Peritoneal Fluid from Pouch of Douglas is not a Suitable Specimen for Molecular Testing in the Diagnosis of Female Genital Tuberculosis in Women Presenting with Infertility
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Date
2024-10
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Publisher
THE INDIAN MEDICAL ASSOCIATION
Abstract
Background : Female genital tuberculosis is a form of Extra-pulmonary tubercular disease that primarily manifests as infertility in women. It's diagnosis is challenging because of difficulty in obtaining appropriate samples for testing. Conventional diagnostic methods, such as microscopy and culture, have limited effectiveness, leading to the use of molecular techniques for accurate diagnosis. This study was conducted to evaluate the suitability of Peritoneal Fluid in the pouch of Douglas or peritoneal washings as an alternate specimen for diagnosing female Genital Tuberculosis. Materials and Methods : A prospective cross-sectional study was conducted on 30 infertile women, clinically suspected of Genital Tuberculosis. Laproscopy was performed to ascertain the presence of morphological signs of Genital Tuberculosis and Peritoneal Fluid or washings were collected for molecular testing of tuberculosis. Results : Among the 30 infertile women (primary infertility = 20; secondary infertility = 10), 11 were aged 21-30 years, while 19 were aged 31-40 years. Pelvic ultrasonogram showed abnormalities in only a third of the cases. In laparoscopy, definite findings of Genital Tuberculosis were noted in 13 cases (43.3%). Others had probable findings of Genital Tuberculosis, comprising of, Pelvic Adhesions, Bilateral or Unilateral Tubal Block, Tubo-ovarian Mass, Fitz Hugh Curtis Syndrome and Hydrosalpinx. Laproscopically obtained Peritoneal Fluid or washings from all the 30 women were tested using cartridge-based Nucleic Acid Amplification and Polymerase Chain Reaction for Mycobacterium Tuberculosis. However, all the samples tested negative. Conclusion : The use of Peritoneal Fluid as a specimen for molecular detection of Mycobacterium Tuberculosis did not yield positive results in this study. Further research is warranted to validate the study’s result and to explore better alternative approaches for the diagnosis of Female Genital Tuberculosis.
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Keywords
Female, Genital Tuberculosis, Infertility, Peritoneal Fluid, Nucleic Acid Amplification, Laproscopy
Citation
Mishra Debadutta, Turuk Jyotirmayee, Palo Seetu, Ray Pratyush Kumar, Mishra Bharadwaj, Pati Sanghamitra . Peritoneal Fluid from Pouch of Douglas is not a Suitable Specimen for Molecular Testing in the Diagnosis of Female Genital Tuberculosis in Women Presenting with Infertility. Journal of the Indian Medical Association. 2024 Oct; 122(10): 49-54