Incidence: - The incidence of genital tuberculosis varies widely with the social status of the patient and her environment. The incidence is about 1 per cent amongst the gynecological patients attending the outpatient department in the developing countries. Incidence is high (5–10%) amongst the patients with infertility. With the prevalence of HIV infection incidence of genital tuberculosis is rising. About 10 per cent of women with pelvic tuberculosis, have urinary tract tuberculosis.
PATHOGENESIS: - The causative organism is Mycobacterium tuberculosis of human type. Very rarely the bovine type may affect the vulva. Genital tuberculosis is almost always secondary to primary infection elsewhere in the extragenital sites such as lungs (50%), lymph nodes, urinary tract, bones and joints. The fallopian tubes are invariably the primary sites of pelvic tuberculosis from where secondary spread occurs to other genital organs.
MODE OF SPREAD: -
Hematogenous: From any of the primary sites, the pelvic organs are involved by hematogenous spread in about 90 per cent cases. If the post-primary hematogenous spread coincides with the growth spurt of the pelvic vessels, the genital organs, the tubes in particular, are likely to be affected. Thus, the pelvic organs are infected during puberty. If the spread precedes the growth phase, the genital organs are spared. The infection remains dormant for a variable period of time (4–6 years) until clinical manifestations appear.
Lymphatic or direct: The pelvic organs are involved directly or by lymphatics from the infected organs such as peritoneum, bowel or mesenteric nodes.
Ascending: Although difficult to prove but sexual transmission from a male with urogenital tuberculosis is possible in vulval, vaginal or cervical lesion.
HOMOEOPATHIC MANAGEMENT OF GENITAL TUBERCULOSIS
Homeopathy treats the person as a whole. It means that the homeopathic medicine for Tuberculosis focuses on the patient as a person, as well as his pathological condition.
The homeopathic medicine for Tuberculosis is selected after a full individualizing examination and case analysis, which includes the medical history of the patients, physical and mental constitution.
Commonly Indicated homeopathy medicines are: -