| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Sharma, Jai Bhagwan Sneha, Jayaramaiah Singh, Urvashi B. Kumar, Sunesh Roy, Kallol Kumar Singh, Neeta Dharmendra, Sona Vanamail, Perumal |
| Spatial Coverage |
India |
| Description |
Author Affiliation: Sharma JB ( Department of Obstetrics and Gynaecology, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: jbsharma2000@gmail.com.); Sneha J ( Department of Obstetrics and Gynaecology, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.); Singh UB ( Department of Obstetrics and Gynaecology, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.); Kumar S ( Department of Obstetrics and Gynaecology, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.); Roy KK ( Department of Obstetrics and Gynaecology, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.); Singh N ( Department of Obstetrics and Gynaecology, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.); Dharmendra S ( Department of Obstetrics and Gynaecology, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.); Vanamail P ( Department of Obstetrics and Gynaecology, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India) |
| Abstract |
STUDY OBJECTIVE: To study the effect of antitubercular treatment (ATT) on the laparoscopic abdominopelvic and fallopian tube findings in female genital tuberculosis (FGBT). DESIGN: Prospective cohort (Canadian Task Force classification II2). SETTING: Tertiary referral center in northern India. PATIENTS: Fifty women with infertility and diagnosed with FGTB on laparoscopy, histopathology findings, or endometrial sampling (acid-fast bacilli culture, granuloma on histopathology, positive polymerase chain reaction). INTERVENTIONS: Diagnostic laparoscopy in all women diagnosed with FGTB before and after a 6-month course of ATT (2 months of rifampicin, isoniazid, pyrazinamide, and ethambutol, followed by 4 months of rifampicin and isoniazid). All procedures were performed by the same surgeon between June 2012 and May 2014. MEASUREMENTS AND MAIN RESULTS: The mean patient age was 28.7 years, mean parity was 0.9, and mean body mass index was 23.6 kg/m(2). Infertility was seen in all 50 women (66% primary infertility, 34% secondary infertility), with a mean duration of 6.06 years. Abnormal laparoscopic findings of FGTB included tubercles in the pelvic peritoneum, fallopian tube, and ovary in 27 women (54%) before ATT and in only 1 (2.04%) woman after ATT (p < .001). Caseous nodules and encysted ascites were seen in 4 women (8%) before ATT, and in no women after ATT (p < .001); however, there was no change from before ATT to after ATT in the rate of pelvic adhesions (42% vs 42.5%) and perihepatic adhesions (56% vs 58%). Laparoscopic findings in fallopian tubes included hydrosalpinx (32%), pyosalpinx (4%), beaded tubes (12%), nonvisualization of tube (20%), and tubal blockage on the right side (56%), left side (50%), and both sides (38%) before ATT. Hydrosalpinx, beaded tubes, and nonvisualized tube were seen in 33.4%, 4.1%, and 20.8% cases, respectively, after ATT; however, free spill increased to 52% on the right side and 50% on left side after ATT. CONCLUSION: ATT improves laparoscopic findings in FGTB with infertility. However, advanced fibrotic lesions (eg, pelvic and perihepatic adhesions, bilateral blocked tubes) do not improve with ATT. |
| File Format |
HTM / HTML |
| ISSN |
15534650 |
| Issue Number |
2 |
| Volume Number |
23 |
| e-ISSN |
15534669 |
| Journal |
Journal of Minimally Invasive Gynecology |
| Language |
English |
| Publisher |
Elsevier |
| Publisher Date |
2016-02-01 |
| Publisher Place |
United States |
| Access Restriction |
One Nation One Subscription (ONOS) |
| Subject Keyword |
Prospective Studies Comparative Study Infertility, Female Complications Humans Fallopian Tube Diseases Fallopian Tubes Drug Therapy Treatment Outcome Laparoscopy Tissue Adhesions Therapeutic Use Journal Article Virology India Pregnancy Pathology Animals Antitubercular Agents Etiology Tuberculosis, Female Genital Adult Female Discipline Gynecology |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Obstetrics and Gynecology |
