Genital tuberculosis

Description:

Genital tuberculosis, in most cases, develops for the second time in the investigation of a drift of an infection from primary center of defeat (from lungs or intestines). Defeat of urinogenital bodies wins first place among extra pulmonary forms of tuberculosis. The statistics of the registered cases of genital tuberculosis is not true as diagnosis during lifetime of the patient does not exceed 6,5%.

Symptoms of Genital tuberculosis:

The first symptoms of a bolezna can appear already during puberty, but in most cases women of 20 — 30 years have genital tuberculosis. Less often the disease occurs at more senior patients and even at women in a postmenopause. Genital tuberculosis has generally erased clinical picture with a big kind of symptoms. It is explained by variability of pathoanatomical changes. Decrease in generative function is the basic, and sometimes and the only symptom of a disease. To the infertility reasons, a thicket of primary, it is worth referring endocrine disturbances, damages of uterine tubes and an endometria. In most cases at patients menstrual function is broken: the amenorrhea, an oligomenorrhea, irregular periods, an algomenorrhea, is more rare meno-and metrorrhagias. Disturbances of menstrual function is caused by defeat of a parenchyma of an ovary, an endometria, and also with tubercular intoxication. The chronic disease with a preyoobladaniye of exudation causes the subfebrile temperature and the pulling, aching pains in the bottom of a stomach because of commissural process in a small basin, defeats of nerve terminations, an angiosclerosis and a hypoxia of fabrics of internal generative organs. The symptoms of tubercular intoxication connected with development of exudative or caseous changes in internal genitalias belong to other displays of a disease. Sometimes, is more often at young patients, genital tuberculosis can begin with signs of "acute abdomen" that often leads to operation in connection with suspicion of an acute appendicitis, an extrauterine pregnancy, an ovary apoplexy.

Reasons of Genital tuberculosis:

From primary center at decrease in immune resistance of an organism because of persistent infections, stresses, etc., mycobacteria get to generative organs. The infection extends in generally hematogenous way, is more often at primary dissimination in the childhood or in the puberty period. At tubercular defeat of a peritoneum the activator gets on uterine tubes limfogenno or a contact way. Direct infection at sexual contacts with sick genital tuberculosis, is possible only in the theory, it is interfered by a multilayer flat epithelium of a vulva, vagina and a vulval portion of a neck of uterus which is steady against mycobacteria. Uterine tubes (90 — 100%) are most subject to infection. The second place is taken by an endometria (25 — 30%). Less often tuberculosis of ovaries (6 — 10%) and necks of uterus (1 — 6%) meets, it is extremely rare — tuberculosis of a vagina and external genitals. In the centers of defeat there are morfogistologichesky changes, typical for tuberculosis: exudation and proliferation of fabric elements, caseous necroses. Tuberculosis of uterine tubes often comes to an end with their obliteration, exudative and proliferative processes can lead to formation of a pyosalpinx, and when involving in specific proliferative process of a muscular layer of uterine tubes in it tubercles are formed, call it a nodose inflammation. At a tubercular endometritis productive changes — tubercular hillocks, caseous necroses of certain sites are also expressed. Tuberculosis of appendages of a uterus often is followed by involvement in process of a peritoneum with ascites, intestines loops with formation of commissures, and in certain cases and fistulas. Genital tuberculosis is often combined with defeat of uric ways.

Treatment of Genital tuberculosis:

Treatment of genital tuberculosis, as well as tuberculosis of any localization, it is necessary to carry out in specialized institutions — antitubercular hospitals, clinics, sanatoria. Therapy has to be complex and include antitubercular chemotherapy, means of increase in protective forces of an organism, physical therapy, surgical treatment according to indications. The main treatment of tuberculosis is the chemotherapy with use not less than 3 drugs. The chemotherapy is appointed individually taking into account a form of a disease, portability of drug, possible development of medicinal stability of mycobacteria of tuberculosis. The wrong treatment of tuberculosis does more harm, than advantage as it transfers easily curable forms of a disease to difficult curable drug resistant tuberculosis. The program of treatment of patients with genital tuberculosis provides long (from 6 to 24 months) reception of several (from 3 to 8) antitubercular drugs. Surgical treatment is appointed only according to strict indications. Operation in itself does not lead to recovery as the tuberculosis infection remains. After operation it is necessary to continue chemotherapy. The physical therapy is appointed after a zatikhaniye of the acute phenomena in the form of a fonoforez of a hydrocortisone, sinusoidal currents, by amplipulsetherapies. Sanatorium treatment of tuberculosis is recognized ineffective and too expensive now. Refused it in the majority of the countries of the world in the middle of the 20th century. In Russia this type of rehabilitation treatment remained as a form of the social help to patients. The climate of mountain, steppe and southern sea resorts is considered the most suitable.