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Gynaecological tuberculosis since 1951.

A M Sutherland

    Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology
    |January 1, 1997
    PubMed
    Summary
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    Gynaecological tuberculosis, a significant cause of infertility and pelvic pain, was treated in 711 patients. Effective drug regimens and surgical interventions led to successful pregnancies in many women.

    Area of Science:

    • Gynecology
    • Infectious Diseases
    • Tuberculosis Research

    Background:

    • Gynaecological tuberculosis presents with symptoms like infertility, pelvic pain, and menstrual irregularities.
    • The study reviewed 711 patients diagnosed with gynaecological tuberculosis between 1951 and 1994.
    • A rise in general tuberculosis incidence, linked to AIDS, has been observed in recent years.

    Purpose of the Study:

    • To analyze the clinical presentation, treatment outcomes, and pregnancy rates in patients with gynaecological tuberculosis.
    • To evaluate the efficacy of various drug regimens and surgical interventions.
    • To identify factors influencing treatment success and adverse drug reactions.

    Main Methods:

    • Retrospective analysis of 711 patients with confirmed gynaecological tuberculosis.

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  • Evaluation of eight different drug treatment programs, including streptomycin, para-aminosalicyclic acid (PAS), isoniazid, rifampicin, and ethambutol.
  • Assessment of surgical interventions for cases resistant to drug therapy.
  • Documentation of presenting symptoms, treatment responses, toxic drug reactions, and pregnancy outcomes.

    • Main Results:

    • Infertility, pelvic pain, excessive menstrual loss, and amenorrhoea were the most common presenting symptoms.
    • The average age of patients at first attendance was 31 years; only 16% of married women had conceived prior to treatment.
    • Optimal drug regimens included streptomycin, PAS, and isoniazid, or rifampicin, ethambutol, and isoniazid.
    • Toxic drug reactions occurred in 114 patients, primarily associated with streptomycin and PAS.
    • Surgery, when employed after drug treatment failure, resulted in no deaths or fistulae.
    • A total of 95 pregnancies were achieved in 57 patients post-treatment.

    Conclusions:

    • Gynaecological tuberculosis significantly impacts fertility and quality of life.
    • Combination drug therapy, particularly with streptomycin, PAS, isoniazid, rifampicin, and ethambutol, is effective.
    • Surgery can be a safe and effective option for drug-resistant cases.
    • Successful treatment can restore fertility, leading to a notable number of pregnancies.