Cervicitis is a common gynecological inflammation. Tuberculous cervicitis can cause infertility, menstrual disorders, lower abdominal pain, in addition to fever, fatigue, loss of appetite, weight loss symptoms. The most common cause of tuberculous cervicitis is hematogenous transmission. 1. Symptoms and Signs 1. Infertility Most patients with genital tuberculosis seek medical treatment due to infertility. Genital tuberculosis is one of the common causes of primary infertility. Due to the destruction and adhesion of the fallopian tube mucosa, the lumen is often blocked; or due to adhesions around the fallopian tube, the lumen sometimes remains partially unobstructed, but the mucosal cilia are destroyed, the fallopian tube is stiff, the peristalsis is restricted, and the transport function is lost; endometrial tuberculosis hinders the implantation and development of the fertilized egg, which can also cause infertility. 2. Menstrual disorders. In the early stage, there may be excessive menstrual flow due to endometrial congestion and ulceration; in the late stage, there may be oligomenorrhea or amenorrhea due to varying degrees of endometrial damage. Most patients are in the late stage when they seek medical treatment. 3. Lower abdominal pain Due to pelvic inflammation and adhesions, there may be varying degrees of lower abdominal pain, which worsens during menstruation. 4. Systemic symptoms If it is in the active stage, there may be general symptoms of tuberculosis, such as fever, night sweats, fatigue, loss of appetite, weight loss, etc. In mild cases, the systemic symptoms are not obvious, and sometimes only fever during menstruation, which is one of the typical clinical manifestations of genital tuberculosis, may occur in severe cases with systemic poisoning symptoms such as high fever. 5. General and gynecological examination Due to the different extent and range of the lesions, there are great differences. Many patients are found to have pelvic tuberculosis without obvious signs and other subjective symptoms when undergoing diagnostic curettage, hysterosalpingography and laparoscopy for infertility. If they also have peritoneal tuberculosis, the abdomen will feel soft or have ascites during the examination. When encapsulated effusion is formed, a cystic mass can be touched, with unclear boundaries and no movement. The surface has intestinal adhesions and percussion is hollow. Papillary hyperplasia and small ulcers can be seen in cervical tuberculosis. 2. Pathological Causes Cervical tuberculosis often spreads from endometrial tuberculosis or spreads through the lymphatic or blood circulation. 1. Hematogenous transmission During adolescence, the reproductive organs develop and have rich blood supply, so Mycobacterium tuberculosis can easily spread through the blood. After Mycobacterium tuberculosis infects the lungs, it can infect the internal reproductive organs within about a year. Because the fallopian tube mucosa is conducive to the latent infection of Mycobacterium tuberculosis, Mycobacterium tuberculosis first invades the fallopian tubes, then spreads to the endometrium and ovaries in turn, and rarely invades the cervix, vagina or vulva. 2. Direct spread: Peritoneal tuberculosis and intestinal tuberculosis can spread directly to the internal reproductive organs. |
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