Genital tuberculosis and infertility

Background: An analytical study to diagnose genital tuberculosis, using various modalities, it`s treatment options and fertility outcomes in infertile labour class women.Methods: A prospective study, where 120 women, presented to hospital due to infertility were subjected to hystero-laparoscopy over 36 months. Endometrium sent for TB-PCR and HPR. Those diagnosed with GTB were given Anti-Tubercular Drugs as per standard regimes and their fertility outcome was studied.Results: Out of 120 women, 32(27%) were diagnosed with GTB using accepted clinical criteria, TB-PCR and endometrial HPR. 30 of these 32 were diagnosed by HLscopic picture (94%) alone, 18 by positive endometrial TB-PCR (58%) and another 3 by HPR (10%). Among 32 women treated, 9(28%) conceived after treatment.Conclusions: High incidence of GTB amongst the labour class warrants strong suspicion and early diagnosis using hystero-laparoscopy and prompt treatment to minimize the short and long-term effects of GTB on fertility

Scar endometriosis after caesarean section: a case series and review of literature

Endometriosis is defined as extra-uterine localization of ectopic functional endometrial gland and stroma. Cystic or solid tumoral masses caused by endometriosis are named as endometrioma. Although these pathologic conditions mostly encountered in ligaments of uterus, ovaries, pouch of douglos and pelvic peritoneum; endometriosis has also been reported in nose, breast, lung, spleen, gastrointestinal tract, kidney, abdominal wall, but scar endometriomais extremely rare. Scar endometriosis is rare and difficult to diagnose. This condition can be confused with other surgical conditions, however imaging techniques and FNAC are indicated towards better diagnostic approach. Medical treatment is helpful in selected cases but wide excision is the treatment of choice. By presenting this paper, and conducting a review of the literature, we intend to increase the awareness of this rather, rare condition

Rare case of deep pelvic retroperitoneal mature cystic teratoma

Mature cystic retroperitoneal teratomas are typically rare childhood tumours. Less than 20% of these occur in adults more than 30 yrs of age. Our adult patient presented with such a tumour, which had grown to a disproportionately large extent. It was deeply embedded in the true pelvis extending laterally to the pelvic wall and inferiorly till the ischiorectal fossa and was adherent to the surrounding structures displacing all. A provisional diagnosis was made after MRI scan and patient was posted for exploratory laparotomy. After extensive blunt and sharp dissection, the cyst wall could be separated from the surrounding structures and successfully excised. Histopathology confirmed the diagnosis. Being such a rare tumour, it is essential to have a high degree of suspicion in such cases that can be supported by advanced imaging modality. Early diagnosis and complete surgical removal are the mainstay of management that provide an excellent prognosis for such patients.