From the Guidelines
Ovarian tuberculosis typically presents with chronic pelvic pain, irregular menstrual cycles, and infertility, along with systemic symptoms such as low-grade fever, night sweats, weight loss, and fatigue 1. The clinical presentation of ovarian tuberculosis can be variable and non-specific, making diagnosis challenging. Patients may also experience gastrointestinal symptoms like abdominal distension and discomfort due to the proximity of affected organs. Some key signs and symptoms of ovarian tuberculosis include:
- Chronic pelvic pain
- Irregular menstrual cycles
- Infertility
- Low-grade fever
- Night sweats
- Weight loss
- Fatigue
- Adnexal masses or ascites on physical examination
- Vaginal discharge or abnormal uterine bleeding
- Abdominal distension and discomfort Diagnosis of ovarian tuberculosis requires a high index of suspicion, and laboratory findings often show elevated inflammatory markers. Definitive diagnosis involves histopathological examination of tissue samples. It is essential to note that the symptoms of ovarian tuberculosis can overlap with other conditions like ovarian cancer, pelvic inflammatory disease, or endometriosis, making early diagnosis and treatment crucial to prevent complications such as tubo-ovarian abscesses, infertility, and chronic pelvic pain 1.
From the Research
Signs and Symptoms of Ovarian TB
The signs and symptoms of ovarian tuberculosis (TB) can be non-specific and may mimic those of ovarian carcinoma, making diagnosis challenging. Some common symptoms include:
- Chronic pelvic pain [(2,3,4,5,6)]
- Abdominal pain [(2,3,4,5,6)]
- Weight loss 3
- Menstrual dysfunction 6
- Abdominal distension 6
- Abdominal mass [(3,6)]
- Hydronephrosis secondary to compressive pelvic mass 2
- Elevated CA-125 levels [(3,4,5,6)]
Diagnostic Challenges
Ovarian TB can be difficult to diagnose due to its non-specific symptoms and similarity to ovarian cancer. Imaging techniques such as ultrasound may not be conclusive 2, and diagnostic laparoscopy combined with peritoneal biopsy may be necessary to provide a definitive diagnosis 4. Frozen-section analysis can also be helpful in differential diagnosis 5.
Treatment and Prognosis
Antitubercular drugs are the treatment of choice for ovarian TB [(2,3,4,6)]. Early diagnosis and treatment are crucial to prevent complications such as infertility [(2,3,4)]. Complete surgery may be difficult and hazardous and should be avoided 6. With proper treatment, patients can experience significant improvement in their health state and regression of symptoms [(2,3,4)].