title: Female genital tuberculosis: early diagnosis by laparoscopy and endometrial polymerase chain reaction.
abstract: OBJECTIVE
  To evaluate the efficacy of laparoscopic visual inspection vs. endometrial tuberculosis (TB) polymerase chain reaction (PCR) for an early diagnosis and management of female genital TB (GTB) in India.
  
  
  METHODS
  Observational case study.
  
  
  RESULTS
  Both laparoscopy and endometrial (endo) TB-PCR were performed on 162 infertile women: 52 endo TB-PCR-positive patients were diagnosed as definite GTB, of whom 44 (84.6%) also showed laparoscopic findings suspicious of TB (Type I). Subgroup analysis showed a similar PCR positivity of 54.5% (24/44) in the strongly suspicious and 54.1% (20/37) in the mildly suspicious patients. Using the Bayesian approach, the maximum likelihood estimates of the sensitivity and specificity of laparoscopy in diagnosing GTB were 0.96 and 0.93 and those of a positive PCR were respectively 0.59 and 0.92. Of the 52 women who were TB-PCR positive, 16 (30.8%) conceived following treatment.
  
  
  CONCLUSIONS
  Endo TB-PCR had high specificity to diagnose GTB, as did laparoscopy. Laparoscopy may therefore be avoided in TB-PCR-positive patients for diagnosis but may still be required to rule out GTB in PCR-negative cases.
authors.affiliation: Gynae and Fertility Research Centre, Jindal In-Vitro Fertilisation and Sant Memorial Hospital, Chandigarh, India. skjindal@ indiachest.org
authors.forename: U N
authors.initials: UN
authors.lastname: Jindal
authors.forename: Y
authors.initials: Y
authors.lastname: Bala
authors.forename: S
authors.initials: S
authors.lastname: Sodhi
authors.forename: S
authors.initials: S
authors.lastname: Verma
authors.forename: S
authors.initials: S
authors.lastname: Jindal
mesh_terms: D000328:Adult; D001499:Bayes Theorem; D042241:Early Diagnosis; D004717:Endometrium / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D010535:Laparoscopy / Q000379:methods*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D014384:Tuberculosis, Female Genital / Q000175:diagnosis*; D055815:Young Adult