Gynaecological tuberculosis, past, present and future.

Until the introduction of the anti-tuberculosis drugs about 25 years ago, the treatment of tuberculosis of the female genital tract was generally unsatisfactory although many different forms of therapy were employed. Surgery was associated with a high incidence of post-operative complications, particularly of fistula, and an appreciable mortality rate. The position improved greatly after the introduction of the anti-tuberculosis drugs. Several drug programmes were employed by the writer, the best results being obtained with a combination of streptomycin, PAS and isoniazid for at least 18 months. Where drug treatment had failed, or where pelvic masses developed, surgery under drug cover was employed. No serious complications and no fatalities occurred in these patients. The question of possible transmission through sexual intercourse of male genitourinary tuberculosis is being investigated. A new drug programme is now being employed, the drugs used being streptomycin, ethambutol and isoniazid.