What are the symptoms of endometrial tuberculosis?

Endometrial tuberculosis is an infectious disease of the female reproductive organs related to Mycobacterium tuberculosis. Endometrial tuberculosis has a great impact on the female fallopian tubes, ovaries and other parts. Among them, the symptoms of endometrial tuberculosis may also appear in abnormal reproductive organ symptoms, such as deformation of the uterine cavity.

1. General symptoms

① Uterine cavity: The shape varies and may be narrowed or deformed to varying degrees. The edge may also be serrated in patients with no history of curettage or abortion.

② There are multiple strictures in the lumen of the fallopian tube, which are typical beaded or small and rigid.

③ When the contrast agent enters the uterine wall: stroma, parauterine lymphatic vessels or blood vessels, endometrial tuberculosis should be considered.

④ There is obstruction between the ampulla and isthmus of the fallopian tube, accompanied by perfusion defect of iodized oil into the fallopian tube interstitium.

⑤ Equivalent to the fallopian tube, ovary and pelvic lymph node area: there are many scattered millet-like translucent spots, which look like calcification foci.

2. Physical abnormalities

Severe patients often have systemic symptoms such as weight loss, low fever, night sweats, fatigue, and have a history of infertility and menstrual abnormalities.

3. Abnormal secretions

Increased vaginal discharge. In endometrial tuberculosis, the endometrium is completely transformed into caseous granuloma-like tissue, and serous and foul-smelling vaginal discharge may occur. If combined with cervical tuberculosis, there may be purulent or purulent-blooded discharge, and contact bleeding.

4. Abdominal pain

Among patients with endometrial tuberculosis, 25% to 50% have varying degrees of lower abdominal pain, which manifests as long-term dull pain in the lower abdomen and worsens before menstruation. If combined with secondary pyogenic infection, obvious abdominal pain, fever and other symptoms similar to acute pelvic inflammatory disease may occur.

5. Menstrual changes

In the early stages of the disease, it manifests as excessive menstruation, while in the late stages, due to endometrial atrophy, the menstrual volume becomes scanty or even amenorrhea.

6. Infertility

Some patients have no obvious symptoms and signs, only infertility.

7. Physical signs

Due to the different severity of the lesions and the range of involvement, the physical signs vary greatly. Abdominal examination: Patients with mild diseases such as endometrial tuberculosis may not have any abnormal findings. When peritoneal tuberculosis is present, there is tenderness, flexibility or ascites in the abdomen. When encapsulated effusion is formed, inactive cystic masses can be palpated. The masses are often adhered to the intestinal tract and may be mildly tender.