A prospective cohort study of cases presenting with unusual findings and ultimately being diagnosed as genital tuberculosis was conducted in the gynaecology OPD, AIIMS, New Delhi, from November 2020 to November 2021 (1 year). Patients were investigated judiciously, diagnosis made and followed up for their response to anti tuberculosis therapy (ATT). RESULTS This data comprises of conglomerate of ten cases with unconventional exhibition of genital tuberculosis. 70% of the cases presented with pain lower abdomen not specifically related to menstrual cycle and often confused with IBD. Tubo ovarian mass (70%) mimicking as simple ovarian cyst, ovarian carcinoma or endometriosis was the most common clinical finding we came across.
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Affiliation(s)
- Ashmita Saha
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Nilanchali Singh
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
| | - Deepika Kashyap
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Anshul Kulshrestha
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Avir Sarkar
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Jai B Sharma
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Kallol Kumar Roy
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
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Siferih M, Gebre T, Hunduma F, Abebe A, Gebremichael A, Sewunet H, Shibabaw T. Review of Asherman syndrome and its hysteroscopic treatment outcomes: experience in a low-resource setting. BMC Womens Health 2024; 24:99. [PMID: 38326846 PMCID: PMC10848492 DOI: 10.1186/s12905-024-02944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 02/01/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Asherman syndrome is one of the endometrial factors that influence a woman's reproductive capacity. However, in our context, it needs to be well-documented. This study aimed to evaluate the clinical characteristics and hysteroscopic treatment outcomes of Asherman syndrome. METHOD A retrospective follow-up study from January 1, 2019, to December 31, 2022, was conducted on cases of Asherman syndrome after hysteroscopic adhesiolysis at St.Paul's Hospital in Addis Ababa, Ethiopia. Clinical data were collected via telephone survey and checklist. Epidata-4.2 and SPSS-26 were employed for data entry and analysis, respectively. RESULT A total of 177 study participants were included in the final analysis. The mean patient age was 31 years (range: 21-39) at the initial presentation, and 32.3 years (range: 22-40) during the phone interview. The majority of the patients (97.7%) had infertility, followed by menstrual abnormalities (73.5%). Among them, nearly half (47.5%) had severe, 38.4% had moderate, and 14.1% had mild Asherman syndrome. The review identified no factor for 51.4% of the participants. Endometrial tuberculosis affected 42 patients (23.7%). It was also the most frequent factor in both moderate and severe cases of Asherman syndrome. Only 14.7% of patients reported menstrual correction. Overall, 11% of women conceived. Nine patients miscarried, three delivered viable babies, and six were still pregnant. The overall rate of adhesion reformation was 36.2%. Four individuals had complications (3 uterine perforations and one fluid overload) making a complication rate of 2.3%. CONCLUSION Our study revealed that severe forms of Asherman syndrome, which are marked by amenorrhea and infertility, were more common, leading to incredibly low rates of conception and the resumption of regular menstruation, as well as high recurrence rates. A high index of suspicion for Asherman syndrome, quick and sensitive diagnostic testing, and the development of a special algorithm to identify endometrial tuberculosis are therefore essential. Future multi-centered studies should focus on adhesion preventive techniques.
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Affiliation(s)
- Melkamu Siferih
- Department of Obstetrics and Gynecology, School of Medicine, Debremarkos University, Debremarkos, Ethiopia.
| | - Thomas Gebre
- Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Fufa Hunduma
- Field Epidemiology, Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Abraham Abebe
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Akebom Gebremichael
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Habtamu Sewunet
- Department of Midwifery, Debremarkos Comprehensive Specialized Hospital, Debremarkos, Ethiopia
| | - Tewodros Shibabaw
- School of Medicine, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
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Sharma JB. JB Sharma's white cotton ball sign: A new laparoscopic sign in abdominopelvic tuberculosis. J Minim Access Surg 2024; 20:24-29. [PMID: 36695245 PMCID: PMC10898634 DOI: 10.4103/jmas.jmas_227_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/31/2022] [Accepted: 12/02/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Abdominopelvic tuberculosis (TB) is a variant of extrapulmonary TB causing significant morbidity, including infertility. MATERIALS AND METHODS Results of 87 cases of diagnostic laparoscopy in cases of abdominopelvic TB diagnosed on composite reference standard (CRS) for demonstration of new laparoscopic white cotton ball sign are presented. RESULTS Mean age, parity and duration of infertility were 27.2 years, 0.21 and 3.1 years, respectively. Oligomenorrhoea and hypomenorrhea were seen in 35 (40.22%) and 32 (36.78%) cases, while infertility was seen in all 87 (100%) cases while abdominal mass was seen in 27 (31.03%) cases and pelvic mass in 37 (42.58%) cases. Positive acid fast bacilli on microscopy and culture of endometrial biopsy was seen in 3.34% and 6.89% cases while epithelioid granuloma was seen in 12.64% cases on endometrial biopsy and in 13.79% cases on peritoneal biopsy. Positive polymerase chain reaction was seen in all cases while definitive abdominal pelvic TB was seen in 35 (40.1%) cases and probable findings in 42 (48.27%) cases. A new laparoscopic white cotton ball sign (resembling a large white cotton ball) was observed in 5 (5.74%) cases and biopsy from 3 showed it to be epithelioid granulomas positive. CONCLUSION Demonstration of a new white cotton ball sign on laparoscopy seems to be a useful finding in abdominal pelvic TB.
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Affiliation(s)
- Jai Bhagwan Sharma
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
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Mondal R, Jaiswal N, Bhave P, Mandal P. Laparoscopic and hysteroscopic findings in women with sub-fertility and tuberculosis: A case series. BJOG 2023. [PMID: 37973605 DOI: 10.1111/1471-0528.17701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 10/07/2023] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Evaluation of hysteroscopic and laparoscopic findings in subfertile women predictive of tuberculosis. DESIGN Retrospective case series analysis. SETTING Tertiary hospital in India. POPULATION A retrospective analysis of 16 784 subfertile women who had undergone diagnostic hysterolaparoscopy (DHL) was conducted between February 2014 and June 2021. METHODS Histopathological evidence, acid-fast bacilli (AFB), culture and GeneXpert MTB/RIF assay were used to diagnose female genital tuberculosis (FGTB). Various hysteroscopic and laparoscopic findings were analysed, and a binary logistic regression assessed associations between these findings and positive diagnostic outcomes. MAIN OUTCOME MEASURES Various hysteroscopic and laparoscopic findings correspond to tubercular manifestation. RESULTS Of the 16,784 patients, 1083 had hysteroscopy and laparoscopy findings suggestive of tuberculosis, and 309 were diagnosed with FGTB based on diagnostic tests. Logistic regression identified variables strongly predictive of positive status outcomes; tuberculous abdomino-pelvic adhesions of various grades, isthmo-ampullary block, tubercle, tubo-ovarian mass, tuberculous hydrosalpinx, complete tubal destruction, tubal diverticula and rigid tube emerged as strong predictors. CONCLUSIONS Logistic regression-derived predictors, alongside specific laparoscopic and hysteroscopic findings, can enhance diagnostic accuracy and clinical decision-making to start antitubercular therapy in subfertile women.
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Affiliation(s)
- Rana Mondal
- Department of Reproductive Medicine, Bansal Hospital, Bhopal, India
| | - Neha Jaiswal
- Department of Reproductive Medicine, Bansal Hospital, Bhopal, India
| | - Priya Bhave
- Department of Reproductive Medicine, Bansal Hospital, Bhopal, India
| | - Priyadarshi Mandal
- Department of Obstetrics and Gynaecology, NRS Medical College and Hospital, Kolkata, India
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Boitor-Borza D, Muresan D. Abdominopelvic tuberculosis in a nonsexually active young woman. Am J Obstet Gynecol 2023; 229:558-560. [PMID: 37148958 DOI: 10.1016/j.ajog.2023.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/31/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Dan Boitor-Borza
- Department of Obstetrics and Gynecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; 1st Department of Obstetrics and Gynecology, Emergency County Hospital Cluj, Cluj-Napoca, Romania
| | - Daniel Muresan
- Department of Obstetrics and Gynecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; 1st Department of Obstetrics and Gynecology, Emergency County Hospital Cluj, Cluj-Napoca, Romania.
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Flores-Lovon K, Soriano-Moreno DR, Medina-Ramirez SA, Fernandez-Guzman D, Caira-Chuquineyra B, Fernandez-Morales J, Tuco KG, Turpo-Prieto J, Alave J, Goicochea-Lugo S. Effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis: a systematic review. BMJ Open 2023; 13:e070456. [PMID: 37758670 PMCID: PMC10537868 DOI: 10.1136/bmjopen-2022-070456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVES To evaluate the efficacy of antituberculosis therapy on pregnancy outcomes in infertile women with genital tuberculosis. DESIGN Systematic review. DATA SOURCES We searched in PubMed/MEDLINE, CENTRAL and EMBASE up to 15 January 2023. Additionally, we manually search the reference lists of included studies. ELIGIBILITY CRITERIA We included randomised controlled trials (RCT), non-RCTs (non-RCT) and cohort studies that evaluated the effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis compared with not receiving antituberculosis treatment or receiving the treatment for a shorter period. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data. We used Cochrane Risk of Bias 1.0 and Risk Of Bias In Non-randomised Studies tools for risk of bias assessment and meta-analysis was not performed. We used Grading of Recommendations, Assessment, Development and Evaluations approach to assess the certainty of the evidence. RESULTS Two RCTs and one non-RCT were included. The antituberculosis regimens were based on isoniazid, rifampicin, pyrazinamide and ethambutol for 6-12 months. In women without structural damage, very low certainty of evidence from one RCT showed that the antituberculosis treatment may have little to no effect on pregnancy, full-term pregnancy, abortion or intrauterine death and ectopic pregnancy, but the evidence is very uncertain. In women with structural damage, very low certainty of evidence from one non-RCT showed that the antituberculosis treatment may reduce the pregnancy rate (297 fewer per 1000, 95% CI -416 to -101), but the evidence is very uncertain. In addition, very low certainty of evidence from one RCT compared a 9-month vs 6-month antituberculosis treatment regimen showed similar effects between the schemes, but the evidence is very uncertain. Two RCTs reported that no adverse events of antituberculosis treatment were noted or were similar in both groups. CONCLUSION The effect of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis is very uncertain. PROSPERO REGISTRATION NUMBER CRD42022273145.
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Affiliation(s)
- Kevin Flores-Lovon
- Medicina, Universidad Nacional de San Agustin de Arequipa, Arequipa, Peru
| | | | | | | | | | | | | | - John Turpo-Prieto
- Medicina, Universidad Nacional de San Agustin de Arequipa, Arequipa, Peru
| | - Jorge Alave
- Medicina, Universidad Peruana Unión, Lima, Peru
| | - Sergio Goicochea-Lugo
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
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Sharma JB, Sharma S, Sharma E, Dharmendra S, Singh S. Immune disturbances in female genital tuberculosis and latent genital tuberculosis. Am J Reprod Immunol 2023; 89:e13632. [PMID: 36494901 DOI: 10.1111/aji.13632] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 09/07/2022] [Accepted: 10/03/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Female genital tuberculosis (FGTB), an important clinical sub-type of extra-pulmonary tuberculosis (EPTB) is responsible for about 10% cases of infertility in India. Both FGTB and latent genital tuberculosis (LGTB) can cause infertility through blockage of fallopian tubes and through altered uterine endometrial receptivity. AIMS This review tries to elucidates the role of various immune factors in FGTB and LGTB. CONTENT Various immune disturbances are observed in FGTB and LGTB like growth factors and cytokines which inhibit implantation and several inflammatory signaling pathways like mitogen activated protein kinase (MAPK), natural killer (NK) cells, nuclear factor kappa-B (NF-KB), tumor necrosis factor (TNF), and toll like receptors (TLR) signaling are dysregulated. These altered immune factors and pathways may be detected in the endometrial biopsies at the early stages of disease before permanent damage. Prompt and adequate treatment with the four anti-tubercular drugs (rifampicin [R], isoniazid [H], pyrazinamide [Z], and ethambutol [E]) can increase pregnancy rates in some of these women. Assisted reproduction especially in-vitro fertilization and embryo transfer may be required for some women. IMPLICATIONS Inflammatory pathways identified from the gene profiling have enabled development of potential biomarkers for early diagnosis of FGTB. Immunomodulation and novel biotechniques like stem cell transplantation, nanoparticles and host directed therapies are being tried in selected patients of FGTB and LGTB with promising results.
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Affiliation(s)
- Jai Bhagwan Sharma
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Sangeeta Sharma
- Department of Paediatrics, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Eshani Sharma
- Department of Medicine, KU School of Medicine, Wichita, Kansas, USA
| | - Sona Dharmendra
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Sheena Singh
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
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Kesharwani H, Mohammad S, Pathak P. Tuberculosis in the Female Genital Tract. Cureus 2022; 14:e28708. [PMID: 36204039 PMCID: PMC9527183 DOI: 10.7759/cureus.28708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/02/2022] [Indexed: 11/05/2022] Open
Abstract
Genitourinary tuberculosis (GUTB) is caused by Mycobacteria tuberculosis bacilli and is typically secondary to tuberculosis (TB) of the lungs. The spread largely occurs through the haematogenous route. Mycobacterium tuberculosis 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.
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Dahiya B, Kamra E, Alam D, Chauhan M, Mehta PK. Insight into diagnosis of female genital tuberculosis. Expert Rev Mol Diagn 2021; 22:625-642. [PMID: 34882522 DOI: 10.1080/14737159.2022.2016395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Female genital tuberculosis (TB) is a common manifestation of extrapulmonary TB (EPTB) with varied clinical presentations, i.e. infertility, pelvic pain and menstrual irregularities. Diagnosis of female genital TB is challenging predominantly due to paucibacillary nature of specimens and inconclusive results obtained by most of the routine laboratory tests. AREAS COVERED This review has briefly summarized the epidemiology, clinical features and transmission of female genital TB. Commonly used laboratory tests include bacteriological examination (smear/culture), tuberculin skin testing, interferon-γ release assays, imaging, laparoscopy/hysteroscopy and histopathological/cytological observations. Further, utility of nucleic acid amplification tests (NAATs), like loop-mediated isothermal amplification, PCR, multiplex-PCR, nested PCR, real-time PCR and GeneXpert® could significantly improve the detection of female genital TB. EXPERT OPINION Currently, there is no single test available for the efficient diagnosis of female genital TB, rather a combination of tests is being employed, which yields moderate diagnostic accuracy. The latest modalities developed for diagnosing pulmonary TB and other clinical EPTB forms, i.e. aptamer-linked immobilized sorbent assay, immuno-PCR (I-PCR), analysis of circulating cell-free DNA by NAATs, and identification of Mycobacterium tuberculosis biomarkers within extracellular vesicles of bodily fluids by I-PCR/nanoparticle-based I-PCR, may also be exploited to further improve the diagnosis of female genital TB.
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Affiliation(s)
- Bhawna Dahiya
- Centre for Biotechnology, Maharshi Dayanand University, Rohtak-124001, Haryana, India
| | - Ekta Kamra
- Centre for Biotechnology, Maharshi Dayanand University, Rohtak-124001, Haryana, India
| | - Danish Alam
- Centre for Biotechnology, Maharshi Dayanand University, Rohtak-124001, Haryana, India
| | - Meenakshi Chauhan
- Dept. of Obstetrics and Gynecology, Pt. B.D. Sharma University of Health Sciences, Rohtak-124001, Haryana, India
| | - Promod K Mehta
- Centre for Biotechnology, Maharshi Dayanand University, Rohtak-124001, Haryana, India
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Garg V, Sahoo A, Saxena V. A cognitive approach to endometrial tuberculosis identification using hierarchical deep fusion method. Soft comput 2021. [DOI: 10.1007/s00500-021-06474-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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