Dr. B. Ramesh, Founder and Chief Laparoscopic Surgeon, Infertility Specialist and Uro-Gynaecologist, 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 subside over the years.
Tuberculosis of the uterus varies from region to region, state to state, from place to place and from people to people. The challenge here is to diagnose tuberculosis of the uterus, tubes and the 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 TB among women. Along with these procedures, one might also require to do endoscopy or laparoscopy to detect the tuberculosis of the uterus and the tubes. All of these methods are designed to detect active lesion called tubercles. Tubercles are nodules that contain caseous necrosis, especially patients being affected by tuberculosis. All these procedure helps 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 the Genital TB, medical practitioners conduct laparoscopy. After analysing if the tubes are damaged, the tubes can be removed to reduce pain and future IVF. If untreated, A nodule that is of 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, the another problem is 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 rented womb. Such kinds of patients are advised to undergo surrogacy.