Abstract:

Objective: To explore the application value of hysteroscopy in infertile women with suspected genital tuberculosis, and provide reference for clinical diagnosis and treatment. Methods: From January 2018 to December 2021, 62 infertile patients of high suspicion of genital tuberculosis with strong positive tuberculin skin test (PPD test) and positive tuberculosis infection T-cell spot test (T-SPOT.TB test) were selected from the Tuberculosis Prevention and Treatment Hospital of Shaanxi Province. They all underwent chest+pelvic CT examination and laparoscopy or combined exploration of hysteroscopy and laparoscopy. The clinical manifestations, chest and pelvic CT results, hysteroscopy and laparoscopy of the patients were analyzed, as well as the diagnostic value of suspected genital tuberculosis. Results: Of the 62 patients, 51 (82.3%) were primary infertility. The chest CT showed that, 10 cases (16.1%) had active pulmonary tuberculosis, 41 cases (66.1%) had inactive pulmonary tuberculosis, and 11 cases (17.7%) had no lesions in the chest. Among the 62 patients, 48 had pelvic lymph node calcification, bilateral adnexal spot calcification, low density mass with uneven density, intrauterine spot calcification and incomplete intestinal obstruction; 25 patients underwent hysteroscopy combined with laparoscopy, and 3 patients were diagnosed as endometrial tuberculosis by hysteroscopy; all the 62 patients were diagnosed as suspected genital tuberculosis through laparoscopy, and 40 were diagnosed as FGT. Conclusion: The location, size, shape, peripheral conditions and pelvic status of the lesions in infertile patients with suspected genital tuberculosis could be clearly detected by laparoscopy or hysteroscopy combined with laparoscopy. This is of great significance for the diagnosis of female suspected genital tuberculosis and can provide reference for clinical diagnosis and treatment.

Key words: Genital diseases, female, Tuberculosis, Laparoscopes, Hysteroscopes