Tuberculosis in the Uterus

Authored by Dr. B. Ramesh, Founder, and Urology Laboratory Laparoscopic Surgeon, Altius Hospital, Bengaluru

The morbidity and mortality rates caused by tuberculosis (TB) is high worldwide, and even worse in developing countries. Tuberculosis of the uterus and the female genital system is very common in India, as women in India are more prone to being affected by it. The burden of TB disease among women is significant, and unbearable, especially in developing countries.

Not only does it have life-threatening complications, but it is a disease that causes infertility, childlessness, dyspareunia, menstrual irregularities and chronic pelvic inflammatory disease. However, the healthcare industry is witnessing such incidence subsided over the years.

Tuberculosis of the uterus varies from region to region, state to state, from place to place, and from person to person. The challenge here is to diagnose tuberculosis of the uterus, tubes and genital system. This is a very difficult process to conduct, as it requires a series of dedicated procedures, including a scan, CT scan and MRI and Blood tests for TB among women. Along with these procedures, one might also require endoscopy or laparoscopy to detect the tuberculosis of the uterus and the tubes. All of these methods are designed to detect active lesions called tubercles. Tubercles are nodules that contain caseous necrosis, especially in patients being affected by tuberculosis. All these procedures help in detecting the bacteria in areas such as the uterus and tubes. If the patient is symptomatic, like irregular menstruation, heavy menstruation or pelvic pain, or infertility. These are the signs to confirm a woman may be suffering from tuberculosis of the uterus or the reproductive system. To detect Genital TB, medical practitioners conduct laparoscopy.  After analyzing if the tubes are damaged, the tubes can be removed to reduce pain and future IVF. If untreated, A nodule that is two centimetres can soon spread all over the intestine and the abdomen. To detect tuberculosis in the areas, an experienced clinician can make the spot diagnosis of tuberculosis of the abdomen and the genital system on Laparoscopy. "

It is easy to detect TB and treat it when found in the early stage. Once we know it has appeared, it's best to treat it in the early stage. In the beginning stage, it is completely treatable with six to nine months of treatment, what we call antitubercular therapy. A therapy that has to be performed with three to four drugs, and many of these patients conceive.

A time might come to remove the tubes because tuberculosis contains bad fluid which may affect the growth of the fetus, Influencing bad outcomes even with IVF treatment. So, another problem is the obliteration of the uterine cavity, what we call Asherman Syndrome, wherein there is no space inside the uterus for the baby to grow. So in these cases, even IVF is not possible. So, the women affected by these complications need surrogacy treatment or a rented womb. Such kinds of patients are advised to undergo surrogacy.

With all the methods and precautions taken, tuberculosis affects all sections of society. Therefore it is important to follow good food habits and keep health in good condition. We want to advise women to use less crowded places that has good ventilation. However, the practice of masking ourselves by keeping us away from the TB Bacteria is also helping cases of tuberculosis come down.

The government of India has taken huge steps to control and eradicate tuberculosis. It has enrolled programmes to reduce the incidence of tuberculosis. Such programs will help in educating the general public and offer a forum for medical practitioners to voice their requirements to heal all women in India with Tuberculosis.