Objective: Evaluation of anti-tubercular therapy on endometrium in Female Genital
Method: Total of 50 women having FGTB on endometrial aspirate (positive AFB, epithelioid
granuloma, positive PCR, laparoscopy or hysteroscopy findings) were enrolled. Ultrasound
was performed for endometrial thickness, mean resistive index and pulsatility index
before and after anti-tubercular therapy (ATT). Diagnostic hysteroscopy was performed for intra-uterine adhesions
and to visualise cavity before and after ATT.
Results: Menstrual cycle improved after anti-tubercular therapy (ATT). Endometrial aspirate findings improved
with disappearance of AFB, epithelioid granuloma and decrease in PCR (94%vs 33%). After ATT, ultrasound
examination of endometrial thickness improved from 7.01±1.48 mm to 7.51±1.48 mm while mean
resistive index and pulsatility index decreased from 0.729±0.304 to 0.692±0.399 and 1.180 to 1.138. With
ATT, improvement was seen in hysteroscopic findings with normal looking cavity increasing from 18(36%)
to 34(72.1%) and pale looking cavity decreasing from 20(42.5%) to 8(16.8%). Before ATT, prevalence of intrauterine
adhesions was 62% which decreased to 28.7% after ATT. Improvement was significant only in
grade I adhesions from 34% to 2.1%, (p<0.001). There was no improvement in higher grade of intrauterine
adhesions with ATT with grade II (6% vs 4.2%) and grade 2a (4% vs 2.1%), grade III being (2% vs 2.1%), grade
II a (4% vs 4.2%), grade Va (4% vs 4.2%) and grade Vb (8% vs 10.6%) before and after ATT respectively.
Conclusion: Early ATT improved menstrual cycle, endometrial thickness and reduced incidence of grade I
adhesions. Advanced stages did not show any improvement.