Endometrial Tuberculosis: Hysteroscopic Findings of a Clinical Case

Prado, Daniela Siqueira; Cardoso, Lucas Félix; Júnior, Raimundo Dantas de Maria; Santana, Guilherme Machado de; Marcelo, Israel Santos; Lima, Marcela Sampaio; Silva, Angela Maria

doi:10.1055/s-0039-1692634

Cited by 5 publications

(1 citation statement)

References 14 publications

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“…This is in contrast to most studies where major findings were intrauterine adhesions, shrunken cavities, and normal uterine cavities. (20)(21)(22)(23). The most common site of tubercular Infection is in the fallopian tube; hence, foci of Infection remain in ostia more commonly than the endometrium, which every month shades during menstruation.…”

Section: Discussionmentioning

confidence: 99%

Hysteroscopic and Laparoscopic finding in Infertile Women with proven Endometrial Tuberculosis

Mondal

Jaiswal

Bhave

2023

Preprint

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Background: Currently, none of the diagnostic procedures for detecting female genital tuberculosis (FGTB) are 100 percent reliable, and the same is true for endoscopic results. There are several studies accessible on hysteroscopic and laparoscopic findings that are suggestive of TB. However, no study to our knowledge summarises the findings of laparoscopic and hysteroscopic examination in subfertile female patients with biopsy, culture, or other laboratory test-proven endometrial tuberculosis. Objective: Evaluation of hysteroscopic and laparoscopic findings in subfertile women suffering from proven endometrial tuberculosis. Materials and methods: 16,784 infertile women had a diagnostic hysterolaparoscopy between February 2014 and June 2021, among which 1084 patients were prescribed anti-tubercular medication based on the results of their findings; however, only 309 individuals had endometrial tuberculosis verified via positive on histopathology examination, AFB demonstration, Culture, and GeneXpert MTB/RIF. We retrospectively observed the diagnostic hysterolaparoscopy findings in those proven cases of subfertile women suffering from FGTB. Results: The major findings on hysteroscopy were periosteal fibrosis (209/309,67.63%), pale endometrium(179/309,57.92%), and micro polyp(138/309,44.66%). Other notable hysteroscopic findings were intrauterine adhesions (88/309,28.47%), endometrial tubercle (78/309,25.24%), endometrial polyp(54/309,14.88%), caseation(42/309,13.59%), focal hyperemia(29/309,9.38%) and diffuse hyperemia(18/309,5.82%). The most common finding on laparoscopy was abdominopelvic adhesions of various grades (297/309,96.11%). The major findings of laparoscopy were tubercle (155/309,50.16%), isthmo ampullary block (118/309,38.18%), tubal diverticula (116/309,37.54%), hydrosalpinx (97/309,31.39%) and TO mass (96/309,31.06%). 5.50% (17/300) had a normal appearance on hysteroscopy, and 1.29% (4/309) had a normal-looking pelvis on laparoscopy. Conclusions: In proven endometrial tuberculosis, significant hysteroscopic findings are periosteal fibrosis, pale endometrium, micro-polyp, and intrauterine adhesions, whereas major laparoscopic findings are various grades of abdominal pelvic adhesions, including perihepatic adhesions, miliary tubercle, isthmo ampullary block, tubal diverticula, caseous material, and hydrosalpinx. Tuberculosis should be considered if these signs are discovered during a diagnostic work-up in infertile people.

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Section: Discussionmentioning

confidence: 99%