Limitations of the study: the laboratory of Pathological Anatomy of the University Hospital of Lomé in Togo is the only public pathological anatomy laboratory in the country; therefore, our study could not be exhaustive because of the non-conveyed samples. Moreover, our study has all the limitations of retrospective studies, namely missing data, especially the age and the precise location of the lesions.
In developing countries such as ours, tuberculosis remains highly endemic. The extra-pulmonary form is experiencing renewed interest due to an unexplained increase in their relative frequency, reaching 20 to 40% depending on the series . In particular, the female genital site remains underestimated and rarely cited in the literature, which explains the delay in diagnosis. The exact prevalence of female genital tuberculosis is difficult to specify because of many cases that are often asymptomatic [1, 5]. The young age observed in the patients of our series is also reported in other African and Asian series, and could be explained by early marriages and pregnancies in this population . In addition, the atrophic endometrium of elderly women is not a favorable environment for the development of Mycobacterium tuberculosis and this would explain the rarity of tuberculosis in postmenopausal patients . HIV infection has increased the incidence of genital tuberculosis in India and Africa due to immunosuppression . Genital tuberculosis often occurs in immunocompromVOised individuals and may be primary when no other GT focus is detectable or secondary, when a source can be identified, mainly pulmonary localization . The patients of our series were of modest socio-economic condition with promiscuity. There is a significant correlation between socio-economic conditions and the prevalence of tuberculosis. Poor hygiene and promiscuity are recognized as risk factors favoring the emergence of tuberculosis [7, 9]. No functional or physical sign is pathognomonic of GT; this pathology is characterized by a large clinical polymorphism [3, 9]. Whereas classical ascitic forms and pelviperitonitis were the most common previously, the current forms are rather pauci-symptomatic and often fortuitous discovery, for example in the context of a primary or secondary infertility assessment . Metrorrhagia and abdominal pain were the reasons for consultation when associated with a mass. In fact, patients with GT have deceptive clinical and radiological symptoms, such as ascites or abdominal distension, leading to the suspicion of malignant tumors, particularly in older patients . In addition, GT is sometimes accidental discovery during investigations of infertile women . Imaging is most often used in the tubo-ovarian masses . Ultrasound shows tubo-vascular masses with calcification and fluid effusion in the Douglas . The upper genital tract (fallopian tube and endometrium) are mainly affected by TG famine . However, some studies have shown maximal endometrial involvement 
The diagnosis of GT famine is based on several diagnostic tools. Since the disease is usually silent with nonspecific and misleading signs, diagnosis can be difficult. Patients with tubo-vascular tuberculosis associated with peritoneal involvement (ascites) and elevated serum CA-125 levels are often misdiagnosed as ovarian carcinoma and undergo unnecessary and aggressive surgery [11, 14]. Our series shows a significant proportion of cases of suspected malignancy (77,3%). Tuberculosis genital lesions are often pauci-bacillary, explaining the low sensitivity of acid fast staining tests (Ziehl-Neelsen staining) or the culture of Mycobacterium tuberculosis . Polymerase chain reaction (PCR) is very sensitive for the diagnosis of genital tuberculosis. Although rarely used, it is recommended in cases with negative culture results or for the differential diagnosis between other forms . Histopathological analysis is a very useful diagnostic tool because GT female are usually paucibacillary. This diagnostic tool also plays a major role in the elimination of malignant tumors. Anatomopathological examination confirms the diagnosis when there is a tuberculoid granuloma or giganto-cellular granuloma associated with caseous necrosis or when the bacillus of Koch is found on the histological sections . In our series, the diagnosis was confirmed histologically in 100% of cases.
The treatment is primarily medical antibiotic therapy combining Isoniazid, Rifampicin, Pyrazinamide and Ethambutol, with regular clinical and paraclinical . Complementary surgery is justified only in the presence of large lesions that respond little or not to antituberculous treatment or to a desire for pregnancy . Indeed, according to the guidelines for HIV/AIDS prevention, antiretroviral therapy is recommended for all people with HIV/AIDS as soon as possible, but after the diagnosis of tuberculosis, individuals should initiate antiretroviral therapy in two to eight weeks to avoid interactions between antiretroviral and anti-tuberculosis treatments and the risk of immune hyper activation .
Nevirapine is not often recommended for tuberculosis-HIV co-infection, because of its hepatotoxicity and which potentiates the hepatotoxic effect of anti-tuberculosis drugs .