scholarly journals Role of GeneXpert in endometrial biopsy for diagnosis of genital tuberculosis in women presenting with infertility

2021 ◽  
Vol 10 (5) ◽  
pp. 1832
Author(s):  
Aafreen Naaz ◽  
Vikram Sarbhai ◽  
Vinita Sarbhai
Keyword(s):  
Cross Sectional Study ◽  
Endometrial Biopsy ◽  
Genital Tuberculosis ◽  
Cross Sectional ◽  
Infertile Women ◽  
Female Genital Tuberculosis ◽  
Diagnostic Modalities ◽  
Low Sensitivity ◽  
Additional Value ◽  
Female Genital

Background: The diagnosis of female genital TB is challenging due to low sensitivity of conventional diagnostic modalities. The new GeneXpert Test on endometrial biopsy is studied for its role in diagnosis of female genital TB.Methods: This is an observational cross-sectional study on 50 infertile women. Premenstrual endometrial biopsy was performed and sent for AFB Smear, M. TB (LJ) medium culture, CB-NAAT by GeneXpert, and histopathology. The results were compared for diagnosis of FGTB.Results: Endometrial Biopsy (EB) could confirm diagnosis of genital TB in 4 cases (8%) out of 50 infertile women. Amongst these 4 cases, GeneXpert was positive in two, AFB were detected on smear in three while one showed both AFB on smear and positive GeneXpert. GeneXpert adds additional value but surely cannot replace any of the other gold standard investigations.Conclusions: GeneXpert is a rapid diagnostic method which is accurate, feasible and affordable. It is useful adjunct to the existing armamentarium in diagnosis of female genital tuberculosis.

HYSTEROSCOPY FOR DIAGNOSIS OF FEMALE GENITAL TUBERCULOSIS IN INFERTILE WOMEN: AN ESSENTIAL TOOL IN MINIMALLY INVASIVE ERA.

2021 ◽  
pp. 73-76
Author(s):  
Vinita Sarbhai ◽  
Aafreen Naaz ◽  
Vikram Sarbhai
Keyword(s):  
Prospective Observational Study ◽  
Uterine Cavity ◽  
Endometrial Biopsy ◽  
Genital Tuberculosis ◽  
Infertile Women ◽  
Female Genital Tuberculosis ◽  
The Common ◽  
Basic Evaluation ◽  
Female Genital

INTRODUCTION: Female genital tuberculosis (FGTB) is difcult to diagnose due to asymptomatic presentation and paucity of denitive investigations. Hysteroscopy can be utilized for the diagnosis of genital tuberculosis in infertile women. This study was done to study the role of hysteroscopy in the diagnosis of genital tuberculosis. METHODS: Prospective observational study was performed on 50 infertile women after basic evaluation of infertility. The women with tubal factors for infertility or unexplained infertility were selected for the study. Premenstrual endometrial biopsy (EB) was done for mycobacteria (AFB) detection. Hysteroscopy was performed in the next cycle if no AFB was detected on EB. ATT was given if genital TB was diagnosed on EB, and hysteroscopy was performed after completion of ATT. Hysteroscopic observations were compared with endometrial biopsy results. RESULTS: A total of 4 (8%) cases were diagnosed as bacteriologically positive for genital tuberculosis in endometrial samples. They were given anti-tubercular treatment. On hysteroscopy, pale endometrium (16%), Intrauterine adhesions (46%), and osteal obliteration (18%) were the common abnormal observations. 12 patients had mild adhesions, 6 had moderate and 5 patients had severe adhesions. Overall, 26 (52%) patients had features of intrauterine brosis, like intra-uterine adhesions or ostial obliteration, which could be suggestive of chronic infection like tuberculosis. Hysteroscopic adhesiolysis was performed in 46% and the cavity was restored. CONCLUSION: Endometrial Biopsy and Hysteroscopy are complementary procedures that together can help in the diagnosis of FGTB. Hysteroscopy is not only the gold standard for diagnosing uterine adhesions, distortion of the uterine cavity and tubal ostia, but it can also be a prognostic and therapeutic tool.

scholarly journals A study to compare the diagnostic accuracy of GeneXpert MTB/RIF/assay and its comparison with liquid culture in clinically suspected cases of genital tuberculosis attending outpatient department of tertiary center

2020 ◽  
Vol 9 (8) ◽  
pp. 3345
Author(s):  
Anu Pathak ◽  
Divya Yadav ◽  
Urvashi Verma ◽  
Yogita Gautam
Keyword(s):  
Liquid Culture ◽  
Endometrial Biopsy ◽  
Obstetrics And Gynecology ◽  
Genital Tuberculosis ◽  
Cross Sectional ◽  
Active Pulmonary Tuberculosis ◽  
Medical College ◽  
Tertiary Center ◽  
Female Genital Tuberculosis ◽  
Female Genital

Background: Tuberculosis is a major health issue globally despite a declining trend in mortality with effective diagnosis and treatment, an estimated 10.4 million persons developing active TB each year with 1.33 million deaths. Objective of this study was to evaluate role of GeneXpert MTB/RIF/assay in diagnosis of female genital tuberculosis in suspected cases of tuberculosis.Methods: It was a cross sectional study done in department of obstetrics and gynecology in S. N. Medical college Agra for a period of 2 year (July 2017 to October 2019). 70 cases were selected from OPD of department of obstetrics and gynecology, S. N. Medical College Agra who met the inclusion and exclusion criteria after taking proper consent. In all selected cases endometrial biopsy sample was taken using endometrial biopsy curette in premenstrual period. All samples of endometrial biopsy were taken under all aseptic precaution from both corneal ends, anterior and posterior wall and lower part of uterus using endometrial biopsy curette and sample was collected in two separate sterile vials having normal saline and was sent for GeneXpert MTB/RIF/assay and liquid culture simultaneously.Results: Out of total 70 clinically suspected cases of female genital tuberculosis in between 20-45 years of age cough with expectoration 94% was the most common respiratory symptom followed by fever 81%, weight loss 56% and anorexia 54%. Prevalence of genital tuberculosis in active pulmonary tuberculosis patients was 30%. Irregular menstruation, vaginal discharge and pelvic pain were present in 69%, 60% and 52% patients respectively.Conclusions: The overall sensitivity of CBNAAT was 22% and specificity was 77%. The overall sensitivity of liquid culture was 28% and specificity was 71%.

scholarly journals Emerging progress on diagnosis and treatment of female genital tuberculosis

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110149
Author(s):  
Ying Wang ◽  
Ruifeng Shao ◽  
Chihua He ◽  
Ligang Chen
Keyword(s):  
Blood Circulation ◽  
Histopathological Examination ◽  
Epidemiological Data ◽  
Endometrial Biopsy ◽  
Effective Management ◽  
Menstrual Disorders ◽  
Genital Tuberculosis ◽  
Infertile Women ◽  
Female Genital Tuberculosis ◽  
Female Genital

Female genital tuberculosis (FGTB) is an infection caused by Mycobacterium tuberculosis and usually occurs secondary to pulmonary tuberculosis (TB) through the blood circulation, lymph circulation, or direct spreading from abdominal TB. FGTB is an uncommon type of TB that can destroy genital organs, and lead to menstrual disorders and infertility. The diagnosis of FGTB is often made by detection of acid-fast bacilli under microscopy, culture with endometrial biopsy, or histopathological examination of epithelioid granuloma on a biopsy. A multidrug anti-TB regimen is the major management of FGTB, including rifampicin, isoniazid, pyrazinamide, and ethambutol, while surgery is proposed in more deteriorated cases. However, the conception rate in infertile women with FGTB is still low, even after multidrug anti-TB therapy. Additionally, the risk of complications, such as ectopic pregnancy or miscarriage, remains high. In this review, we summarize the characteristics of FGTB, present current epidemiological data, and focus on its early diagnosis and effective management.

Effect of Antitubercular Therapy on Endometrial Function in Infertile Women with Female Genital Tuberculosis

2016 ◽  
Vol 16 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Jai Bhagwan Sharma ◽  
Jayaramaiah Sneha ◽  
Urvashi B. Singh ◽  
Sunesh Kumar ◽  
Kallol Kumar Roy ◽  
...  
Keyword(s):  
Antitubercular Therapy ◽  
Genital Tuberculosis ◽  
Infertile Women ◽  
Female Genital Tuberculosis ◽  
Female Genital

scholarly journals Comparison of diagnostic accuracy of bactec culture, gene-xpert and histopathology in the diagnosis of genital tuberculosis in women with infertility

2020 ◽  
Vol 9 (4) ◽  
pp. 1614
Author(s):  
Rachna Chaudhary ◽  
Vandana Dhama ◽  
Manisha Singh ◽  
Shakun Singh
Keyword(s):  
Endometrial Biopsy ◽  
Reproductive Age ◽  
Specific Method ◽  
Suspected Case ◽  
Genital Tuberculosis ◽  
Diagnostic Dilemma ◽  
Medical College ◽  
Female Genital Tuberculosis ◽  
Actual Incidence ◽  
Female Genital

Background: Female genital tuberculosis (FGTB) is often a silent disease sparing no age group but majority of patients are in the reproductive age. In infertility patient’s incidence of FGTB varies from 3-16% in India but the actual incidence of genital tuberculosis may be under reported due to asymptomatic presentation and paucity of investigations.Methods: Prospective case control study was conducted from June 2018 to May 2019 in LLRM Medical College Meerut. A total 100 Endometrial samples were collected during diagnostic laparoscopy from all suspected case of genital TB, presented with either primary or secondary infertility and samples sent for histopathology, Gene-xpert and Bactec culture.Results: Out of 100 samples Bactec culture was positive in 2 samples, Gene-xpert positive in 3 samples. On histopathology out of 100 cases, non-specific endometritis was found in 1 case, tubercular-endometritis in 1 case, proliferative enometrium (anovulatory) in 40 cases and secretory endometrium found in 58 cases.Conclusions: Female genital TB poses a diagnostic dilemma because of its varied presentation and lack of sensitive and specific method of diagnosis. Culture though remains the gold standard of diagnosis of female genital TB, gene-xpert, histopathology, Bactec culture or laparoscopy can be used for starting treatment. Endometrial biopsy on histopathology shows not only Tubercular endometritis but also gives hormone response on endometrium, local factors of endometrium concerning non-specific and specific infections and anovulatory cycles.

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