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Endometrial tuberculosis


Prevalence of endometrial tuberculosis in women has been found an absolute cause for female infertility. It has been estimated that approximately, eight to ten million women are affected by this condition.

Female with endometrial or genital tuberculosis may have no history of pulmonary tuberculosis. In most of the cases, the condition is often unrecognised because this tuberculosis is asymptomatic; and it is not discovered until the patient undergoes medical test for infertility.


Infertility is a condition in which a woman is unable to become pregnant. There are many causes and factors of female infertility including endometrial tuberculosis affecting ample of women. In such cases affected woman fallopian tubes (tube which carries ovum to uterus) is also  damaged due to infection.

Symptoms of endometrial tuberculosis:
Endometrial tuberculosis is usually a silent infection with no apparent symptoms as bacteria remains latent for long period. However, Many patient with endometrial TB present with,

  • Irregular Vaginal Bleeding:
    • Women may have disturbed normal cycle and may have Unusual or irregular vaginal bleeding. Few may complain of remarkably long or heavy menstrual periods while other patient may suffer from absence of normal menstrual period called amenorrhea.  
  • Unusual Vaginal Discharge:
    • Excessive vaginal discharge can be found in women suffering from latent endometrial infection.  Appearance or consistency of vaginal discharge may also change due to vaginal infection.
  • Pelvic pain:
    • Women with endometrial tuberculosis may experience mild to severe pelvic pain.

Diagnosis of endometrial tuberculosis
Diagnosis of endometrial tuberculosis is dependent on several factors such as clinical history and physical examination, epidemiological context and result of special investigations such as

  • HSG or Hysterosalpingography- it is a radiologic assessment of the endometrium, perform to know the shape of the uterine cavity as well to check the patency of the fallopian tubes.
  • Culture of Tubercle bacillus-Tissue obtained from the endometrium is tested in laboratory to detect the presence of M.tuberculie
  • Biopsy of the endometrial tissues-Histo-pathological examination of endometrial tissue of the suspected patient is done in laboratory to reveal the presence of tubercular infection.
  • PCR (polymerase chain reaction)-This test is commonly employed for the diagnosis of tuberculosis.PCR is a technique   to amplify   DNA sequence. PCR on endometrial tissue is done under ideal laboratory conditions and the presence of DNA sequences unique to the tubercle bacillus, would help to make a diagnosis of TB infection.
  • PAMP (Pathogen Associated Molecular Pattern)-One of the popular tests for detecting endometrial tuberculosis uses 'reproductive molecular immunology' techniques for PAMP (pathogen-associated molecular pattern) for immunopathological evaluation. Pamp has been proven to very reliable in diagnosis of tuberculosis.


Treatment

Medications.

Medications (antibiotics) are available for   tuberculosis treatment. But it takes much longer to treat TB than treating other types of bacterial infections. Recommended duration for antibiotic dose is six months. The drugs and length of treatment depend on one’s age, overall health, and possible drug resistance. One of well-known drugs is AKT3 is often being prescribed by doctors.

Tuberculosis of the endometrium is usually associated with infertility. Once a woman is diagnosed with endometrial tuberculosis, infertility is certainly to be experienced. However, with proper and early diagnosis and treatment, cure of the disease is possible and fertility of female can be preserved. Unassisted conceptions are unlikely to occur; In vitro fertilization and embryo transfer offer the only realistic treatment for tuberculosis infertility.



author of article: Simab Shahin
References:

 

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