Original Research Paper

PROPORTION OF GENITAL TUBERCULOSIS IN CASES OF INFERTILITY, ABNORMAL UTERINE BLEEDING AND PELVIC INFLAMMATORY DISEASE

  Abstract :

Background: Genital TB may cause menstrual irregularities, pelvic pain and infertility. The true incidence of genital TB, however, is unknown as there is usually a paucity of symptoms and varying presentations causing a challenge in its detection Aim and objective: To evaluate the clinical presentations in females for genital tuberculosis. To find out the causes of genital tuberculosis in females. To find out the proportion of genital tuberculosis in cases of infertility.To find out the proportion of genital tuberculosis in cases of abnormal uterine bleeding. To find out the proportion of genital tuberculosis in cases of pelvic inflammatory disease. To calculate the percentage of genital tuberculosis patients who respond to anti tubercular drugs.Material and Methods: The study has been conducted on the 156 women complaining of infertility, symptoms of pelvic pain, menstrual abnormalities, pelvic mass or per vaginal discharge, attending the department of Obstetrics and Gynaecology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh in association of Department of pathology and department of Radiology and microbiology over a period of February 2019 to August 2020. The study was done on 156 patients. Out of which 43 patients were included in group I (Infertility), 62 patients were included in group II (Abnormal uterine bleeding) and 51 patients were included in group III (Pelvic inflammatory disease).Result: In our study genital tuberculosis patients who presented with complain (90%) belonged to age group 18-39 years which was comparable to study by Sharma et JB al (2008)[11] in which age of presentation in 80% of women is 20-40 years. ESR was raised in 66.67% cases. Abnormal HSG was seen in 45% of patients. genital tuberculosis in case of abnormal uterine bleeding is 12.90%.6% of patients of pelvic inflammatory disease were genital tuberculosis positive. The patient were follower up and given full course of anti tubercular drugs for 6 months and response was observed. 1 out of 6 infertility patients in our study conceived after ATT course by assisted reproductive technique amounting to response rate of 16.66%.Conclusion: So the result of our study shows that the incidence of female genital tuberculosis in increasing, so gynaecologist will be increasingly faced with cases of tuberculosis and its consequences. Genital tuberculosis may be asymptomatic or may present with atypical symptoms or mimic other conditions. It is imperative to consider the possibility of tuberculosis in women in reproductive age group who presents with the symptoms of infertility, chronic pelvic pain and menstrual dysfunction, where other causes have been excluded. Failing to consider the possibility of tuberculosis may result in unnecessary and ineffective intervention. To increase the chance of identifying TB bacilli, immunological, bacteriological and nucleic acid amplification tests should be employed.

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