New Delhi, March 22
It all started with mild
abdominal pain and irregular vaginal bleeding for 30-year-old Isha Ravi.
Failing to heed the symptoms, the problem aggravated and Isha began to
suffer from irregular periods, chest pain and pain in the abdomen.
Despite umpteen attempts by Isha and her husband, the couple failed to
conceive.
It was a moment of shock for Isha and her husband, when
the doctor revealed that she was an acute patient of "Genital
Tuberculosis". An endometrial biopsy was recommended to test the lining
of her uterus which clearly stated that she was infertile and the
problem aggravated due to her not paying heed to the disease at the
initial level.
Though doctors clearly told her that she won't be
able to conceive ever, they have suggested to Isha to start the
medication to prevent any sort of complication.
Doctors say that
nearly 90 percent of women with genital tuberculosis are diagnosed in
the 15-40 years age group. Infertility on account of genital
tuberculosis is 60-80 percent. Doctors say that usually TB of the uterus
and fallopian tubes is the cause for infertility but in the case of
Isha the "endometrium lining" of her uterus was damaged.
A thick, healthy lining of the uterus, known as the endometrium is necessary for a healthy menstrual cycle and pregnancy.
Recent
studies have concluded that till a decade ago only 10 percent of the
total tuberculosis patients suffered from genital tuberculosis, but the
percentage has now increased to 30 percent due to ignoring the disease
in the initial stages and lack of awareness.
"The tuberculosis
starts affecting the genitals once the 'mycobacterium tuberculosis'
enters the human body. Initially it does not affect and remains silent
as most of us can fight off the infection. However, later these latent
bacilli can get reactivated, and then spread throughout the body through
the blood stream. It is only when it lodges and infects the genital
tract, that TB bacteria can cause genital TB and can cause infertility,"
Rajesh Chawla, senior consultant, respiratory medicine at Delhi-based
Indraprastha Apollo Hospital told IANS.
In males, genital
tuberculosis causes tuberculous epididymo-orchitis, blocking the
ureteral passage, as a result of which the man becomes azoospermic -
lack of sperms - and is not able to ejaculate during intercourse because
the tract is blocked.
"While in the woman the TB causes
infection of the uterus, fallopian tubes; this infection can often be
silent, and may not cause any symptoms or signs at all. It later on
leads to infertility. The problems may also include bleeding discharge,
ulcers, among other symptoms," Chawla told IANS.
A recent study
by the Indian Journal of Medical Research through its survey stated that
the number of women with genital tuberculosis in India has increased to
30 percent in 2015 from 19 percent in 2011.
The report also stated that Saudi Arabia has the second highest number of genital tuberculosis patients with 21 percent.
Vikas
Maurya, senior consultant, respiratory medicine and Interventional
pulmonology at Delhi-based BLK Super Speciality Hospital told IANS:
"Genital TB is a matter of great concern because the symptoms don't
appear easily and by the time it's realized it already leaves an impact
on the fertility of humans."
He said that even sexual intercourse with an infected person is one of the means of getting genital tuberculosis.
"As
being a silent intruder it's very difficult to notice the problem in
the initial stage. Symptoms like irregular menstrual cycle, vaginal
discharge that is stained with blood, pain after intercourse could be
noticed in females, while in males -- unable to ejaculate, low sperm
motility and pituitary gland not able to produce sufficient hormones can
be seen," Maurya told IANS.
Emphasing that genital tuberculosis
and the problem of infertility can be cured, he said that women worry
whether after contracting genital TB will they be able to conceive.
Maurya said proper TB medication can help the women go on and have a
successful pregnancy.
"The treatment with anti-TB medicines
should be started to avoid more complications. The course of antibiotics
for six to eight months should be completed properly, but it doesn't
guarantee the repair of fallopian tubes. Many doctors perform surgery to
repair the tubes, but it's a futile job. Lastly, the intervention has
to be either in-vitro fertilization or Intracytoplasmic sperm injection
(ICSI)," he added.
According to the World Health
Organisation(WHO), India accounts for more than 300,000 TB deaths every
year and ranks at fifth position in the global scale in TB incidents.
Anurag
Khaitan, senior consultant, Urology at Gurgaon-based Paras Hospital
told IANS: "The disease is very old and has been prevalent since ancient
times; it has been found even in Egyptian mummies."
Stressing on
the need for awareness, Khaitan said If a family member or colleague is
an active TB patient, then people around them need to be cautious and
should go for tests like chest X-Ray, tuberculin test to know whether
they have been hit by TB or not.
"The government agencies and non
governmental organisations need to create awareness through various
media. Free medicines need to be supplied. DOTS (Directly Observed
Treatment, Short Course) and vaccination are very successful
programmes," Khaitan told IANS.
(Rupesh Dutta can be reached at [email protected])
