Tuberculosis Presenting as Uterine Prolapse in a Developing Community

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.

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.

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