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Perceptions in Reproductive Medicine

Tuberculosis Presenting as Uterine Prolapse in a Developing Community

Wilson onuigbo1* and H Farrar2

1Medical Foundation & Clinic, Nigeria

2Nigeria Christian Hospital, Nigeria

*Corresponding author: Wilson Onuigbo, Medical Foundation & Clinic, Enugu 400001, Nigeria

Submission: February 02, 2018;Published: March 29, 2018

DOI: 10.31031/PRM.2018.01.000524

ISSN: 2640-9666
Volume1 Issue5

Abstract

Uterine prolapse has interested mankind from antiquity. Several aspects of it have been reported from diverse countries. Based on the suggestion from a group that the establishment of a histopathology data pool facilitates epidemiological analysis, this paper comes from such a pool serving an ethnic group in a developing community. The case concerns the surgical repair that yielded a specimen which proved to be the exhibition of tuberculous granulomata. Therefore, it deserves some documentation.

Keywords: Uterus; Prolapse; Operation; Biopsy; Tuberculosis

Case Report

AF, an Igbo patient aged 25 years, presented with uterine prolapse at the Nigerian Christian Hospital, Aba, to one of us (HF). She was prepared for operation which was carried out. It was noted that the peritoneal surfaces were seeded all over with various sized nodes from 2mm to 2cm.

The senior author (WO) received a whitish globular tissue 2cm across. Microscopy revealed characteristic tuberculous granulomas. Curiously, healing with fibrosis appeared to be taking place.

Discussion

The subject of uterine prolapse has been contributed to from countries as diverse as UK [4], Russia [5], USA [6], The Netherlands [7], and Israel [8]. Points of interest have varied. Thus, it has been queried whether hysterectomy is necessary [9]. The factors that may increase a woman’s risk of uterine prolapse include her number of vaginal delivery of a large infant, increasing age, and frequent heavy lifting [10]. Indeed, a review of the subject included “urinary and faecal incontineous, obstructive defaecation and sexual dysfunction” [11].

According to USA associates [12] “Most patients with pelvic organ prolapse are asymptomatic”. Indeed, the underlying tuberculosis of our patient was not what brought her to our attention. Rather, it was the uterine prolapsed.

References

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  2. Macartney JC, Rollaston TP, Codling BW (1980) Use of a histopathology data pool for epidemiological analysis. J Clin Pathol 33(4): 351-353.
  3. Basden GT (1966) Among the Ibos of Nigeria. Frank Cass, London.
  4. Jha S, Sanderson P (2014) A review of pelvic organ prolapse during pregnancy. Current Women`s Health Reviews 10(1): 26-32.
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  6. Ryan KM, Karen SA, Christian WJ (2016) surgical repair of pelvic organ prolapse in elderly patients. Curr Opin Urol 26(2): 193-200.
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  8. Fink K, Shachar IB, Braun NM (2016) Uterine preservation for advanced pelvic organ prolapse repair: Anatomical results and patient satisfaction. Int Braz J Urol 42(4): 773-778.
  9. Jefferis H, Jackson SR, Price N (2016) Management of uterine prolapse: Is hysterectomy necessary? Obstet Gynaecol 18(1): 17-23.
  10. Ringold S, Lynm C, Glass RM (2005) Uterine prolapse. JAMA 293(16): 2054.
  11. Dietz HP (2015) Pelvic organ prolapsed-a review. Aust Fam Physician 44(7): 446-452.
  12. Kuncharapu I, Majeroni BA, Johnson DW (2010) Pelvic organ prolapse. Am Fam Phy 81(9): 1111- 1117.

© 2018 Wilson Onuigbo. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.

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