Six months versus nine months anti-tuberculous therapy for female genital tuberculosis: a randomized controlled trial

Sharma, Jai Bhagwan; Singh, Neeta; Dharmendra, Sona; Singh, Urvashi; Vanamail, Perumal; Kumar, Sunesh; Roy, Kallol Kumar; Hari, Smriti; Iyer, Venkateswaran K.; Sharma, Sandeep

doi:10.1016/j.ejogrb.2016.05.035

Cited by 30 publications

(26 citation statements)

References 21 publications

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“…It possibly reduced the diagnostic rate of FGTB in those presenting with simple performance of TBP, and not bene cial for accurate assessment of healing of FGTB lesions. Furthermore, AFB on polymerase chain reaction, bene cial for early diagnosis and e cacy assessment of FGTB treatment especially when typical TB granulomas was found in endometrium [12,16,20], was not taken in the study for our lacking of equipments in the speci c period.…”

Section: Discussionmentioning

confidence: 99%

“…However, the duration of managing FGTB or abdominal TB continues to be controversial especially when the intermittent or shorter-course regimen, showing a high risk of treatment failure and disease relapse [7][8][9][10], is no more advocated by World Health Organization (2017 update guidelines for treatment of DS-TB) [6]. Despite 6-month ATT showing objective e cacy for managing FGTB or abdominal TB in some randomized controlled trials excluding older patients or patients with comorbidity of other types of TB [11,12], there is lack of data especially real-world data supporting its e cacy. It brings a new debate, how to make a simpli ed, optimized strategy of ATT, for managing FGTB in patients at different age categories especially those with comorbidity of other types of TB and/or immune-de cient diseases.…”

Section: Introductionmentioning

confidence: 99%

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Optimized duration of antituberculosis treatment for managing female genital tuberculosis: real-world experience from a high prevalence region in Eastern China

Sun

Wang

Ding

et al. 2020

Preprint

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Background Duration of antituberculosis therapy (ATT) for managing female genital tuberculosis (FGTB) is controversial with the intermittent regimen no more advocated. We therefore conducted a prospective, real-world research to compare 6 months and 9 months of ATT.Methods Between 2012 and 2018, 109 drug-susceptible patients newly diagnosed with FGTB and/or tuberculous peritonitis (genital, 13; peritoneal, 34; mixed, 62) received naïve treatment for 9-12 months and further 18-month follow-up. Data on disease features at baseline and long-term outcome (intent-to-treat) were compared between group A (aged 18-35 yr) and group B (aged 36-81 yr). Efficacy and side effects of treatment were compared within each group 6 months and 9 months from ATT initiation (per-protocol), respectively. Results In contrast to group B at baseline, group A had more clinical evidence predicting active tuberculosis (P < 0.05), severer performance of genital lesions and pelvic adhensions (P < 0.05), more signs of active pulmonary tuberculosis (P < 0.01), and less performance of only TBP (P < 0.01). Intent-to-treat analysis showed higher incidence of overall single side effects and poor compliance in group B (P < 0.05), and similar recurrence rate between 2 groups. Per-protocol analysis showed increased complete response rate (P < 0.01) and similar incidence of side effects (P > 0.05) in group A, similar complete response rate (P > 0.05) and increased incidence of overall single side effects (P < 0.05) in group B at 9-month duration.Conclusions Younger females with FGTB had a greater risk of systemic infection of tuberculosis compared to older ones. Nine-month ATT using daily therapy proved to be beneficial for younger patients at reproductive age. Six-month option was suitable for older patients for reducing side effects and poor compliance in the duration of treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Optimized duration of antituberculosis treatment for managing female genital tuberculosis: real-world experience from a high prevalence region in Eastern China

Sun

Wang

Ding

et al. 2020

Preprint

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“…Diagnostic laparoscopy is the best modality to diagnose female genital tuberculosis by providing opportunity to assess the genital tract, intestines, omentum, liver and peritoneal cavity for various tuberculous lesions [2]. It also provides an opportunity to take directed biopsies from representative areas under direct visualization [3]. It may show various tubal pathologies like hydrosalpinx, pyosalpinx, alternate constriction and dilatation of fallopian tubes (Sharma's python sign) [4].…”

Section: Discussionmentioning

confidence: 99%

“…Positron emission tomography may be useful in tubercular tuboovarian masses with increased FDG uptake [2]. Laparoscopy is the most reliable modality to diagnose abdominal and genital tuberculosis by providing opportunity to assess the severity and extension of disease and also to obtain biopsy from suitable areas and to assess the condition and patency of fallopian tubes [3]. A new sign of FGTB on laparoscopy is presented here.…”

Section: Introductionmentioning

confidence: 91%

Sharma’s Kissing Fallopian Tubes Sign: A New Tubal Sign in Female Genital Tuberculosis

Sharma

2016

J Obstet Gynecol India

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“…Pulmonary TB is the most common form, but TB can affect the other parts of the body ( 2 ). Female genital TB (GTB) is an important disease and in infected women it causes morbidity, menstrual irregularity, pregnancy loss, short and long-term sequelae ( 2 - 4 ).…”

Section: Introductionmentioning

confidence: 99%

Female genital tuberculosis cases with distinct clinical symptoms: Four case reports

Aslan

Ülger

et al. 2018

IJRM

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Background:Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Genital TB (GTB) is a form of extrapulmonary TB that occurs more frequently in women, in whom it classically presents in association with menstrual irregularity, pregnancy loss and short and long-term sequelae especially infertility in infected women. Patients with GTB are usually young women diagnosed during workup for infertility. GTB is rare in postmenopausal women and responsible for only approximately 1% of postmenopausal bleeding. In this study, we aimed to evaluate the laboratory, clinical and demographic characteristics of female GTB cases.Case:We presented four female GTB cases with distinct clinical symptoms. All patients have no history of TB, and no acid-fast bacilli were seen in smears prepared from the clinical materials of the patients. Histopathological examinations revealed granulomatous inflammation in all patients.Conclusion: In the light of the clinical features of these cases we aimed to emphasize that, female GTB must be taken into account in the patients with different clinical symptoms like postmenopausal bleeding, menometrorrhagia, infertility, and menstrual irregularities. We believe that these symptoms will be helpful for the diagnosis and treatment of female GTB.

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Six months versus nine months anti-tuberculous therapy for female genital tuberculosis: a randomized controlled trial

Cited by 30 publications

References 21 publications

Optimized duration of antituberculosis treatment for managing female genital tuberculosis: real-world experience from a high prevalence region in Eastern China

Optimized duration of antituberculosis treatment for managing female genital tuberculosis: real-world experience from a high prevalence region in Eastern China

Sharma’s Kissing Fallopian Tubes Sign: A New Tubal Sign in Female Genital Tuberculosis

Female genital tuberculosis cases with distinct clinical symptoms: Four case reports

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