Tuberculosis of female genital organs

Tuberculosis of female genitalia is always a secondary disease; Occurs when the infection is transferred from the primary focus (lungs) by hematogenous way or through the lymph vessels from the mesenteric lymph nodes and peritoneum. The most common are the fallopian tubes, rarely the endometrium and the ovaries, very rarely the cervix, the vagina and the vulva. There are exudative, productive and caseous forms.

Symptoms are often disguised. The disease is taken for inflammation of the uterine appendages, caused by pyogenic microbes. To some extent, the general symptoms are expressed: malaise, adynamia, mild fatigue, hypotension, decreased appetite, sweating, subfebrile temperature. The menstrual function is impaired: hypo-oligomenorrhoea is more common, acyclical bleeding is less common, amenorrhea or algodismenorea. As a rule, primary infertility develops. The pain is uncertain.

The diagnosis allows you to put a carefully collected history (including information on contact with tuberculosis patients), an intradermal test with tuberculin, the use of a tuberculin provocative Koch test with an assessment of the focal reaction, a histological study of endometrial scraping (detection of tuberculous tubercles) and appendages removed during surgery, Time of operation tuberculous tubercles on peritoneum of tubes. An important indication of the possibility of tuberculosis infection is exacerbation of chronic inflammation of the appendages under the influence of thermal physiotherapy procedures. Detect tuberculous mycobacteria in secretions from the uterus, menstrual blood is very difficult. The radiological method (hysterosalpingography) can provide additional information, since the rigidity of the tubes, their strictures, obstruction in the ampullar sections, intrauterine synechiae are often found in genital tuberculosis.

Treatment. Normalization of work and rest, nutrition, vitamins. If the diagnosis is made for the first time, a specific antibacterial therapy is carried out with a continuous course lasting 1-1.5 years, during which a series of preparations alternate with simultaneous administration of at least two. The treatment is carried out under the supervision of a TB dispensary doctor, then - sanatorium treatment, autumn and spring courses of antibiotic therapy. When adhesive processes are sometimes prescribed corticosteroids. Operative treatment is shown only with the encysted, long-existing inflammatory formations.

The prognosis with timely and adequate treatment for life is favorable; For menstrual and generative function-unfavorable.