Genital tuberculosis (GTB) is a type of tuberculosis (TB) that affects the genital tract, including the uterus, fallopian tubes, ovaries, and vagina in women and the testes, epididymis, and prostate gland in men. It is caused by the bacterium Mycobacterium tuberculosis, which is the same bacterium that causes pulmonary tuberculosis.
Genital tuberculosis can affect fertility in both men and women. In women, GTB can lead to infertility by causing scarring and blockage of the fallopian tubes, which prevents the egg from reaching the uterus and can also cause damage to the endometrium (the lining of the uterus). GTB can also cause the formation of adhesions (scar tissue) in the pelvis, which can further obstruct the fallopian tubes or prevent the normal functioning of the ovaries.
In men, GTB can cause blockage of the epididymis, which is the tube that carries sperm from the testes to the vas deferens, leading to infertility. GTB can also cause inflammation of the prostate gland, which can lead to decreased semen quality.
Dr Beena Muktesh, Clinical Director- Fertility & IVF, Motherhood Fertility & IVF, explains, “The bacteria that causes tuberculosis (TB) primarily affects the lungs but if left untreated in the early stages, it can also spread and result in secondary infections to other organs and even the fallopian tubes or genital tracts, which can decrease the likelihood of becoming pregnant. It has the potential to cause serious damage to the fallopian tubes and may also result in infertility and other major health issues in both men and women.”
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Genital TB is the most prevalent extrapulmonary site in women. The fallopian tubes are first affected by the infection, then the uterus, ovaries, cervix, and vagina. When fallopian tubes are infected with TB, the bacteria inhibit fertilised eggs from entering the tube and instead spread to the uterus. In many cases, genital TB does not cause any noticeable symptoms. However, when symptoms do occur, they can vary depending on the part of the reproductive system that is affected. Some common symptoms of genital TB are:
- Pain in the lower abdomen or pelvis region
- Pain during intercourse
- Abnormal vaginal bleeding
- Regular vaginal discharge
- Irregular periods
- Swelling and lumps in the groin area
- Fatigue and weight loss
- Low-grade fever”
Genital TB is an infection of the reproductive system which is generally secondary to tuberculosis infection elsewhere in the body.
Explaining the diagnosis and the treatments, Dr Parul Gupta, Nova Fertility Centre, says, “The majority of genital TB cases have been reported in individuals between the ages of 20 and 45. The infection is often asymptomatic and is first discovered during tests for infertility. Genital TB is the urinary tract’s quiet attacker and thus diagnosing it can be challenging.” Some of the symptoms can include Irregular periods, amenorrhea, and infertility.
For the diagnosis of genital TB in a female, a doctor may advise the following tests:
- Complete Blood pcount
- Test for tuberculin or Mantoux test
- X-rays of the chest
- Histological analysis
- Period blood for cultural purposes
- Hysterosalpingography
- Ultrasonography
- Laparoscopy
- Hysteroscopy
Genital TB Treatment
Directly Observed Treatment Short course (DOTS): This therapy is a highly successful, affordable and effective option for genital TB. It is broken down into two phases: the initial therapy, which consists of three anti-TB medications for two months, and the continuation phase, which consists of two anti-TB medications for another four to ten months.
Antitubercular chemotherapy: Patients have a shorter course of treatment for six to nine months.
Surgery: Surgery is occasionally used to treat genital TB in patients especially when there is a tubercular mass.
As this disease is challenging to identify, the symptoms are frequently mistaken for those of other infections. The best way to prevent contracting genital tuberculosis is to keep up a healthy lifestyle and seek prompt medical attention if you are diagnosed with any kind of TB and family screening if one member is affected for TB.
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