Tuberculosis of female genital organs – a path to infertility (clinical observation of genital tuberculosis in a teenage girl)
https://doi.org/10.21518/ms2025-251
Abstract
Every year, 7.5 million children are infected, about 23 thousand of which lead to death. One of the forms of extrapulmonary tuberculosis is tuberculosis of the female genital organs, which accounts for 5% of all female pelvic infections, it accompa- nies 10% of cases of pulmonary tuberculosis. Most often manifested as a chronic inflammatory disease of the pelvic organs and infertility, in advanced cases, genital tuberculosis leads to irreversible damage to the female genital tract. Most cases of genital tuberculosis are observed in fertile people aged 20 to 45 years (in 0.5–2.0 adult women per 100 thousand), in child- hood and adolescence it is extremely rare. Infection of girls with tuberculosis in itself does not have a negative effect on the formation and development of their reproductive system, but in some cases, at an early stage of the disease, tuberculosis infec- tion can get there through the blood or lymph. In this regard, each clinical case may be of interest to doctors treating girls with gynecological problems. This article discusses a clinical case of genital tuberculosis in a 14-year-old teenage girl. The clinical course was manifested by pain in the lower abdomen. Ultrasound showed a large formation in the pelvis, ascites, and carci- nomatosis. Genital tuberculosis was suspected after chest CT, which showed signs of tuberculous lung disease. Laparoscopic examination revealed inflammatory lesions of the uterus, fallopian tubes, and both ovaries with complete replacement of the right ovarian tissue with a cyst. Therefore, timely and correct diagnostics, treatment of genital tuberculosis at the subclinical level is the only way to avoid irreversible damage to the pelvic organs.
About the Authors
E. A. Mateykovich
Tyumen State Medical University;
Maternity Hospital No. 3 of Tyumen;
Perinatal Center
Russian Federation
Russian Federation
Elena A. Mateykovich, Cand. Sci. (Med.), Associate Professor, Director of the Institute of Maternity and Childhood, Tyumen State Medical University; Doctor Obstetrician-Gynecologist, Maternity Hospital No. 3 of Tyumen; Perinatal Center
54, Odesskaya St., Tyumen, 625023;
31, Bldg. 1, Bauman St., Tyumen, 625032;
1, Daudelnaya St., Tyumen, 625002
M. A. Akselrov
Tyumen State Medical University;
Regional Clinical Hospital No. 2
Russian Federation
Russian Federation
Mikhail A. Akselrov, Dr. Sci. (Med.), Associate Professor, Head of the Department of Pediatric Surgery, Tyumen State Medical University; Head of the Pediatric Surgical Department No. 1, Regional Clinical Hospital No. 2
54, Odesskaya St., Tyumen, 625023;
75, Bldg. 2, Melnikaite St., Tyumen, 625039
G. R. Akhmetyanova
Regional Clinical Hospital No. 2
Russian Federation
Russian Federation
Guzel R. Akhmetyanova, Pediatric Gynecologist
75, Bldg. 2, Melnikaite St., Tyumen, 625039
S. M. Dadasheva
Regional Clinical Hospital No. 2
Russian Federation
Russian Federation
Selminaz M. Dadasheva, Doctor Pediatric Surgeon
75, Bldg. 2, Melnikaite St., Tyumen, 625039
D. N. Lapin
Regional Clinical Hospital No. 2
Russian Federation
Russian Federation
Denis N. Lapin, Head of the Gynecological Department
75, Bldg. 2, Melnikaite St., Tyumen, 625039
S. P. Sakharov
Tyumen State Medical University;
Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
Sergey P. Sakharov, Cand. Sci. (Med.), Associate Professor, Deputy of Director of the Institute of Maternity and Childhood, Tyumen State Medical University; Doctor surgeon, Pediatric Surgeon, Regional Clinical Hospital No. 1
54, Odesskaya St., Tyumen, 625023;
Bldg. 10, Semovski- kh St., Tyumen, 625062
References
1. Jaganath D, Beaudry J, Salazar-Austin N. Tuberculosis in Children. Infect Dis Clin North Am. 2022;36(1):49–71. https://doi.org/10.1016/j.idc.2021.11.008.
2. Pavlenok IV, Tursunova NV, Stavitskaya NV. Tuberculosis Situation in Children and Adolescents in the Siberian Federal District in 2020–2022. Tuberculosis and Lung Diseases. 2023;101(1S):6–12. (In Russ.) https://doi.org/10.58838/2075-1230-2023-101-1S-6-12.
3. Sharma JB, Manchanda S, Jaiswal P, Dharmendra S, Singh U, Hari S. Computed tomographic findings in female genital tuberculosis tuboovarian masses. Indian J Tuberc. 2022;69(1):58–64. https://doi.org/10.1016/j.ijtb.2021.03.001.
4. Giannacopoulos KCh, Hatzidaki EG, Papanicolaou NC, Relakis KJ, Kokori HG, Giannacopoulou CC. Genital tuberculosis in a HIV infected woman: a case report. Eur J Obstet Gynecol Reprod Biol. 1998;80(2):227–229. https://doi.org/10.1016/s0301-2115(98)00112-2.
5. Figueroa-Damian R, Martinez-Velazco I, Villagrana-Zesati R, ArredondoGarcia JL. Tuberculosis of the female reproductive tract: effect on function. Int J Fertil Menopausal Stud. 1996;41(4):430–436. Available at: https://pubmed.ncbi.nlm.nih.gov/8894801.
6. Namavar Jahromi B, Parsanezhad ME, Ghane-Shirazi R. Female genital tuberculosis and infertility. Int J Gynaecol Obstet. 2001;75(3):269–272. https://doi.org/10.1016/s0020-7292(01)00494-5.
7. Sharma JB, Sharma E, Sharma S, Dharmendra S. Female genital tuberculosis: Revisited. Indian J Med Res. 2018;148(Suppl.):S71–S83. https://doi.org/10.4103/ijmr.IJMR_648_18.
8. Grace GA, Devaleenal DB, Natrajan M. Genital tuberculosis in females. Indian J Med Res. 2017;145(4):425–436. https://doi.org/10.4103/ijmr.IJMR_1550_15.
9. Sharma JB, Sharma E, Sharma S, Dharmendra S. Recent Advances in Diagnosis and Management of Female Genital Tuberculosis. J Obstet Gynaecol India. 2021;71(5):476–487. https://doi.org/10.1007/ s13224-021-01523-9.
10. Duggal S, Duggal N, Hans C, Mahajan RK. Female genital TB and HIV coinfection. Indian J Med Microbiol. 2009;27(4):361–363. https://doi.org/10.4103/0255-0857.55461.
11. Kolesnikova LI, Leshchenko OY, Malanova AB. The present-day view of the problem of female genital tuberculosis. Akusherstvo i Ginekologiya (Russian Federation). 2014;(9):24–29. (In Russ.) Available at: https://aig-journal.ru/articles/Sovremennyi-vzglyad-na-problemu-tuberkuleza-jenskih-polovyhorganov.html.
12. Aka N, Vural EZ. Evaluation of patients with active pulmonary tuberculosis for genital involvement. J Obstet Gynaecol Res. 1997;23(4):337–340. https://doi.org/10.1111/j.1447-0756.1997.tb00854.x.
13. Danish Zahoor D, Bhat MM, Kanth M, Farhana A. Prevalence of genital tuberculosis in infertile women; a study from a tertiary care center in North India. Int J Cont Med Res. 2019;6(6):F1–F3. http://doi.org/10.21276/ijcmr.2019.6.6.17.
14. Tal R, Lawal T, Granger E, Simoni M, Hui P, Buza N, Pal L. Genital tuberculosis screening at an academic fertility center in the United States. Am J Obstet Gynecol. 2020;223(5):737.e1-737.e10. https://doi.org/10.1016/j.ajog.2020.05.045.
15. Аксенова ВА, Барышникова ЛА, Бармина НА, Баронова ОД, Васильева ИА, Довгалюк ИФ и др. Туберкулез у детей: клинические рекомендации. 2022. Режим доступа: https://disuria.ru/_ld/11/1194_kr22a15a19MZk.pdf.
16. Kesharwani H, Mohammad S, Pathak P. Tuberculosis in the Female Genital Tract. Cureus. 2022;14(9):e28708. https://doi.org/10.7759/cureus.28708.
17. Bapna N, Swarnkar M, Kotia N. Genital tuberculosis and its consequences on subsequent fertility. J Obstet Gynaecol India. 2005;55:534–537.
18. Bishai WR. Rekindling old controversy on elusive lair of latent tuberculosis. Lancet. 2000;356(9248):2113–2114. https://doi.org/10.1016/S01406736(00)03485-1.
19. Chavhan GB, Hira P, Rathod K, Zacharia TT, Chawla A, Badhe P, Parmar H. Female genital tuberculosis: hysterosalpingographic appearances. Br J Radiol. 2004;77(914):164–169. https://doi.org/10.1259/bjr/27379200.
20. Mordyk AV, Yakovleva AA, Nikolaeva IN, Leontiev VV. Extrapulmonary tuberculosis problem in epidemiologic situation. Pacific Medical Journal. 2015;(3):19–21. (In Russ.) Available at: https://www.tmj-vgmu.ru/jour/article/view/538/494.
21. Skrahina AM, Peresada OA, Salonka II, Dziusmikeyeva MI. Characteristics of the current diagnostic methods for female genital tuberculosis. Medical Panorama. 2013;(9):18–23. (In Russ.) Available at: https://www.bsmu.by/ upload/iblock/ccd/ksa88d53kbb4dlkfy18hzlmhbwfdxt3s/2015020511270816.pdf.
22. Drozdetskaya IV, Mordyk AV, Porkulevich NI. Urogenital tuberculosis in children 0–14 years old in the structure of other localizations of tuberculosis. Urology Herald. 2021;9(2):34–44. (In Russ.) https://doi.org/10.21886/23086424-2021-9-2-34-44.
23. Djuwantono T, Permadi W, Septiani L, Faried A, Halim D, Parwati I. Female genital tuberculosis and infertility: serial cases report in Bandung, Indonesia and literature review. BMC Res Notes. 2017;10(1):683. https://doi.org/10.1186/s13104-017-3057-z.
24. Klinyshkova TV, Iakovleva AA, Plekhanova MA, Dolgikh TI, Frolova NB, Kuz’menko EV, Tsertsanova EA. Diagnostic aspects of genital tuberculosis in women with tuboperitoneal infertility. Russian Bulletin of Obstetrician-Gynecologist. 2014;14(1):63–67. (In Russ.) Available at: https://www.mediasphera.ru/issues/rossijskij-vestnik-akushera-ginekolo ga/2014/1/031726-61222014111.
25. Sharma JB. Current Diagnosis and Management of Female Genital Tuberculosis. J Obstet Gynaecol India. 2015;65(6):362–371. https://doi.org/10.1007/s13224-015-0780-z.
26. Sotskiy PO, Sotskaya OL, Ohanesyan LR, Safaryan MD. The role of hystersalpingography in the diagnosis of uterine and tube diseases in women with familite mediterranean fever and infertility. REJR. 2022;12(4):95–105. (In Russ.) https://doi.org/10.21569/2222-7415-2022-12-4-95-105.
27. Sharma JB. In vitro fertilization and embryo transfer in female genital tuberculosis. IVF Lite. 2015;2:14. https://doi.org/10.4103/2348-2907.158735.
28. Ishrat S, Fatima P. Genital tuberculosis in the infertile women – an update. Mymensingh Med J. 2015;24(1):215–220. Available at: https://pubmed.ncbi.nlm.nih.gov/25725695.
29. Guo F, Zhou MJ, Zhang AJ. Advances in the Treatment of Recurrent Implantation Failure. Reprod Devel Med. 2017;1(2):123. https://doi.org/10.4103/2096-2924.216860.
30. Figueiredo AA, Lucon AM, Srougi M. Urogenital Tuberculosis. Microbiol Spectr. 2017;5(1). https://doi.org/10.1128/microbiolspec.tnmi7-0015-2016.
31. Malushko A.V. Tubal factor infertility as an outcome of genital tuberculosis. Obstetrics and Gynaecology of Saint-Petersburg. 2019;(3-4):63–65. (In Russ.) Available at: https://elpub.ru/elpub-article/spbakush/149.
32. Stakhanov VA, Batyrov FA, Borisova MI, Oganezova GS, Kiselevich OK, Bogdanova YeV, Katorgin NA. Extrapulmonary tuberculosis in training programs at different stages of medical education. Tuberculosis and Lung Diseases.2011;88(5):172. (In Russ.) Available at: https://elibrary.ru/nwbhlf.
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For citations:
Mateykovich EA, Akselrov MA, Akhmetyanova GR, Dadasheva SM, Lapin DN, Sakharov SP. Tuberculosis of female genital organs – a path to infertility (clinical observation of genital tuberculosis in a teenage girl). Meditsinskiy sovet = Medical Council. 2025;19(13):212-217. (In Russ.) https://doi.org/10.21518/ms2025-251
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