Tuberculosis in the Female Genital Tract

Area of Science:

• Infectious Diseases
• Reproductive Medicine
• Public Health

Background:

• Genitourinary tuberculosis (GUTB) originates from Mycobacterium tuberculosis, often secondary to pulmonary tuberculosis, spreading hematogenously.
• Female genital TB (FGTB) is a significant cause of infertility in underdeveloped nations, characterized by tubal blockage and damage to reproductive organs.
• FGTB can present with mild or asymptomatic symptoms, complicating diagnosis and potentially mimicking malignancy, necessitating careful clinical evaluation.

Purpose of the Study:

• To summarize the current understanding of genitourinary tuberculosis, with a focus on female genital TB.
• To highlight the diagnostic challenges and methods for FGTB, including its role in infertility.
• To review recent advancements in the management of FGTB and its impact on reproductive outcomes.

Main Methods:

• Literature review focusing on the epidemiology, pathogenesis, diagnosis, and management of GUTB and FGTB.
• Analysis of diagnostic modalities, emphasizing hysterosalpingography as a key screening tool for tubal infertility.
• Synthesis of information on treatment strategies, including multidrug anti-TB regimens and surgical interventions.

Main Results:

• FGTB is a primary cause of infertility due to fallopian tube and endometrial involvement, often presenting insidiously.
• Hysterosalpingography is identified as the gold standard for detecting FGTB and assessing tubal patency.
• Multimodal therapy, including anti-TB drugs and surgery, offers improved outcomes but conception rates remain low, with persistent risks of complications.

Conclusions:

• FGTB requires high clinical suspicion in cases of infertility, especially in endemic regions, to avoid delayed diagnosis and surgical interventions.
• Effective management relies on early detection through accurate diagnostic tools and adherence to multidrug anti-TB regimens.
• Despite treatment, women with FGTB face challenges in achieving pregnancy and are at increased risk for adverse obstetric outcomes, underscoring the need for ongoing research and support.