SCHISTOSOMIASIS IN WOMEN - MANIFESTATIONS IN THE UPPER REPRODUCTIVE-TRACT

Female genital schistosomiasis (FGS) is a neglected disease entity whi ch may give rise to considerable suffering among women of child-bearin g age in areas where schistosomiasis (especially due to Schistosoma ha ematobium) is prevalent. The close relation between the vessels in gen ital organs and the urinary bladder enables the parasite to easily cha nge location to virtually any organs in the female pelvic area. Sympto ms concur with the anatomical location of worm pairs and their ova. Le sions of the lower female genital tract can easily be investigated by cytology, histology or direct demonstration of eggs in scrapings or bi opsies whereas schistosomiasis of the upper genital tract is clinicall y indecipherable and less accessible for examination. In the literatur e there are references to FGS as a cause of infertility, complications of pregnancy, menstrual disorders, problems related to sexual interco urse, diagnostic similarities to STDs and cancer, unspecified complain ts related to blood loss, chronic abdominal pain, social segregation a nd related psychological problems. The diagnosis of female upper genit al schistosomiasis is difficult and the authors point out possible dia gnostic procedures which might be helpful for further understanding of this complex entity.