Genital tuberculosis is a secondary disease, the development of which is provoked by mycobacteria. A pathology is formed against the background of a primary infection that affects the lungs or intestines. Such a disease enters the genitals by the lymphogenous, contact, or hematogenous route.
Infection classification
According to the clinical and morphological characteristics, genital tuberculosis is divided into the following forms:
- Caseous. The disease proceeds with acute and severe processes.
- Chronic Symptoms with this form are poorly expressed.
- Subacute Significant lesions and exudative-proliferative changes occur.
- The completed process. Encapsulation of foci occurs.
In addition, tuberculosis affecting the genitals can be active, silent, and inactive. In the first case, the disease lasts for 2 years, and in the second it develops within 2-4. Inactive tuberculosis is the process left after therapy. When the course of the disease in four years becomes more severe, then an exacerbation has occurred. And if signs of genital tuberculosis appeared only after many years, then we are talking about relapse.
Another such disease is classified depending on the area of infection: endometrium, salpingoophoritis and salpingitis. The bacteria of this type of tuberculosis are also divided into MBT (+) and MBT (-).
Reasons for the development of pathology
Infection with such a disease can happen at any age. If a person has strong immunity, then mycobacteria will not manifest themselves immediately, which complicates the diagnosis.
The latent period sometimes lasts for years and even decades, but when provocative factors occur, the symptoms of the disease begin to appear. For example, with a deterioration in the protective functions of the body, due to severe infections of a different nature, pathologies of internal organs, with exhaustion, as a result of stress, a protracted cold, surgical intervention.
When tuberculosis affects the lungs, mycobacteria begin to spread to the genitals. If at the early stage no symptoms appear, the disease will form imperceptibly. Although the presence of signs does not always guarantee that genital tuberculosis will manifest itself.
Genital tuberculosis: symptoms
The main signs of this pathology can occur in adolescence during puberty. Mostly the weaker sex from 20 to 40 years suffer from it. Genital tuberculosis after this period is extremely rare.
This infectious disease can occur without obvious symptoms or differ in their variety. Quite often, the main sign of tuberculosis affecting the genitals in women is the inability to conceive a child, due to endocrine disorders or infection of the fallopian tubes and the mucous side of the vagina.
Other signs of genital tuberculosis
In addition, such an ailment can be accompanied by symptoms such as lack of appetite, amenorrhea, causeless weight loss, vascular sclerosis, night sweats, acute abdominal pain, which is often confused with ectopic pregnancy and appendicitis. In addition, with genital tuberculosis, women are often disturbed by unpleasant sensations in the lower abdomen and low-grade fever.
Genitourinary mycobacteria
This type of tuberculosis requires timely diagnosis and treatment. The disease begins with tubercular lesions of organs. First of all, the kidney suffers and only after that the ureter or the bladder.
Tuberculosis of the urinary and genital organs is formed, as a rule, during the initial period of the lesion, before the development of the immune system in adolescence and childhood. With this ailment, urination is often disturbed, it can be quickened and accompanied by pain. In some cases, urine is excreted in small portions.
When mycobacteria affect the organs of the urinary system, hematuria appears, aching and dull pains in the lumbar region, increased urge to the toilet due to a decrease in the capacity of the urea. Also, this disease can provoke the appearance of pyuria, in which pus is visible in the urine or white blood cells are formed.
Genital tuberculosis in men
This pathology rarely affects young men who have not reached puberty. Mostly affected by this disease are men aged 21 to 50 years, during a period of increased sexual activity.
There is tuberculosis of the male genital organs usually in the form of fistulous, focal, miliary, focal and destructive forms. Patients with a similar diagnosis complain of an ulcer on the head of the penis, a fistula of the perineum or scrotum, redness of the skin, a decrease in the volume of ejaculate, pus or an admixture of blood in semen, infertility. In addition to everything, they have a swelling of the genitals, a painful orgasm and a decrease in potency.
Many people with this diagnosis feel dull pains that are localized in the perineum, lower back, and scrotum. When mycobacteria affect the prostate or seminal vesicles, constipation and a feeling of heaviness in the rectum often occur.
Forms of the disease
Genital tuberculosis in the stronger sex is classified into two main forms:
- An acute stage affects about 30% of people. The sudden swelling of the appendage of the ovary , severe pain, redness of the skin of the scrotum, high body temperature, poor health, chills are characteristic.
- The chronic stage occurs in 70% of people. The disease with this form proceeds sluggishly and slowly with normal or subfebrile temperature. There are pulling pains, a moderate redness of the scrotum occurs. The appendages of the testicles are tuberous and dense, often complicated by a fistula or soldered to the skin of the scrotum.
Clinical course of the disease in the weaker sex
Female genital tuberculosis, as a rule, is distinguished by an erased manifestation and a wide variety of symptoms. Sometimes the only sign of pathology is the inability to get pregnant. Infertility develops as a result of endocrine disorders, damage to the fallopian tubes or endometrium.
Most patients experience menstrual dysfunction: primary and secondary amenorrhea, irregular periods, oligomenorrhea. A similar malfunction occurs in the female body as a result of tuberculous intoxication, damage to the mucous side of the vagina inside the uterus and ovarian parenchyma.
Genital tuberculosis in women is mainly chronic. With this form, the processes of the release of inflammatory fluid from the blood into the tissues predominate. The temperature often rises to subfebrile digits. There are aching and pulling pain in the lower abdominal cavity, since adhesions in the small pelvis, atherosclerosis of the internal genital organs and tissue hypoxia occur.
Genital tuberculosis with exudative and caseous changes is manifested by symptoms of intoxication:
- losing weight;
- intermittent fever;
- constant weakness and fatigue;
- lack of desire to eat.
Moreover, girls with genital tuberculosis may be disturbed by the symptoms of an “acute abdomen”, since the peritoneum is involved in the process. Sometimes this condition leads to surgery due to suspected ectopic pregnancy, appendicitis or rupture of ovarian tissue.
Pathology diagnostics
Genital tuberculosis in many cases is detected during examination by a gynecologist. At the same time, women come for other reasons. In the appendages, changes occur that appear when the tuberculous inflammatory process develops in them. When a specialist suspects this disease during examination, he sends patients to a TB dispensary.
In this medical institution, a woman undergoes a full range of diagnostic measures. First of all, she will take a special skin test to detect active tuberculous inflammation in the body. To detect the disease, a swab from the genital tract is done. To detect mycobacterium tuberculosis, they also resort to PCR diagnostics.
Diagnosis of genital tuberculosis also involves hysterosalpingography. This procedure allows you to see a violation of the patency of one or both of the fallopian tubes, the internal shape of the uterus, narrowing, fusion.
If foci of tubercle bacillus are found in the female body outside the genitals, an X-ray of the lungs is done. More ladies will have to undergo laparoscopy, because this procedure allows you to examine the internal organs and detect tuberculous inflammation on their surface. In addition, with its help it is possible to assess the severity of the adhesions in the pelvic cavity.
How to prevent the development of genital tuberculosis?
To prevent the onset of this disease, it is necessary to start acting from an early age. From the first month of life, a baby must be given a vaccine against tuberculosis. Re-vaccination of BCG is carried out at 7, 12 and 17 years. Prevention also involves boosting the immune system and strengthening the body.
Therapeutic measures
Treatment of genital tuberculosis is carried out only in a specialized sanatorium, hospital or TB dispensary. For the treatment of this disease, chemotherapeutic drugs are used, as a rule, at least two drugs of bactericidal action are combined. This takes into account their effectiveness and tolerance by the patient.
Medicines for the treatment of genital tuberculosis
For such purposes, doctors prescribe: metazide, streptomycin, rifam-pitsin, isoniazid, ethambutol, kanamycin and other drugs. In the first 12-18 months, biomycin or kanamycin is used in combination with phtivazide or tubazide. A good result is given by a combination of ethambutol and rifampicin with isoniazid for 15 months.
In addition to antibacterial drugs, patients are recommended to use antioxidants and vitamins. Modern chemotherapy has significantly reduced the need for surgery in women. Moreover, in case of problems with the conception of tuberculosis, plastic pipe is not recommended.
Remember that the treatment of such a pathology is a laborious and long process that requires a lot of patience from the patient.