Genital TB is almost always secondary to TB elsewhere in the body—usually pulmonary and sometimes renal, gastrointestinal, bone, or joint; occasionally it is part of a generalized miliary disease process. If the bacilli are not eradicated, there is a lifelong risk of reactivation, especially in conjunction with diseases or drugs that cause attenuation of T-cell response (e.g. Hodgkin’s lymphoma, AIDS, steroids, stress, or malnutrition). The mode of spread is usually hematogenous or lymphatic and occasionally occurs by way of direct contiguity with an intraabdominal or peritoneal focus.5, 33 The focus in the lung often heals, and the lesion may lie dormant in the genital tract for years, only to reactivate at a later time.