22 feb. 2011 Diacritical Aspects of Tuboperitoneal Infertility Associated with Genital Tuberculosis
Tatyana Vladimirovna Klinyshkova1, Anastasiya Alekseevna Yakovleva2, Mariya Aleksandrovna Plekhanova1, Natalya Borisovna Frolova3, Elena Valentinovna Kuzmenko3
1Omsk State Medical University, Omsk, Russia;
2Clinical TB Dispensary No. 4, Omsk, Russia;
3Clinical Hospital at the Omsk-Passenger station.
Background: The article discusses the genital tuberculosis (GT) diacrisis, which causes infertility in 10-27,8% of cases.
Methods: In order to determine the character of tuboperitoneal infertility associated with GT, the authors examined 44 patients with infertility, placed for endoscopic treatment. The study was conducted in two stages. Inclusion criteria for comparison group 1: reproductive age, 2 years of infertility-related supervision, laparoscopic confirmation of tuboperitoneal infertility (TPI) and lack of data on genital tuberculosis (GT). The critical level of p was 0.05 for all statistical analysis procedures (ranking by 3 levels of statistically significant differences: p0.05; p0.01; p0.001).
Results: Patients with TPIF and GT regardless of a particular process stage showed prevalence of proximal tubal occlusion type, compared with TPIF regardless of GT, along with dominance of distal occlusion, pronounced adhesive process of uterine appendages, increased frequency of chlamydial infection in past history. During TPIF associated with active GT, specific features of local humoral immunity implied the increase in IgM (2,950 ± 0,22 OD) in the intact PF, among patients with old GT – increase in IgA (1,646 ± 0,16 OD) and IgG (1,565 ± 0,32 OD ) to TMB, in contrast to the comparison group.Conclusion: The definition of significant clinical, endoscopic, and immunological features typical for tuboperitoneal infertility associated with genital tuberculosis is recommended at suspicion on GT and laparoscopic surgery in patients with a long tubal infertility. This will shorten the time of disease disclosure, and therefore increase the effectiveness of treating patients with GT.
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