Genital tuberculosis in female; major cause of infertility

Genital Tuberculosis

शब्द एक्स्प्रेस संवाददाता
बिहिबार १० चैत, २०७८
२ वर्षअघि
genital tb

Tuberculosis (TB) is a major public health problem worldwide despite a declining trend in mortality, with effective diagnosis and treatment.

About 60 percent of TB cases and deaths occur among males, but the disease burden is high among women also. Genital TB in females is well recognized as an important aetiological factor for infertility in countries with a high prevalence of TB.

Genitourinary TB is a common form of extrapulmonary TB (EPTB) worldwide (27%) with genital TB alone accounting for 9 percent of all EPTB cases. However, the burden of genital TB in females is underestimated as most of the patients are asymptomatic and usually diagnosed during evaluation for infertility.

Genital TB is mostly secondary to pulmonary TB or extrapulmonary foci such as kidneys, meninges, skeletal system, and gastrointestinal system. TB bacilli infect the genital tract by four routes – hematogenous route (with lungs as the common primary focus), descending direct spread, lymphatic spread, and rarely as primary infection of the genitalia through sexual transmission.

Tuberculosis affects the female genital organs, especially the fallopian tubes, and thereby causes infertility. The genital organs affected by Mycobacterium tuberculosis (in descending order of frequency) are as follows: fallopian tubes (95-100%), uterine endometrium (50-60%), ovaries (20-30%), cervix (5-15%), uterine myometrium (2.5%) and vagina/vulva (1%).

It can occur in any age group, but women in the reproductive age group (15-45 years) are the most affected. In most cases, the disease is asymptomatic or can present with a few symptoms among which infertility is the most common.

Menstrual irregularities such as oligomenorrhoea, hypomenorrhea, amenorrhoea, menorrhagia, dysmenorrhoea, metrorrhagia, pelvic pain, and abnormal vaginal discharge are the other symptoms reported to it. In postmenopausal women, genital TB presents with symptoms resembling endometrial malignancy, such as postmenopausal bleeding, persistent leucorrhoea, and pyometra.

Genital TB can mimic or coexist with other gynecological and abdominal pathologies such as genital carcinomas, acute appendicitis, ovarian cysts, PID, or ectopic pregnancy. Genital TB is a major cause of infertility in women, and prevalence is generally underestimated because of the asymptomatic nature of the infection and diagnostic challenges.

Clinicians need to be aware of this important cause of infertility and menstrual dysfunction in women. Screening for genital TB needs to be a part of an evaluation of infertility and menstrual abnormalities. Early diagnosis and correct treatment are vital to avoid complications and restore fertility.

प्रकाशित समय: बिहिबार १० चैत, २०७८, २१:३१:३५
गोठगाउँमा शिवरात्री मेला हुने
सोमबार २१ फाल्गुण, २०८०
विराटनगरमा तेस्रो संस्करणको इक्वालिटी कप क्रिकेट हुँदै
सोमबार २१ फाल्गुण, २०८०
सेवामा प्रवेश गरेको १८ वर्ष पुगेकै दिन झुन्डिएको अवस्थामा भेटिए डिएसपी बस्याल
सोमबार २१ फाल्गुण, २०८०
कानेपोखरीमा कार्यालय सहयोगी बन्न लिखित परीक्षा पास गर्नुपर्ने !
सोमबार २१ फाल्गुण, २०८०
कोही नभएको मौका पारी कामदारलाई बलात्कार, एक हप्तापछि पक्राउ परे होटल सञ्चालक
सोमबार २१ फाल्गुण, २०८०
टिपर आतंक : खोटाङमा टिपरले लियो मोटरसाइकल चालकको ज्यान
सोमबार २१ फाल्गुण, २०८०
हेरिटेज इन्टरनेसनल स्कुलमा बाल क्लब गठन
आईतबार २० फाल्गुण, २०८०
त्रिकोणात्मक सिरिजको उपाधिका लागि नेपाल र नेदरल्यान्ड्स भिड्ने
आईतबार २० फाल्गुण, २०८०
प्रदेशस्तरीय हाजिरी जवाफमा उत्कृष्ट शिक्षादीपका विद्यार्थी सम्मानित
आईतबार २० फाल्गुण, २०८०
अब बिहेको निमन्त्रणा कार्डमा बेहुला-बेहुलीकै जन्ममिति राख्नुपर्ने
आईतबार २० फाल्गुण, २०८०
अस्पताल बसेरै बित्यो डाक्टरको कारागारको समय !
शुक्रबार ५ माघ, २०८०
‘बुढेशकाल’ मा जन्मिएका जुम्ल्याहा सन्तान अस्ताए, आफू पनि ६ घण्टा मार्वल स्टोनले थिचिए
शुक्रबार ११ फाल्गुण, २०८०
कानेपोखरी : अनुमतिबिना ढोका खोलेको भन्दै अध्यक्षले गरिन् कार्यालय सहयोगीलाई निलम्बन
बुधबार १७ माघ, २०८०
मोटरसाइकल दुर्घटनामा कर्मचारीको मृत्यु, विराटनगरमा बिहीबार बिदा
बुधबार २४ माघ, २०८०
स्वास्थ्य मन्त्रालयले माग्यो करारमा कर्मचारी
बुधबार २४ माघ, २०८०
चार सय करोडको लगानीमा विराट क्यान्सर इन्स्टिच्युट सञ्चालनमा
आईतबार २१ माघ, २०८०
बुबाको मृत्युपछि आमाको गर्जो धान्दै थिइन् सम्झना, सडक दुर्घटनामा गयो उनकै ज्यान
बिहिबार १७ फाल्गुण, २०८०
तीव्र गतिको मोटरसाइकल दुर्घटनामा बिते रामधुनीका करण
बुधबार १६ फाल्गुण, २०८०
विराटनगरका दुई युवती, जो लागुऔषधसहित समातिए
मङ्गलबार १६ माघ, २०८०
इटहरीमा हात्तीले मोटरसाइकल लछारपछार पार्दा एक जना घाइते
बिहिबार १८ माघ, २०८०