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Hysteroscopic and Laparoscopic finding in Infertile Women with proven Endometrial Tuberculosis
  • Rana Mondal,
  • Neha Jaiswal,
  • Priya Bhave
Rana Mondal
Bansal Hospital

Corresponding Author:[email protected]

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Neha Jaiswal
Bansal Hospital
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Priya Bhave
Bansal Hospital
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Background: Currently, none of the diagnostic procedures for detecting female genital tuberculosis (FGTB) are 100 percent reliable, and the same is true for endoscopic results. There are several studies accessible on hysteroscopic and laparoscopic findings that are suggestive of TB. However, no study to our knowledge summarises the findings of laparoscopic and hysteroscopic examination in subfertile female patients with biopsy, culture, or other laboratory test-proven endometrial tuberculosis. Objective: Evaluation of hysteroscopic and laparoscopic findings in subfertile women suffering from proven endometrial tuberculosis. Materials and methods: 16,784 infertile women had a diagnostic hysterolaparoscopy between February 2014 and June 2021, among which 1084 patients were prescribed anti-tubercular medication based on the results of their findings; however, only 309 individuals had endometrial tuberculosis verified via positive on histopathology examination, AFB demonstration, Culture, and GeneXpert MTB/RIF. We retrospectively observed the diagnostic hysterolaparoscopy findings in those proven cases of subfertile women suffering from FGTB. Results: The major findings on hysteroscopy were periosteal fibrosis (209/309,67.63%), pale endometrium(179/309,57.92%), and micro polyp(138/309,44.66%). Other notable hysteroscopic findings were intrauterine adhesions (88/309,28.47%), endometrial tubercle (78/309,25.24%), endometrial polyp(54/309,14.88%), caseation(42/309,13.59%), focal hyperemia(29/309,9.38%) and diffuse hyperemia(18/309,5.82%). The most common finding on laparoscopy was abdominopelvic adhesions of various grades (297/309,96.11%). The major findings of laparoscopy were tubercle (155/309,50.16%), isthmo ampullary block (118/309,38.18%), tubal diverticula (116/309,37.54%), hydrosalpinx (97/309,31.39%) and TO mass (96/309,31.06%). 5.50% (17/300) had a normal appearance on hysteroscopy, and 1.29% (4/309) had a normal-looking pelvis on laparoscopy. Conclusions: In proven endometrial tuberculosis, significant hysteroscopic findings are periosteal fibrosis, pale endometrium, micro-polyp, and intrauterine adhesions, whereas major laparoscopic findings are various grades of abdominal pelvic adhesions, including perihepatic adhesions, miliary tubercle, isthmo ampullary block, tubal diverticula, caseous material, and hydrosalpinx. Tuberculosis should be considered if these signs are discovered during a diagnostic work-up in infertile people.
02 Feb 2023Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
07 Feb 2023Submission Checks Completed
07 Feb 2023Assigned to Editor
07 Feb 2023Review(s) Completed, Editorial Evaluation Pending
15 Feb 2023Reviewer(s) Assigned
14 Jun 2023Editorial Decision: Revise Major
16 Aug 20231st Revision Received
17 Aug 2023Assigned to Editor
17 Aug 2023Submission Checks Completed
17 Aug 2023Review(s) Completed, Editorial Evaluation Pending
20 Sep 2023Editorial Decision: Revise Major
04 Oct 20232nd Revision Received
05 Oct 2023Submission Checks Completed
05 Oct 2023Assigned to Editor
05 Oct 2023Review(s) Completed, Editorial Evaluation Pending
06 Oct 2023Editorial Decision: Revise Major
07 Oct 20233rd Revision Received
17 Oct 2023Editorial Decision: Accept