Role of laparoscopy in diagnosing genital tuberculosis in suspected women: A cross-sectional study from a tertiary care hospital in Northern India

This study was included 60 women with suspected genital tuberculosis, attending outpatient department of a tertiary care hospital. The aim was to evaluate the role and accuracy of laparoscopy in the diagnosis of genital tuberculosis. The patients were investigated for tuberculosis with Erythrocyte Sedimentation Rate, Montoux, chest X-ray, serum ELISA, CA125, ultrasonography, endometrial biopsy and laparoscopic biopsy. Culture or histopathology was taken as a gold standard for confirming the cases of genital tuberculosis. 30 patients were confirmed as positive. Comparison was made between the various diagnostic modalities. Baseline investigations like complete blood count, differential leukocyte count, ESR, Montoux, and some special tests like CA125 and serum ELISA were helpful in supporting the diagnosis in only some patients. The sensitivity, specificity, positive and negative predictive value of endometrial biopsy in diagnosing GT was 6.6%, 100%, 100% and 51.7% respectively. Laparoscopic gross visualization alone, staining, culture and histology were able to detect 86.6%, 33.3%, 50% and 63.3% of cases respectively. Many patients would have been missed if laparoscopy was not performed. It helps in macroscopic visualization of pelvic cavity and obtaining biopsies for ZN staining, culture and histopathology. This increases the pickup rate of positive cases and helps in confirmation of the diagnosis.