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Observational Study
. 2023 Feb-Mar;157(2&3):183-191.
doi: 10.4103/ijmr.ijmr_2498_21.

Laparoscopic evaluation of female genital tuberculosis in infertility: An observational study

Jai Bhagwan Sharma  1 , Surendra Kumar Sharma  2 , Sona Dharmendra  1 , Urvashi B Singh  3 , Sunesh Kumar  1 , Kallol Kumar Roy  1
Affiliations
Observational Study

Laparoscopic evaluation of female genital tuberculosis in infertility: An observational study

Jai Bhagwan Sharma et al. Indian J Med Res. 2023 Feb-Mar.

Abstract

Background & objectives: Female genital tuberculosis (FGTB) is an important variety of extrapulmonary TB causing significant morbidity, especially infertility, in developing countries like India. The aim of this study was to evaluate the laparoscopic findings of the FGTB.

Methods: This was a cross-sectional study on 374 cases of diagnostic laparoscopy performed on FGTB cases with infertility. All patients underwent history taking and clinical examination and endometrial sampling/biopsy for acid-fast bacilli, microscopy, culture, PCR, GeneXpert (only last 167 cases) and histopathological evidence of epithelioid granuloma. Diagnostic laparoscopy was performed in all the cases to evaluate the findings of FGTB.

Results: Mean age, parity, body mass index and duration of infertility were 27.5 yr, 0.29, 22.6 kg/m2 and 3.78 years, respectively. Primary infertility was found in 81 per cent and secondary infertility in 18.18 per cent of cases. Endometrial biopsy was positive for AFB microscopy in 4.8 per cent, culture in 6.4 per cent and epithelioid granuloma in 15.5 per cent. Positive peritoneal biopsy granuloma was seen in 5.88 per cent, PCR in 314 (83.95%) and GeneXpert in 31 (18.56%, out of last 167 cases) cases. Definite findings of FGTB were seen in 164 (43.86%) cases with beaded tubes (12.29%), tubercles (32.88%) and caseous nodules (14.96%). Probable findings of FGTB were seen in 210 (56.14%) cases with pelvic adhesions (23.52%), perihepatic adhesions (47.86%), shaggy areas (11.7%), pelvic adhesions (11.71%), encysted ascites (10.42%) and frozen pelvis in 3.7 per cent of cases.

Interpretation & conclusions: The finding of this study suggests that laparoscopy is a useful modality to diagnose FGTB with a higher pickup rate of cases. Hence it should be included as a part of composite reference standard.

Keywords: Adhesions; beaded tubes; caseous nodules; complications; diagnostic laparoscopy; endometrial sampling; tubercles.

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Conflict of interest statement

Conflicts of Interest: None.

Figures

Figure
Figure
Diagnostic algorithm. FGTB, female genital tuberculosis
See this image and copyright information in PMC

References

    1. World Health Organization. WHO global tuberculosis report 2020. Geneva: WHO; 2020.
    1. Central TB Division, Directorate General of Health Services. India TB. Report: National tuberculosis elimination programme: Status report. New Delhi: Ministry of Health and Family Welfare; 2020.
    1. Yadav S, Singh P, Hemal A, Kumar R. Genital tuberculosis: Current status of diagnosis and management. Transl Androl Urol. 2017;6:222–33. - PMC - PubMed
    1. Parvez R, Sugunan AP, Vijayachari P, Burma SP, Mandal A, Saha MK, et al. Prevalence of female genital tuberculosis, its risk factors and associated clinical features among the women of Andaman Islands, India: A community-based study. Public Health. 2017;148:56–62. - PubMed
    1. Sharma JB, Sharma E, Sharma S, Dharmendra S. Genital tuberculosis revisted. Indian J Med Res. 2018;148(Suppl S1):71–83. - PMC - PubMed

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