People know that tuberculosis can be caused by tubercle bacilli entering the lungs, but in fact, tuberculosis bacilli can not only invade the lungs, but also the human pleura, peritoneum, intestines, bones, genital tract and lymphatic system, urinary system, etc., so that these parts also get tuberculosis. In particular, female genital tuberculosis is of great concern because of its harmful effects. Female genital tuberculosis, also known as tuberculous pelvic inflammatory disease, occurs mostly in women of childbearing age between 20 and 40 years old. It is often secondary to downstream infection, and the majority of patients have primary tuberculosis lesions. According to statistics, abdominal tuberculosis accounts for more than 50% of primary cases, followed by pulmonary tuberculosis, tuberculous pleurisy, and occasionally tuberculosis of the kidneys, bones, and joints. There are also very few primary cases, such as severe genital tuberculosis in the male partner such as epididymal tuberculosis, seminal vesicle tuberculosis or ulcerative lymphatic gland tuberculosis, which can be transmitted through sexual intercourse, and the tuberculosis bacteria can be infected upstream. It can be said that female genital TB infection comes from multiple sources. When the tubercle bacilli invade the female genital tract, the first offender is the fallopian tube, which accounts for about 85% to 95% of tuberculosis in the female reproductive system; it then spreads to the endometrium, of which about 60% to 80% can lead to endometrial tuberculosis. If tuberculosis develops in the endometrium, necrosis and ulceration may occur, eventually causing adhesions to shrink the uterine cavity. Ovarian tuberculosis occurs after tubal tuberculosis and can also be transmitted by blood. If the infection spreads from tubal tuberculosis, it mainly presents as periovarian inflammation with small nodules or abscesses on the ovarian surface. If the infection spreads from the fallopian tubes, it mainly presents as periovarian inflammation with small nodules or abscesses on the ovarian surface. If the infection spreads by blood, it mostly invades the deeper tissues of the ovaries, resulting in extensive necrosis or abscess formation. The danger of female genital tuberculosis is that it directly disrupts menstruation and fertility. It is well documented that 25% of female infertility is caused by genital tuberculosis. Many patients have no symptoms at the beginning and only find out that they have TB when they are examined for the cause of infertility; or they have varying degrees of lower abdominal pain due to pelvic inflammation and adhesions, irregular menstruation, abnormal leucorrhea, and their general health is greatly affected before they seek medical attention; in some cases, the disease is only confirmed during pathological examination after surgery. Why does genital tuberculosis cause infertility? We know that the fallopian tubes always bear the brunt of tuberculosis, regardless of the route through which the bacillus invades the female reproductive tract. The tubal lumen is blocked due to mucosal lesions and adhesions, or the tubal peristalsis is abnormal due to the destruction of mucosal cilia and incompetence, as well as adhesions with the surrounding tissues and organs, making it impossible for the patient to conceive. If there is also endometrial tuberculosis, in the early stage, due to endometrial congestion and ulceration, menstruation is often excessive; in the late stage, due to endometrial destruction of different degrees, the uterine cavity adhesions shrink, resulting in scanty menstruation first, and then amenorrhea. The folklore of “dry blood consumption” refers to this disease. In ovarian tuberculosis, ovarian dysfunction and severe tissue destruction can also lead to infertility, menstrual disorders or amenorrhea. The onset of female genital tuberculosis is often slow and there are often no conscious symptoms, so it is especially important to prevent the disease once it is detected. First of all, it is important to prevent the first invasion of tuberculosis bacteria and to avoid the occurrence of primary lesions. In addition to increasing nutrition, improving physical fitness and avoiding overexertion, contact with tuberculosis patients should be avoided as much as possible to prevent respiratory infection. Second, women who already have tuberculosis of the lung, pleura, intestine, lymph, etc. should be treated early and thoroughly to prevent spread. Third, early detection is crucial. If a girl is 18 years old and has not yet seen her first menstruation or has scanty menstruation, if she is unmarried and has low fever, night sweats, or lower abdominal pain, or if she has been married for one year and has not conceived or has menstrual disorders, she should seek early medical attention to find the cause. For those diagnosed with genital tuberculosis, regardless of whether the primary lesion is found in the respiratory, digestive or urinary systems, treatment should be stepped up to control the progression of the disease, and it may be possible to restore fertility. Even if there is no hope of having children after marriage, the health of the body can be ensured to remain unaffected. Treatment plan 1. Supportive therapy. Acute patients need bed rest and should rest for at least 3 months. Chronic patients can engage in some light work, but should pay attention to the combination of work and rest, strengthen nutrition, and participate in physical exercise appropriately to enhance physical fitness. 2.Anti-tuberculosis drug treatment. Anti-tuberculosis drug therapy is effective for more than 90% of female genital tuberculosis. Drug therapy should follow the principles of early, combined, regular, moderate and full. Combined treatment with rifampin, isoniazid, ethambutol, streptomycin and pyrazinamide and other anti-tuberculosis drugs for a period of 18-24 months has achieved good results. 3.Surgical treatment. If the pelvic mass shrinks after drug treatment but cannot completely subside, especially if malignant tumor cannot be excluded; if the treatment is ineffective or recurrent after treatment; if the drug treatment for endometrial tuberculosis is ineffective, surgical treatment should be performed. In order to avoid the spread of infection during surgery and to reduce adhesions to the advantage of surgery, anti-tuberculosis drugs should be used for 1-2 months before surgery and continue to be treated with anti-tuberculosis drugs after surgery to achieve complete cure. Total hysterectomy and bilateral adnexal resection are preferred, and ovarian function should be preserved as much as possible in young women. Since the adhesions caused by genital tuberculosis are often extensive and tight, oral intestinal disinfectant drugs and clean enemas should be given before surgery, and attention should be paid to the anatomical relationships during surgery to avoid injury. Prevention is to enhance physical fitness, get BCG vaccination, and actively prevent and treat tuberculosis, lymphatic tuberculosis and intestinal tuberculosis.