Endometrial Tuberculosis

Endometrial TB is usually secondary to pulmonary, renal, gastrointestinal, bone, or joint TB, occasionally part of miliary pulmonary TB. Female genital TB usually first affects the fallopian tubes, then gradually invades the endometrium and ovaries, rarely the cervix, vagina, or vulva.

Common Symptoms

Fatigue; station doctor; increased vaginal discharge; lower abdominal heaviness; night sweats; abdominal pain; low fever; lower abdominal pain

Causes and Pathogenesis

Endometrial TB usually spreads from tubal TB. Genital TB first infects the tubes, then spreads to the endometrium, ovaries, and cervix. Cyclic endometrial shedding discharges foci, so lesions are usually confined to the endometrium as scattered miliary tubercles; rare severe cases invade the myometrium. The uterus is normal or slightly small. After infection, there is a latent period; when resistance declines, bacilli invade the endometrium and eventually its basal layer, causing oligomenorrhea or amenorrhea. Pathology: Curettings show tubercles with caseous necrosis; typical tubercles have 1-2 giant cells in horseshoe arrangement surrounded by epithelioid cells, lymphocytes, and plasma cells. Peritubercular glands are insensitive to ovarian hormones, showing persistent hyperplasia or deficient secretion. Severe caseous necrosis forms superficial ulcers destroying most or all endometrium, later scarring causes permanent amenorrhea.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Endometrial TB is usually secondary, mainly to pulmonary TB; thus preventing pulmonary TB is key. (1) Vaccination: As with pulmonary TB, strengthen TB education and child/adolescent health care. Vaccination age: neonates ≥2200 g may receive BCG at 24 h, with catch-up within 3 months if needed; Mantoux-negative infants up to adolescent girls should be vaccinated. Contraindications: avoid pregnancy during active TB; Desopo and Springett reported recurrence <1‰ after 5+ years follow-up, so pregnancy should wait 5+ years after stabilization. Note: vaginal discharge and menstrual blood may contain bacilli; isolate patients. (2) Build resistance: balance work and rest, avoid late nights, eat well, increase fresh fruits/vegetables (vitamins) and poultry/fish/eggs/milk (protein), and exercise.

Department to Visit

It is recommended to visit the Gynecology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.