14-05-2025
The Silent Threat: All About Genitourinary Tuberculosis And Its Impact On Fertility
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Genitourinary tuberculosis is a form of extrapulmonary tuberculosis that affects the urinary tract and the female reproductive organs.
GUTB may cause infertility by inflaming and scarring reproductive organs.
When most people think of tuberculosis, they picture a disease that affects the lungs. However, tuberculosis doesn't always stay confined to the respiratory system. It can quietly spread to other parts of the body, often going undetected. One such lesser-known form is genitourinary tuberculosis (GUTB) – a stealthy intruder that targets the female reproductive system. Often symptomless until significant damage is done, GUTB can be an underlying and overlooked cause of infertility in women.
Genitourinary tuberculosis is a type of extrapulmonary tuberculosis that has a direct impact on the kidneys, urinary bladder, fallopian tubes, uterus, ovaries and also other parts of the reproductive system as well as the urinary system. In many cases, it develops after the primary infection has settled elsewhere, often years later. What makes GUTB particularly dangerous is its stealthy nature; most women show no obvious symptoms until they face difficulty conceiving.
Impact On Female Fertility
Dr. Harish Bhatia, Founder Director of Rebreathe Clinic and Senior Chest Specialist & Director & Head of Dept. of Respiratory Medicine with MGS Hospital says, 'The female reproductive organ that is most affected by tuberculosis is the fallopian tube, followed by the endometrium, which is the lining of the uterus. The tuberculosis bacteria lead to inflammation, scarring and adhesions, making the tubes blocked and creating an inhospitable environment. In some cases, the ovaries may also be involved, affecting ovulation."
Dr Bhatia adds, 'Common symptoms – if they occur – include pelvic pain, irregular menstrual cycles, or unexplained amenorrhea (absence of periods). But often, the only red flag is unexplained infertility. Studies suggest that in endemic regions like India, up to 18% of women with infertility may have underlying genital tuberculosis."
GUTB is notoriously hard to detect. Standard tests of tuberculosis are not always helpful and even there may be no abnormalities seen even on the pelvic examination. Dr Bhatia mentions, 'For accurate diagnosis, an endometrial biopsy, laparoscopy or molecular tests such as PCR is required."
Talking about its treatment, Dr Bhatia mentions, 'Treatment typically includes a six-month course of anti-tuberculosis medications, similar to pulmonary tuberculosis. However, the damage caused to reproductive organs may be irreversible, especially if diagnosed late. This makes early detection and prompt treatment crucial."
Awareness Is Crucial
The silent nature of genitourinary tuberculosis makes awareness critical. Women who struggle with infertility should get evaluated for GUTB if other causes of infertility have been ruled out. While genitourinary TB may be silent, its consequences on fertility are profound. Breaking the silence around it is the first step toward giving affected women a fair chance at motherhood.
First Published:
May 14, 2025, 15:27 IST
