Comparison of clinical and laparascopic features of infertile women suffering from genital tuberculosis (TB) or pelvic inflammatory disease (PID) or endometriosis.

OBJECTIVE: The objective of the study was to analyze the clinical and laparoscopic features, which may help to differentiate between infertility in females due to Genital Tuberculosis from Pelvic Inflammatory Disease (PID) and Endometriosis.

METHODS: This case control study was carried out in a teaching tertiary care hospital. Medical records were searched from 1st January 1987 to 31st December 2000 and 43 infertile women with biopsy proven genital tract tuberculosis were found. Equal number of infertile females with diagnosed PID and Endometriosis were randomly selected. Comparisons were done between features of Genital Tuberculosis with PID and Endometriosis separately and also genital tuberculosis with combined controls of PID and Endometriosis.

RESULTS: Patients with genital tuberculosis commonly had primary infertility. PID and Endometriosis patients had early menarche and increased duration of menstruation. On physical examination, patients with Genital Tuberculosis were found to have short heights. No significant findings were observes in the pelvic examination and menstruation history between the comparison groups. Laparascopic examination revealed that fallopian tubes were abnormal, tortuous, bilaterally blocked and thickly adherent more commonly in Genital Tuberculosis when compared to other groups.

CONCLUSION: The primary infertility patients with chronic malnutrition and massive adhesive fallopian tubes on laproscopic examination should be evaluated for genital tuberculosis.