Hysteroscopic markers for endometrial tuberculosis
Download
1 / 23

HYSTEROSCOPIC MARKERS FOR ENDOMETRIAL TUBERCULOSIS - PowerPoint PPT Presentation


  • 599 Views
  • Uploaded on

HYSTEROSCOPIC MARKERS FOR ENDOMETRIAL TUBERCULOSIS. Dr. PAAYAL CHOBE. Dr. Paayal Chobe. MBBS (gold medalist), MD OBGY Clinical fellowship in Gynae -Laparoscopy-Mumbai BEAMS Diploma in Gynae Laparoscopy KIEL & GIESSEN GERMANY Presented poster in AICOG 2003 BANGALORE

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'HYSTEROSCOPIC MARKERS FOR ENDOMETRIAL TUBERCULOSIS' - arnoldo


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Dr paayal chobe
Dr. Paayal Chobe

  • MBBS (gold medalist), MD OBGY

  • Clinical fellowship in Gynae -Laparoscopy-Mumbai BEAMS

  • Diploma in Gynae Laparoscopy KIEL & GIESSEN GERMANY

  • Presented poster in AICOG 2003 BANGALORE

  • Presented paper use of Misoprostol prior to hysteroscopy AMOGS 2009-Aurangabad

  • Faculty in state conference AMOGS 2009


GENITO URINARY TUBERCUOSIS

Always secondary to Tuberculosis elsewhere in the body usually in the Lungs, Peritoneum, Lymph Glands and Bone.

1st case was recorded by Morgagni on autopsy.


Incidence
INCIDENCE:

  • Involvement of organs –Norries

    Site %

    Fallopian tubes 85-90

    Endometrium 35-50

    Ovaries 5-6

    Cervix 3

    Vagina & vulva 2


  • Involvement of Endometrium

  • Extensive

  • The Endometrium is replaced by hyalanized connective tissue thereby --------obliterating the cavity.

  • Patients present as Oligomenorrhoea to Amenorrhoea.


Hysteroscopy
HYSTEROSCOPY-

  • Purely visual method of investigation.

  • Gives better overall view of all the pathological conditions and changes of the

    endometrium.

  • Better tissue perception as compared to hysterosalphingography(HSG)

  • Should ideally be coupled with laparoscopy


Pre requisites
Pre-Requisites

  • Proper counseling

  • Detailed history taking and P/S P/V examinations

  • Pre-menstrual

  • Role of Misoprostol prior to hysteroscopy

  • Paper presented at AMOGS 2009 study conducted at Gauravi Centre For Laparoscopy by Dr. Paayal Chobe


Diagnostic hysteroscopy
Diagnostic Hysteroscopy

  • Distension medium-normal saline

  • Sites to look for markers-endocervix

  • Uterine cavity

  • Endometrium

  • Tubal ostium


Hysteroscopic pictures
Hysteroscopic Pictures

Normal endometrial cavity on hysteroscopy




Hysteroscopy markers
Hysteroscopy Markers

  • Usually os stenosed –so difficulty in passing hysteroscope---misoprostol can be used prior

  • Endocervical canal-narrow

  • Endometrial cavity-obliterated,adhesions and distorted.

  • Endometrial lining-pale,patchy

  • Advanced cases tubal ostia not visualised.







Confirmatory test
Confirmatory test

  • Endometrial biopsy-

  • However negative endometrial biopsy is not an indication for discontinuing AKT as HPE of endometrium does not necessarily reflect the state of fallopian tubes



Other confirmatory tests
Other confirmatory tests

  • TB PCR-polmerase chain reaction

  • Senitivity 80-90%


Newer horizons
Newer horizons

  • TB Interferon-gamma release assays

  • Most recent available test


Summary
Summary-

  • Endometrial tuberculosis-important cause of infertility

  • Hysteroscopy better than HSG to diagnose

  • Hysteroscopy should ideally be coupled with laparoscopy

  • Endometrial biopsy-confirmatory test



ad