Increased difficulties and complications encountered during hysteroscopy in women with genital tuberculosis

Background: Genital tuberculosis (TB) in women is a common disease in developing countries, and hysteroscopy and laparoscopy are vital tools in diagnosis.

Study objective: To retrospectively compare the difficulties encountered and complications of hysteroscopy in women with and without genital TB.

Design: Case-control clinical audit (Canadian Task Force classification II-1).

Setting: Medical college and hospital.

Patients: Ninety-nine women who underwent hysteroscopy, with or without other procedures, who were found to have genital TB at various investigations (group 1) and 289 women who underwent hysteroscopy during the same period with similar characteristics but without evidence of genital TB (group 2, controls).

Intervention: Hysteroscopy.

Measurements and main results: Difficulties encountered and complications observed were recorded, compared, and analyzed using the χ(2) and Fisher exact tests. Indications for hysteroscopy in the study vs the control group were infertility in 92 patients (92.92%) vs 124 (42.90 %), amenorrhea in 6 (6.66%) vs 12 (4.15%), and postmenopausal bleeding in 1 (1.11%) vs 29 (10.03%). Difficulties and complications were significantly higher in group 1. Inability to distend the cavity was observed in 8 women in group 1 (8.08%) vs 2 in group 2 (0.69%). Excessive bleeding was observed in 5 women in group 1 (5.05%) vs 1 in group 2 (0.35 %). Uterine perforation was observed in 8 women in group 1 (8.08%) vs 5 in group 2 (1.73%), and flare-up of genital TB was observed in 1 woman in group 1.

Conclusion: Hysteroscopy in women with genital TB is associated with difficulty in performing the procedure and with higher rates of complications.