EVALUATION OF ENDOMETRIAL TUBERCULOSIS BY ENDOMETRIAL BIOPSY AT OUR TERITIARY CARE CENTRE
DOI:
https://doi.org/10.61841/8sq1wc89Keywords:
genital tuberculosis, acid fast bacilli, endometrial tuberculosis,, chest X ray,, ultrasonography,, infertility.Abstract
Background: Tuberculosis (TB) is one of the most frequent communicable endemic diseases in poorer areas of the world and remains a major cause of morbidity and mortality across the globe despite of availability of effective anti-tubercular medications. The incidence of female genital tuberculosis (FGTB) is higher in developing countries; the disease usually affects fallopian tubes, uterine endometrium, ovaries, cervix, uterine myometrium and vagina/vulva. Genital TB causes infertility, menstrual irregularity and pregnancy loss in women. It is thus well recognized as an important etiological cause for infertility in areas with high prevalence of tuberculosis. Objectives of the study: To study the prevalence of endometrial tuberculosis among the infertility subjects undergoing endometrial biopsy. Materials and Methods: Demographic data regarding age, menstrual pattern, type of infertility, past-history of TB in any part of the body or history of TB contact. All the subjects were evaluated for GTB by CXR, USG, Culture AFB, Biopsy, and histopathological examination. Results: We performed various investigations which include CXR, USG and CS for AFB, we found that all the subjects had normal CXR, 158 had tubo-ovarian mass on USG, and culture for AFB was positive in 32 subjects. We further evaluated endometrial involvement in 110 infertility subjects we found that tubercular endometritis was found in 13 subjects accounting for 11.8 % prevalence, 9 women had endometrial hyperplasia, 16 had nonspecific endometritis, 34 had proliferative epithelium, and 38 had secretary epithelium. Discussion and Conclusion: In our study, we found the prevalence of 11.8% endometrial tuberculosis in subjects suffering from infertility. Female genital tuberculosis is an underestimated disease mainly due to its asymptomatic nature and lack of sensitive tests. It is detected most frequently when a woman presents to with unexplained infertility. Therefore, screening for genital TB should be routinely done for the evaluation of infertility.
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