Gynaecological tuberculosis since 1951

A study has been made of 711 patients with proved gynaecological tuberculosis investigated between 1 January 1951 and 31 December 1994. The main presenting symptoms in order of frequency were infertility, pelvic pain, excessive menstrual loss and amenorrhoea. The average age at first attendance was 31 years, only 16% of married women had been pregnant and palpable adnexal masses were found in 47%. Eight drug programmes were used, the best results being obtained with streptomycin, para-aminosalicyclic (PAS) acid and isoniazid or with rifampicin, ethambutol and isoniazid. Toxic drug reactions occurred in 114 patients, the drugs responsible in the majority being streptomycin and PAS. Where drug treatment failed, surgery under further drug cover was employed in 85 patients, with no deaths and no fistulae. After treatment, there were 95 pregnancies in 57 patients. In recent years there has been a rise in the incidence of tuberculosis in general in the Western world. Many factors play a part in this, by far the most important being the spread of AIDS.