Tubal Tuberculosis

Tuberculous salpingitis is salpingitis caused by tubercle bacilli, often granulomatous, showing chronic inflammatory changes such as ulcers, caseous type, miliary nodules, isthmic nodosum, or simple hypertrophy. It is confirmed by finding tubercle bacilli or typical tubercles histologically, with systemic TB manifestations. It most often affects women aged 20-40, also postmenopausal women; improving diagnostic techniques have shown rising incidence.

Common Symptoms

Female infertility; shifting dullness; delayed menstruation; menstrual back pain; uterine bleeding; ascites; abdominal pain; fatigue; low fever; weight loss

Causes and Pathogenesis

Internal genital TB is generally secondary; pelvic lesions spread directly to adjacent organs, first infecting the tubes. Tubal mucosa favors latent bacilli, which may remain dormant 1-10+ years before reactivation. Tubal TB is usually bilateral. The main pathogen is human-type M. tuberculosis (5% bovine type); the fimbriated end remains patent, distinguishing it from purulent salpingitis. 1. Exudative type: tubes enlarged to fist size with caseous material, minimal adhesions, prone to torsion, sometimes straw-colored ascites. 2. Proliferative-adhesive type (more common): tubes slightly enlarged with thickened walls, multiple miliary nodules, dense surrounding adhesions, caseous material, patent fimbriae, sometimes loculated effusion.

Treatment

Surgical treatment, drug therapy, supportive therapy

Preventive Measures

BCG vaccination clearly prevents miliary and meningeal TB in infants/children with immature cellular immunity. Contact prevention: patients should adhere to full therapy; after 2 weeks of standard treatment infectiousness drops 95%. Contacts should be screened. Disinfection: boil utensils/clothes 10-15 min, sun bedding 4-6 h, or UV-disinfect 2 h. Ventilate every 10 minutes (4-5 exchanges remove 99% of bacilli). Practice good hygiene. Drug prophylaxis: strongly positive Mantoux reactors, open-TB contacts, silicosis, dialysis, diabetes, or long-term corticosteroid users may take isoniazid (adults 1 mg/kg, children 10 mg/kg) for 1 year. The goal is preventing disease in those already infected; only ~10% of infected persons ever develop TB, depending on virulence and resistance.

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.