Tuberculosis of genital organs: symptoms, diagnosis, treatment
Genital tuberculosis is secondarya disease whose development is provoked by mycobacteria. The pathology is formed on the background of the primary infection, which affects the lungs or intestines. Such a disease falls on the genitals with lymphogenous, contact or hematogenous pathways.
Classification of infection
According to clinical and morphological characteristics, tuberculosis of genital organs is divided into the following forms:
- Caseous. The disease proceeds with acute and severe processes.
- Chronic. Symptomatic in this form is weakly expressed.
- Subacute. There is a significant lesion and exudative-proliferative changes.
- The finished process. There is an encapsulation of the foci.
In addition, tuberculosis, affecting sexualbodies, can be active, fading and inactive. In the first case, the disease lasts for 2 years, and in the second case it develops within 2-4. Inactive tuberculosis is the process that remains after therapy. When the course of the disease in four years becomes more severe, then there is an exacerbation. And if the signs of genital tuberculosis appeared only after many years, then it is a question of relapse.
Another such disease is classified depending on the area of infection: endometrium, salpingoophoritis and salpingitis. Bacteria of this type of tuberculosis are also divided into MBT (+) and MBT (-).
Causes of pathology development
Infection with such a disease can happen at any age. If a person has strong immunity, the mycobacteria will not manifest themselves immediately, which makes diagnosis difficult.
The latent period sometimes lasts for years and evendecades, but when there are provoking factors, the symptoms of the disease begin to manifest. For example, if the protective functions of the body worsen, because of severe infections of a different nature, pathologies of internal organs, when exhausted, as a result of stress, prolonged cold, surgical intervention.
When tuberculosis affects the lungs, mycobacteriabegin to spread to the genitals. If no symptoms appear at an early stage, the disease will form imperceptibly. Although the presence of signs does not always guarantee that genital tuberculosis will manifest itself.
Tuberculosis of the reproductive organs: symptoms
The main signs of this pathology can arisein adolescence during puberty. It affects mainly the representatives of the weaker sex from 20 to 40 years. Genital tuberculosis after this period is extremely rare.
This infectious disease is able to leakwithout obvious symptoms or differ in their diversity. Quite often, the main sign of tuberculosis affecting the sexual organs in women is the impossibility of conception of the child, due to endocrine disorders or infection of the fallopian tubes and mucous side of the vagina.
Other signs of genital tuberculosis
To all other things, such an ailment canaccompanied by symptoms such as lack of appetite, amenorrhea, causeless weight loss, vascular sclerosis, night sweats, acute pain in the abdominal cavity, which is often confused with ectopic pregnancy and appendicitis. In addition, in genital tuberculosis, women are often disturbed by unpleasant sensations in the lower abdomen and subfebrile fever.
The defeat of mycobacteria of the genitourinary system
This type of tuberculosis requirestimely diagnosis and treatment. The disease begins with tubercular lesions of organs. In the first place, 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 primary period of defeat, until the development of the immune system in adolescence and childhood. With such a malaise, there is often a violation of urination, it can be rapid and accompanied by cuts. In some cases, urine is excreted in small portions.
When mycobacteria affect the organs of the urinarysystem, there is hematuria, aching and blunt pain in the lumbar region, frequent urge to the toilet due to a decrease in the capacity of the urea. Still this disease is capable to provoke occurrence of a pyuria at which in a pee the pus is visible or leucocytes are formed.
Tuberculosis of the genital organs in men
This pathology rarely affects young men who have not reached puberty. Mostly men are affected by this disease between the ages of 21 and 50, during the period of increased sexual activity.
There is tuberculosis of male genital organsusually in the form of fistulous, focal, miliary, focal-destructive forms. Patients with a similar diagnosis complain of an ulcer on the head of the penis, the presence of a fistula crotch or scrotum, redness of the skin, a decrease in the volume of the ejaculate, pus or an admixture of blood in the semen, infertility. In addition to all they have swelling of the genital organs, painful orgasm and a decrease in potency.
Many people with this diagnosis feel dull pain,which are localized in the perineum, waist, scrotum. When the mycobacteria of the prostate gland or seminal vesicles are affected, constipation and a feeling of heaviness in the rectum often occur.
Forms of the disease
Genital TB in the stronger sex is classified into two main forms:
- An acute stage affects about 30% of people. Characterized by a sudden swelling of the epididymis, strong pain, reddening of the skin of the scrotum, high body temperature, poor health, chills.
- Chronic stage occurs in 70% of people. The disease with this form is lethargic and slow with normal or subfebrile temperature. There are pains of a pulling character, there is a moderate reddening of the scrotum. Eggs appendages 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
Tuberculosis of female genital organs, as a rule,is characterized by an erased manifestation and a wide variety of symptoms. Sometimes the only sign of pathology is the inability to become pregnant. Infertility develops as a result of endocrine disorders, damage to the fallopian tubes or endometrium.
Most patients face a violationmenstrual function: primary and secondary amenorrhea, irregular monthly, oligomenorrhea. There is a similar failure in the female body as a result of tuberculous intoxication, lesions of the mucous side of the vagina inside the uterus and the parenchyma of the ovary.
Tuberculosis of genital organs in women is mainlyhas a chronic course. With this form, the processes of the release of inflammatory fluid from the blood into tissues predominate. The temperature often rises to subfebrile digits. There are aching and pulling painful sensations in the bottom of the abdominal cavity, as the formation of adhesions in the small pelvis, atherosclerosis of internal genital organs and tissue hypoxia.
Tuberculosis of the genital organs with exudative and caseous changes is manifested by symptoms of intoxication:
- weight loss;
- periodic fever;
- constant weakness and fatigue;
- lack of desire to eat.
And girls with genital tuberculosis canTo disturb symptoms of "an acute stomach" as in the process the peritoneum is involved. Sometimes this condition leads to surgery due to suspicion of ectopic pregnancy, appendicitis or rupture of ovarian tissue.
Diagnosis of pathology
Tuberculosis of the genital organs in many casesare found during the examination by a gynecologist. At the same time, women turn for other reasons. In the appendages there are changes that appear when the tuberculous inflammatory process develops in them. When a specialist has suspicions of this disease, he sends patients to a TB dispensary.
In this medical institution, a woman passesfull complex of diagnostic measures. The first thing she will take a special skin test to detect active tuberculosis inflammation in the body. To detect the disease, a smear is made from the genital tract. To identify mycobacteria tuberculosis still resort to PCR diagnostics.
Diagnosis of genital tuberculosisassumes also the performance of hysterosalpingography. This procedure allows you to see the violation of patency of one or both fallopian tubes, internal shape of the uterus, constriction, adhesion.
When tubercle bacilli are detected inthe female body outside the genitals makes a radiograph of the lungs. Even the ladies will have to undergo laparoscopy, because this procedure allows you to examine the internal organs and reveal on their surface tuberculous inflammation. In addition, it helps to assess the severity of the adhesion process in the pelvic cavity.
How to prevent the development of genital tuberculosis?
To prevent the appearance of this disease,it is necessary to start acting at an early age. To the kid from the first month of life it is necessary to do the vaccine against tuberculosis. The repeated inoculation of BCG is carried out at 7, 12 and 17 years. Prevention also means enhancing the immune system and strengthening the body.
Therapeutic measures
Treatment of tuberculosis of genital organs is carried outonly in a specialized sanatorium, inpatient or anti-tuberculosis dispensary. To treat this disease using chemotherapeutic drugs, usually combine at least two drugs of bactericidal action. This takes into account their effectiveness and patient tolerance.
Medications for the treatment of genital tuberculosis
For such purposes, doctors appoint: metazide, streptomycin, rifamp-picin, isoniazid, ethambutol, kanamycin and other drugs. In the first 12-18 months, biomycin or kanamycin is used in combination with ftyvazid or tubazid. A good result is a combination of ethambutol irifampicin with isoniazid for 15 months.
In addition to antibacterial drugs, patientsit is recommended to use antioxidants and vitamins. Modern chemotherapy significantly reduced the need for surgery in women. Moreover, in cases of problems with the conception of tuberculosis, the plasticity of the tubes is not recommended.
Remember that treating such a pathology is a time-consuming and long process, which requires a lot of patience from the patient.