Insights on female genital tuberculosis: Diagnostic strategies and challenges

We read with great interest the article entitled "Laparo scopic and hysteroscopic findings in women with sub fertility and tuberculosis: A case series" by Mondal et al. 1 The authors present a substantial single centre cohort of subfertile patients exhibiting hysteroscopic and/or lapa roscopic evidence of genital tuberculosis among 309 patients.Predictive factors identified in this group of women, including tuberculous abdominopelvic adhesions, isthmo ampullary block, tubercles, tubo ovarian masses, tuberculous hydrosalpinx, complete tubal destruction, tubal diverticula and rigid tubes, hold promise in optimis ing antitubercular therapy.We commend the authors for highlighting these findings, particularly as genital tract tuberculosis, although common in developing countries, remains relatively rare in Europe.A recent systematic review emphasised the uncertain impact of antituberculosis treatment, comprising isonia zid, rifampicin, pyrazinamide and ethambutol, on fertility outcomes.These outcomes encompass pregnancy rates, full term pregnancies, abortion rates, intrauterine deaths and ectopic pregnancy rates, regardless of the structural damage caused by tuberculosis. 2Furthermore, it is imper ative to note that genital tuberculosis may mimic findings of ovarian malignancy, posing a diagnostic challenge. 3dditionally, we would like to highlight that diagnostic laparoscopy can present challenges in patients with genital tuberculosis, including difficulties with creating a pneu moperitoneum and with trocar/cannula insertion, and potential increased risk of bowel or bladder injury and/or wound infection. 4nce again, we extend our gratitude to the authors for their exceptional contribution. AU T HOR C ON T R I BU T ION SCI and NV generated the initial ideas, envisioning the con cept behind this project.DB played a crucial role in refining and ensuring the scientific accuracy of the manuscript.