Female Genital Tuberculosis
Female Genital Tuberculosisis always a secondary disease. Occurs when the infection is transferred from the primary lesion (lungs) by hematogenous or through the lymphatic vessels from the mesenteric lymph nodes and the peritoneum.
The fallopian tubes are most often affected, less often the endometrium and ovaries, not very often the cervix, vagina and vulva.
There are exudative, productive and caseous forms.
Symptoms and course
Symptoms are not often disguised. The disease is taken for inflammation of the uterine appendages, caused by pyogenic microbes.
In varying degrees, common symptoms are expressed: malaise, weakness, easy fatigue, hypotension, loss of appetite, sweating, low-grade fever.
Menstrual function is impaired: more often there is hypooligomenorrhea, less often acyclic bleeding, amenorrhea or algomenorrhea. As a rule, primary infertility develops. The pain is uncertain.
The diagnosis can be made by carefully collecting anamnesis (including information on contact with tuberculosis patients), an intracutaneous test with tuberculin, the use of a Koch provocative test for tuberculosis with an assessment of a focal reaction, a histological examination of endometrial scraping (detection of tuberculous tubercles), and remote surgery. time of operation tuberculous tubercles on peritoneum of tubes.
An important indication of the likelihood of tuberculosis infection is the exacerbation of chronic inflammation of the appendages under the influence of thermal physiotherapy procedures.
Detect tuberculous mycobacteria in the discharge from the uterus, menstrual blood is very difficult. The X-ray method (hysterosalpingography) can provide additional information, since the rigidity of the tubes, their strictures, obstruction in the ampullary sections, and intrauterine synechia are often found in genital tuberculosis.
Normalization of work and leisure, nutrition, vitamins. If the diagnosis is established for the first time, specific antibacterial therapy is carried out with a continuous course lasting 1-1.5 years, during which a number of products are alternated with simultaneous administration of at least 2.
The treatment is carried out under the supervision of a TB dispensary doctor, then - sanatorium treatment, autumn and spring courses of antibiotic therapy. In adhesions, corticosteroids are sometimes prescribed.
Surgical treatment is indicated only with encysted, long-existing inflammatory formations.
The prognosis for timely and adequate treatment for life is favorable; for menstrual and generative function is unfavorable.