<p>Correlation of Clinical Features, Laboratory Finding, and Pelvic Ultrasonography of Pulmonary Tuberculosis Women with Infertility</p>

Abstract

Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/UdG0GRk0ZWM Background and purpose: The prevalence of tuberculosis (TB) in Indonesia is still high, whereas the prevalence of extra pulmonary tuberculosis such as female genital tuberculosis (FGTB) affecting infertility is unknown. FGTB caused irreversible severe damaged of tubes and endometrium, resulting in tubal occlusion and partial or total obliteration of the uterine cavity. Diagnosis of FGTB is difficult. Therefore, a prompt diagnosis and treatment of pulmonary TB in women can prevent fertility complications. This study aims to analyze the correlation of clinical features taken from the history, physical examination, investigation of blood laboratory and gynecological ultrasound of pulmonary tuberculosis women with infertility. Patients and methods: This was an observational analytic study with cross-sectional method. Subjects were women with pulmonary TB treated in TB-DOTS (tuberculosisdirectly observed treatment, short-course) services at Dr Hasan Sadikin Hospital Bandung during December 2016 until March 2017. Subjects were divided into two groups consist of 32 TB patients with infertility, and 35 TB patients without infertility. Results: The results showed that clinical features such as intermenstrual bleeding, endometrial synechiae, hydrosalpinx and endometritis appearance were the difference between two groups (p <0.001), those clinical features had a moderate correlation with the incidence of pulmonary tuberculosis women. Conclusion: Clinical features like endometrial synechia and ultrasound imaging such as hydrosalpinx and endometritis encountered in pulmonary and extra pulmonary tuberculosis patients with infertility can be used as a basis for the diagnosis of alleged genital TB.

Evaluation of role of transabdominal and transvaginal ultrasound in diagnosis of female genital tuberculosis

“…Three- and fourth-dimensional scans are even more useful in diagnosis subtle changes of FGTB. [ 18 19 20 ] Although ultrasound is more useful in abdominal tuberculous peritonitis where it can detect tuberculous ascites with incomplete septation, lattice type of ascites (fibrous band in ascitic fluid), loculated ascites, thickened band or adhesion, omental thickening, and peritoneal thickening, it can also be helpful in detection of simple and complex tubo-ovarian masses. [ 21 ] In pelvic TB, it can detect hydrosalpinx as tubal dilatation with septa due to tubal mucosal thickening resembling cogwheel appearance.…”

“…[ 21 ] In pelvic TB, it can detect hydrosalpinx as tubal dilatation with septa due to tubal mucosal thickening resembling cogwheel appearance. [ 18 ] It can also detect unilateral or bilateral pyosalpinx. [ 22 ] Abdominopelvic TB can cause incompletely septated ascites, particulate ascites, loculated ascites, thickened peritoneum or omentum, adnexal masses, adhesions, tubo-ovarian abscess, or complexes.…”

“…[ 15 16 17 ] Ultrasound, especially three dimensional (3D) and four dimensional, is an economical and useful modality in diagnosis of FGTB, particularly in tubo-ovarian masses, and can detect hydrosalpinx which appears as tubal dilatation with septa due to tubal mucosal thickening resembling cogwheel appearance. [ 18 ] Ultrasound also detects endometrial disease as thin, diffuse endometrial images with irregular borders accompanied by fluid accumulation in endometrial cavity. [ 19 20 ] We present the study on 175 cases of FGTB diagnosed on composite reference standard (CRS) (combination of various tests and laparoscopy) and role of ultrasound to detect tubal, ovarian, and endometrial diseases.…”

Comparison of Hysterosalpingography With Laparoscopy in the Diagnosis of Tubal Factor of Female Infertility

“…Considering the low cost and high efficiency of HSG in diagnosing infertility, many scholars recommend HSG as an auxiliary routine outpatient examination in the assessment of infertility (7,18). Hydrosalpinx is the morphological change in the fallopian tube resulting from chronic inflammation stimulation (19,20). Ultrasound and HSG help diagnose hydrosalpinx, but the exploration of hysteroscopy combined with laparoscopy was considered the gold standard for the diagnosis of hydrosalpinx, which could simultaneously inspect the situation of the pelvic cavity (21)(22)(23).…”