Accepted Manuscript Endometrial tuberculosis in a unicornuate uterus with a rudimentary horn Atul Kumar, MS Alka Kumar, MS
PII:
S1553-4650(14)00055-7
DOI:
10.1016/j.jmig.2014.01.025
Reference:
JMIG 2247
To appear in:
The Journal of Minimally Invasive Gynecology
Received Date: 30 January 2014 Accepted Date: 30 January 2014
Please cite this article as: Kumar A, Kumar A, Endometrial tuberculosis in a unicornuate uterus with a rudimentary horn, The Journal of Minimally Invasive Gynecology (2014), doi: 10.1016/ j.jmig.2014.01.025. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT 1
Kumar Title page
RI PT
Title: Endometrial tuberculosis in a unicornuate uterus with a rudimentary horn
SC
Name of first author (Corresponding author): Atul Kumar Degree: MS Affiliation: Hysteroscopic surgery division, Women's Health Centre Address: 11 Rathore Nagar, Queens Road, Viashali Nagar, Jaipur 302021, India Telephone no: +91-141-4007546, Fax no: +91-141-2351403 Email: [email protected]
EP
TE D
M AN U
Name of second author: Alka Kumar Degree: MS Affiliation: Hysteroscopic surgery division, Women's Health Centre Address: 11 Rathore Nagar, Queens Road, Viashali Nagar, Jaipur 302021, India Telephone no: +91-141-4007546, Fax no: +91-141-2351403 Email: [email protected]
AC C
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
ACCEPTED MANUSCRIPT 2
MANUSCRIPT
41 42
A 28 year old woman suffering with 5 year primary infertility was referred
44
for endoscopic evaluation. Laparoscopy revealed a unicornuate uterus with a
45
right sided rudimentary horn, the right fallopian tube was seen attached to
46
the rudimentary horn and the right ovary appeared unremarkable (Figure 1).
47
The left adnexa appeared unremarkable. The hysteroscope was next
48
introduced and as at the 9 O’clock location of the frame (Figure 2) the right
49
cornuae and the right ostium were not seen thereby substantiating the non-
50
communicating nature of the right rudimentary horn. The left cornuae was
51
seen as at the 3 O’clock location of the frame (Figure 2). A close up view of
52
the left cornuae revealed a bizarre pale and dirty looking endometrium,
53
multiple small adhesions were present, whitish superficial deposits were
54
seen, no endometrial glands could be identified and the left ostium could not
55
be identified (Figure 3). Such picture raised a strong suspicion of
56
endometrial tuberculosis [1-5] and targeted biopsies were taken.
57
Histopathology revealed endometrial tissue containing a few glands in
58
proliferative phase and a few non-caseating epitheloid granulomata were
59
present. Polymerase chain reaction [2-5] was suggestive of mycobacterium
60
tuberculosis.
AC C
EP
TE D
M AN U
SC
RI PT
43
ACCEPTED MANUSCRIPT 3 61
In this case laparoscopic chromotubation was also performed, and the left
63
tube was found patent to methylene blue dye and no spillage of the dye was
64
seen from the right tube. Endometrial tuberculosis is generally considered
65
inconsistent with open tube, but exceptions to the same do exist [5-7].
RI PT
62
68
72 73 74 75 76 77 78
2. Kumar A, Kumar A. Intraluminal tubal adhesions. Fertil Steril. 2008; 89(2):434-5
TE D
71
Laparosc. 2004; 11(1):2
3. Kumar A, Kumar A. Relook hysteroscopy after antitubercular therapy. Fertil Steril. 2008 ; 89(3):701-2
EP
70
1. Kumar A, Kumar A. Endometrial tuberculosis. J Am Assoc Gynecol
4. Kumar A, Kumar A. Unusual appearing tubercular deposits at
AC C
69
M AN U
RFERENCES
67
SC
66
hysteroscopy. JMIG. 2007; 14(2):144
5. Kumar A, Kumar A. Relook hysteroscopy after antitubercular therapy. Fertil Steril. 2008 ; 89(3):701-2
ACCEPTED MANUSCRIPT 4
6. Bapna N, Swarankar M, Kotia N. Genital tuberculosis and its
80
consequences on subsequent fertility. J Obstet Gynecol Ind
81
2005;55:534–7
82
RI PT
79
7. Norburn LM,Walker AHC. Two cases of proved endometrial
tuberculosis followed by successful pregnancy. J Obstet Gynaecol Br
84
Emp 1956;63:173–5
SC
83
M AN U
85
FIGURE LEGENDS
86 87
Figure 1: A unicornuate uterus with a right rudimentary horn
89
Figure 2: The left cornuae is seen at the 3 O’ clock location and the right
90
cornuae is not seen as at the 9 o’ clock location of the picture
91
Figure 3: Close up view of the left cornuae shows a bizarre endometrium
EP AC C
92
TE D
88
AC C
EP
TE D
M AN U
SC
RI PT
ACCEPTED MANUSCRIPT
AC C
EP
TE D
M AN U
SC
RI PT
ACCEPTED MANUSCRIPT
AC C
EP
TE D
M AN U
SC
RI PT
ACCEPTED MANUSCRIPT
ACCEPTED MANUSCRIPT
AC C
EP
TE D
M AN U
SC
RI PT
http://www.AAGL.org/jmig-21-4-JMIG-D-14-00054
PII:
S1553-4650(14)00055-7
DOI:
10.1016/j.jmig.2014.01.025
Reference:
JMIG 2247
To appear in:
The Journal of Minimally Invasive Gynecology
Received Date: 30 January 2014 Accepted Date: 30 January 2014
Please cite this article as: Kumar A, Kumar A, Endometrial tuberculosis in a unicornuate uterus with a rudimentary horn, The Journal of Minimally Invasive Gynecology (2014), doi: 10.1016/ j.jmig.2014.01.025. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT 1
Kumar Title page
RI PT
Title: Endometrial tuberculosis in a unicornuate uterus with a rudimentary horn
SC
Name of first author (Corresponding author): Atul Kumar Degree: MS Affiliation: Hysteroscopic surgery division, Women's Health Centre Address: 11 Rathore Nagar, Queens Road, Viashali Nagar, Jaipur 302021, India Telephone no: +91-141-4007546, Fax no: +91-141-2351403 Email: [email protected]
EP
TE D
M AN U
Name of second author: Alka Kumar Degree: MS Affiliation: Hysteroscopic surgery division, Women's Health Centre Address: 11 Rathore Nagar, Queens Road, Viashali Nagar, Jaipur 302021, India Telephone no: +91-141-4007546, Fax no: +91-141-2351403 Email: [email protected]
AC C
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
ACCEPTED MANUSCRIPT 2
MANUSCRIPT
41 42
A 28 year old woman suffering with 5 year primary infertility was referred
44
for endoscopic evaluation. Laparoscopy revealed a unicornuate uterus with a
45
right sided rudimentary horn, the right fallopian tube was seen attached to
46
the rudimentary horn and the right ovary appeared unremarkable (Figure 1).
47
The left adnexa appeared unremarkable. The hysteroscope was next
48
introduced and as at the 9 O’clock location of the frame (Figure 2) the right
49
cornuae and the right ostium were not seen thereby substantiating the non-
50
communicating nature of the right rudimentary horn. The left cornuae was
51
seen as at the 3 O’clock location of the frame (Figure 2). A close up view of
52
the left cornuae revealed a bizarre pale and dirty looking endometrium,
53
multiple small adhesions were present, whitish superficial deposits were
54
seen, no endometrial glands could be identified and the left ostium could not
55
be identified (Figure 3). Such picture raised a strong suspicion of
56
endometrial tuberculosis [1-5] and targeted biopsies were taken.
57
Histopathology revealed endometrial tissue containing a few glands in
58
proliferative phase and a few non-caseating epitheloid granulomata were
59
present. Polymerase chain reaction [2-5] was suggestive of mycobacterium
60
tuberculosis.
AC C
EP
TE D
M AN U
SC
RI PT
43
ACCEPTED MANUSCRIPT 3 61
In this case laparoscopic chromotubation was also performed, and the left
63
tube was found patent to methylene blue dye and no spillage of the dye was
64
seen from the right tube. Endometrial tuberculosis is generally considered
65
inconsistent with open tube, but exceptions to the same do exist [5-7].
RI PT
62
68
72 73 74 75 76 77 78
2. Kumar A, Kumar A. Intraluminal tubal adhesions. Fertil Steril. 2008; 89(2):434-5
TE D
71
Laparosc. 2004; 11(1):2
3. Kumar A, Kumar A. Relook hysteroscopy after antitubercular therapy. Fertil Steril. 2008 ; 89(3):701-2
EP
70
1. Kumar A, Kumar A. Endometrial tuberculosis. J Am Assoc Gynecol
4. Kumar A, Kumar A. Unusual appearing tubercular deposits at
AC C
69
M AN U
RFERENCES
67
SC
66
hysteroscopy. JMIG. 2007; 14(2):144
5. Kumar A, Kumar A. Relook hysteroscopy after antitubercular therapy. Fertil Steril. 2008 ; 89(3):701-2
ACCEPTED MANUSCRIPT 4
6. Bapna N, Swarankar M, Kotia N. Genital tuberculosis and its
80
consequences on subsequent fertility. J Obstet Gynecol Ind
81
2005;55:534–7
82
RI PT
79
7. Norburn LM,Walker AHC. Two cases of proved endometrial
tuberculosis followed by successful pregnancy. J Obstet Gynaecol Br
84
Emp 1956;63:173–5
SC
83
M AN U
85
FIGURE LEGENDS
86 87
Figure 1: A unicornuate uterus with a right rudimentary horn
89
Figure 2: The left cornuae is seen at the 3 O’ clock location and the right
90
cornuae is not seen as at the 9 o’ clock location of the picture
91
Figure 3: Close up view of the left cornuae shows a bizarre endometrium
EP AC C
92
TE D
88
AC C
EP
TE D
M AN U
SC
RI PT
ACCEPTED MANUSCRIPT
AC C
EP
TE D
M AN U
SC
RI PT
ACCEPTED MANUSCRIPT
AC C
EP
TE D
M AN U
SC
RI PT
ACCEPTED MANUSCRIPT
ACCEPTED MANUSCRIPT
AC C
EP
TE D
M AN U
SC
RI PT
http://www.AAGL.org/jmig-21-4-JMIG-D-14-00054
