Direct Spread From a Neighboring Viscus
Direct extension to the genital tract organs from tuberculous abdominal viscera, such as the bladder, rectum, appendix, and intestines, has been described. Some researchers believe that this spread is along the peritoneal surface. However, peritoneal involvement can also be the result of spillage of infected material from the fallopian tubes; thus, the primary process is not always clear. It also may occur when adhesions bind the bladder or intestine to the fallopian tubes and perforation of a tuberculous ulcer results in direct spread to the genital organs.