A brief discussion on endometrial tuberculosis

Endometrial tuberculosis often follows pulmonary tuberculosis, renal tuberculosis, gastrointestinal tuberculosis, bone or joint tuberculosis, etc. Occasionally, it can also be part of systemic miliary tuberculosis. Infectious diseases of female reproductive organs caused by Mycobacterium tuberculosis often first invade the fallopian tubes, then gradually invade the endometrium and ovaries, and rarely involve the cervix, vagina and vulva. Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, which seriously endangers people's health.

Due to factors such as HIV infection, multidrug-resistant tuberculosis and immigration, the global tuberculosis epidemic has rebounded, with about 10 million new tuberculosis patients and about 3 million deaths from tuberculosis each year. In 2000, the fourth tuberculosis epidemiological sampling survey in my country showed that there were 4.6 million active pulmonary tuberculosis patients nationwide, indicating that the epidemic of tuberculosis in my country is still quite serious and tuberculosis prevention and control work is facing new challenges. As the number of pulmonary tuberculosis patients increases, the number of female genital tract tuberculosis patients has also increased accordingly.

Endometrial tuberculosis is usually caused by the spread of fallopian tube tuberculosis. When tuberculosis bacteria infect the body, the disease usually does not occur immediately, but after a period of incubation. During the incubation period, when the body's resistance is poor, tuberculosis bacteria can invade the endometrium and eventually affect the basal layer of the endometrium.

Pathogenesis of endometrial tuberculosis

1. Development Path:

Female genital tuberculosis first infects the fallopian tubes and then gradually spreads to the endometrium, ovaries, cervix, etc. As the endometrium sheds periodically, the endometrial tuberculosis lesions are discharged with it. The lesions are mostly confined to the endometrium, with scattered millet-like nodules in the early stage. In very rare severe cases, the lesions invade the myometrium. The uterus is normal in size or slightly smaller, and there is no abnormality in appearance.

2. Characteristics of endometrial tuberculosis nodules:

The glands surrounding tuberculous nodules are insensitive to ovarian hormones and manifest as persistent hyperplasia or insufficient secretion.

3. Consequences:

Severe endometrial tuberculosis leads to caseous necrosis and superficial ulcers, which destroy most or all of the endometrium. Scars may form in the future, and the endometrium may lose all its function and cause amenorrhea.

Prevention of Endometrial Tuberculosis

How should endometrial tuberculosis be prevented? Endometrial tuberculosis is mostly secondary infection, and the primary lesion is mainly pulmonary tuberculosis. Therefore, actively preventing and treating pulmonary tuberculosis is of great significance to preventing genital tuberculosis. Its preventive measures are the same as those for pulmonary tuberculosis. In addition to strengthening anti-tuberculosis publicity and education, the health care of children and adolescents should be strengthened. Newborns weighing more than 2200g can be vaccinated with BCG 24 hours after birth, and can be boosted within 3 months if necessary. Infants over 3 months old and adolescent girls with negative tuberculin tests should be vaccinated with BCG. Pregnancy should be avoided during the active period of tuberculosis. In addition, patients with genital tuberculosis may have tuberculosis bacteria in their vaginal secretions and menstrual blood, and isolation should be strengthened to avoid infection.