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Urethritis with ureaplasma in women

Ureaplasmic urethritis: causes, signs, diagnosis, treatment and prevention

The inflammatory process in the urethra caused by ureaplasmas (an infectious agent) leads to the development of the disease - ureaplasma urethritis. More common in men.

It is detected by chance during diagnostics, detection of specific antibodies in the blood and urine.

If the disease is not treated, then the symptoms will become apparent in about a month: cramps and burning during urination, discharge with discharge of pus and an unpleasant odor.

Etiology of disease

Ureaplasma is a microorganism that is the causative agent of a disease called ureaplasmosis. This microorganism has long been considered to belong to the genus Mycoplasma, but soon the ability of the microorganism to split urea was discovered, so scientists were forced to identify it as a separate subgroup of microorganisms.

This pathogen enters the body sexually. Its main localization occurs in the genitourinary system, but it also has a detrimental effect on all other organ systems of the human body.

This microorganism affects not only sperm and eggs, reducing their activity and partially destroying and destroying, but also the joints of the body, leading to such a difficult disease as rheumatoid arthritis, for example, as well as other diseases of the musculoskeletal system. This fact was discovered by scientists analyzing human joint fluid under a microscope.

If we talk about the disease itself - ureaplasmosis, then we can note the fact that it is not always caused by the direct presence of ureaplasma in the body. There were cases when a pathogenic agent was detected in apparently healthy people during tests at a dispensary.

Reason for development

Ureaplasma, like a gonococcal infection, is often found in the urine or bloodstream in men and women under the influence of a number of factors. The number of stab leukocytes increases hundreds of times.

Main causes of infection:

• indiscriminate sexual relations;
• hypothermia;
• Untimely treatment of the inflammatory process in one or another part of the genitourinary system;
• irregular and untimely emptying of the bladder when urging;
• abuse of alcohol, fatty and salty foods;
• diseases: vesiculitis, balanoposthitis, Reiter's syndrome, prostatitis.

The help of a urologist is required. It is better not to neglect contacting a specialist doctor, because this can lead to the development of complications that can lead to harmful consequences that are incurable.

The first and earliest sign of urethritis is discomfort in the urethra during the stay of ureaplasmas in the incubation period.

After about 2-3 weeks, unpleasant symptoms as a reaction of the body to the development of the inflammatory process appear in an acute form and are quite obvious to the naked eye:

• pain and burning when urinating;
• pain in the lower abdomen;
• increased urge to urinate;
• painful urination with pus and blood particles.

In women, the symptoms are:

• itching and burning in the vagina, in the vulva area;
• unpleasantly smelling transparent discharge;
• pain in the urethra.

In men, symptoms may not appear immediately and may be absent for a long time while the virus is in a latent state.

• redness, swelling and swelling of the head of the penis;
• adhesions, sticking together of the ends of the foreskin;
• discomfort during intercourse

Against the background of inflammation, the testes are subject to damage during sexual transmission of ureaplasmas. Can begin the development of infertility. Lack of treatment will lead to a chronic form of the disease. Symptoms will worsen, but disappear completely for a while.

Diagnosis

The main diagnostic method is a smear from the urethra. To prescribe a treatment course, it is important for a doctor to identify the true pathogen that caused the development of the disease. The patient's sexual life, the symptoms, the nature and color of purulent discharge are studied.

• chemical, physical test by taking purulent contents with a metal probe from the urethral mucosa;
• thermal test by exposing the secretions to high temperature;
• bacteriological method, when, perhaps, an increase in the number of bacteria when they are attached to ureaplasmas;
• X-ray of the urethra in case of development of the disease on the background of trauma;
• ureteroscopy;
• urinalysis for density, abnormal levels of leukocytes and erythrocytes when turbid, purulent discharge is discharged;
• PCR smear, STD, urine culture;
• screening method;
• endoscopy;
• ultrasound;
• Profilometry, uroflowmetry.

When affected by ureaplasmas, the genitourinary system is prone to strictures. The microflora of urine is subject to study in order to establish an infectious agent in order to prescribe a subsequent effective treatment.

Treatment is complex, a urologist can prescribe a range of medications:

• antibiotics;
• immunostimulants;
• general tonic preparations;
• bifidobacteria and lactobacilli to restore the microflora in the intestine.

The technique is developed by a doctor, taking into account the cause that led to the disease, the existing symptoms. Usually the patient undergoes inpatient treatment, because in case of incomplete treatment with antimicrobial drugs and alcohol abuse, for example, by men, it can lead to a lack of proper results, the transition of ureaplasma urethritis to the chronic stage.

Drugs are prescribed exclusively by a doctor, taking into account the presence of the prevailing pathogenic flora: trichomonas, gonococcal, mixed. When a viral infection is attached, Acyclovir, Gerpevir are prescribed.

It is advisable to take antibiotics only in the treatment of urethritis caused exclusively by bacteria. They do not kill the pathogenic flora caused by viruses. The nonspecific form of the disease is treated with antihistamines, immunostimulants. Antibiotics in this case will be simply useless.

Physiotherapy, magnetotherapy, electrophoresis are indicated. Medicinal herbs or pharmaceutical formulations (Miramistin, Dioxidin) are applicable for installations by introducing into the urethra.

Urethritis caused by ureaplasmas is considered a serious disease. If you do not contact a urologist in a timely manner, it can lead to serious and irreversible consequences.

Complications

Ureaplasma, when reaching large colonies in urine, will lead to the development of complications: prostatitis, vesiculitis. The disease will become chronic. Differentiation from other diseases will become difficult.

Clinical symptoms may be blurred or absent altogether for a long time. Be careful and do not miss a single symptom in order to maintain your health and not get sick in the future.

Prevention

The genitourinary system in men and women is vulnerable, not resistant to the onslaught of many bacteria and viruses. Symptoms of ureaplasmosis may not be noticed immediately due to the latent course of the pathogen, and in case of infection with a viral agent, they may be completely absent for up to several months. Many patients do not experience much discomfort. There is no fever, and a slight malaise is attributed to fatigue, a hard day at work, or a cold.

Observing personal hygiene and simple recommendations, you can avoid the development of ureaplasmic urethritis.

• clearness in intimate relationships;
• use of condoms;
• avoiding hypothermia;
• timely emptying of the bladder;
• proper personal hygiene, especially by women due to the shorter urethra, unlike men;
• treatment of any pathologies in the genitourinary system;
• exclusion from the diet of salty, spicy, fatty foods, alcohol;
• leading a healthy lifestyle;
• playing sports.

Non-compliance with personal hygiene measures, a decrease in immunity often leads to infection with ureaplasmas of the genitourinary system. Nothing prevents the penetration of viruses and bacteria of various etiologies.

The development of the inflammatory process must be stopped at the initial stage, so as not to start the problem. If unpleasant symptoms appear during urination, you should not hesitate to contact a doctor for a complete diagnosis.

Urethritis caused by ureaplasmas leads to infertility, which is undesirable for men and women of reproductive age.

The main thing in life is health. It cannot be bought with money and cannot be fully restored if it has already been lost. It is much easier to carry out disease prevention, consult doctors on time, undergo examinations at the slightest suspicion of a disease and lead a healthy lifestyle than to treat a developed disease, which may already be useless. Therefore, you should never forget about your health.

Ureaplasma in women causes, symptoms, diagnosis and treatment regimen

Among the bacteria that are the causative agents of sexually transmitted diseases, one of the most common gynecologists named ureaplasma. It belongs to the group of conditionally pathogenic microorganisms present in the natural microflora of the genitals, and the degree of its danger has not yet been determined. Is it necessary to start treatment if it was found in a woman, and how does she manifest herself?

What is ureaplasma

A genus of bacteria belonging to the family Mycoplasmataceae and the order of mycoplasmas (single-celled microorganisms that are the simplest of self-reproducing) - such a definition in official medicine is given to ureaplasma. A little over half a century ago (in 1954), the bacterium Ureaplasma urealyticum was isolated from a patient suffering from non-gonococcal urethritis (inflammation of the urethra). Some characteristics of this microorganism:

• Ureaplasma is a small (0.3 micron in diameter) intracellular parasites, opportunistic flora, which is characterized by pathological activity (the initial appearance and exacerbation of a disease that is in a chronic form) only when certain factors appear, including abortion, a decrease in immunity, installed intrauterine device, hypothermia.
• Doctors speculate that the activity of the Ureaplasma urealyticum bacterium is associated with miscarriage, premature delivery, but the hypotheses have not yet been confirmed.
• Unlike other mycoplasmas, ureaplasmas have their own function in the human body: they break down urea to ammonia.
• According to the data of 2015, the genus Ureaplasma has 7 species of bacteria, among which the clinically important (in terms of the frequency of lesions of the female body) are Ureaplasma urealyticum (with a weakly expressed membrane, invades the mucous membranes of the urinary tract) and Ureaplasma parvum (provokes the formation of stones , present on the genitals of both sexes).

The disease that this microorganism causes is called "ureaplasmosis" (one of the varieties of mycoplasmosis). It was diagnosed in some women suffering from infertility and chronic problems of the urogenital area, but ureaplasmosis was not included in the current International Classification of Diseases (ICD-10). The manifestation of pathological activity of ureaplasma can lead to damage to the cervix, prostate, urethra (urethra), and may be accompanied by the following diseases:

• adnexitis (inflammatory process in the appendages);
• colpitis;
• cervicitis;
• cervical erosion;
• endometritis;
• pyelonephritis;
• vaginitis;
• gonorrhea;
• chlamydia.

Mechanism of disease development

The pathogenesis of ureaplasmosis is based on adhesive-invasive properties (the ability to overcome the membrane barrier and attach or adhere to the surface) and enzyme-forming. Thanks to them, a bacterium that got into the urinary organs:

Against the background of what is happening (a decrease in the number of immunoglobulins of a specific group), the body's defenses are reduced, the immune response to the activity of infectious agents is weakening. If the activity of ureaplasma, which has received a pathogenic status, is low, the disease is asymptomatic, the inflammatory process is sluggish, destructive changes are minimal. With a high activity of the bacterium (against the background of concomitant factors), the symptoms of ureaplasmosis appear, because:

• tissue permeability increases;
• vascular response increases;
• epithelial cells begin to break down.

Is it necessary to treat ureaplasma

The hostility of a microorganism for a healthy person (when ureaplasma in women is conditionally pathogenic) in modern medicine continues to be discussed. Doctors detect the bacterium in 60% of adults who do not have pathological processes in the body, and in 30% of newborns, but it can be in a harmless state for years. If the microflora of the vagina and urinary tract is normal, this is a sufficient protective barrier to prevent inflammation. If symptoms of ureaplasmosis appear, you need to take care of the issue of treatment.

Reason for manifestation

Like most other bacteria that are opportunistic in nature, ureaplasma is present among the natural microflora of the genital organs and urinary tract in 70% of women. Doctors diagnose it in every 3rd newborn and even in schoolgirls who are not sexually active (more than 20% of teenage girls), but it makes itself felt only in rare cases. The development of ureaplasmosis begins only against the background of the appearance of certain factors that turn a conditionally pathogenic microorganism into an infectious agent:

• Hormonal imbalance is the primary cause of ureaplasmosis in pregnant women entering the menopause who take hormone-based drugs. An equally important point are diseases of the endocrine system, especially those associated with the functioning of the ovaries.
• Decreased immunity - both against the background of taking immunosuppressants (drugs that suppress the body's defenses: prescribed in the treatment of oncology), and against the background of infectious viral or bacterial diseases: influenza, SARS, etc.
• Vaginal dysbacteriosis - a violation of the natural microflora of the vagina, gynecologists associate mainly with hormonal imbalance, sexually transmitted infections, violation of the rules of intimate hygiene. This situation provokes the activity of all conditionally pathogenic microorganisms, therefore, candidiasis (thrush) may appear with ureaplasmosis.
• Invasive interventions - not only abortion (mainly the curettage procedure), but also the treatment and diagnostic manipulations of a gynecologist are dangerous: urethroscopy, hysteroscopy, cystoscopy, surgical intervention for cervical erosion.
• Frequent change of sexual partners - unprotected sex and the constant appearance of casual sexual partners leads to the introduction of infectious agents into the vagina, which provokes the activation of ureaplasma and other opportunistic microorganisms against the background of general changes in the microflora.

Transmission paths

Ureaplasma in women is much more common than in men (they have a tendency to self-heal), so they are considered the main carriers of the infection. Among all the ways of transmission, the leader is sexual - among all those infected, about 80% are people who have sexual contacts, especially without a permanent partner. The transmission of the causative agent of ureaplasmosis is possible both with unprotected vaginal intercourse and with oral intercourse. Bacteria present:

• in women - in the secret of the cervical canal, vagina;
• in men - in the secret of the prostate, urethra, sperm.

Some doctors suggest the possibility of infection through household contact: through the patient's personal hygiene items, but the theory has not yet received proper confirmation. It is almost impossible to get infected in the bath, pool and other common areas. In addition, there are several other ways that are relevant for childhood infection:

• During childbirth, when passing through the birth canal - this is how small children become infected (30% of newborn girls get ureaplasmosis), even if the mother does not experience symptoms of ureaplasmosis.
• Through the amniotic fluid (intrauterine through the placenta) - bacteria will be found in the oral cavity, nasopharynx, conjunctiva. Infection mainly occurs in the 1st trimester of pregnancy, when the disease worsens in the mother.

Types of ureaplasma in women

There are several ways to classify this disease: according to the severity of manifestations, it is often divided into asymptomatic carriage and an active inflammatory process (typical of other forms). According to the duration, ureaplasmosis happens:

• Early - subdivided into sluggish (erased symptoms, can be observed in the incubation period - 2-4 weeks), acute (pronounced manifestations, may be accompanied by severe intoxication; lasts 1-2 months, damage mainly to the urinary system), subacute (transient stage to chronic).
• Chronic - appears 2 months after the development of any of the previous forms. The organs of the reproductive system may be affected. Mostly looks similar to carriage, but is periodically accompanied by relapses, manifesting themselves as an acute form. Stress factors are often the catalyst.

Carrier

The most common option is when ureaplasma in women is present in the body, but does not manifest itself at all. Carriage in the absence of risk factors may never make itself felt, as in the latent (hidden) course of the disease, but the bacterium is transmitted to the sexual partner. As soon as immunity decreases, a stressful situation occurs, the hormonal background is shaken, a woman may experience erased symptoms (rare mucous discharge, vaginal itching), but the general condition will remain normal, and the described manifestations will quickly disappear on their own.

Acute ureaplasmosis

If sexually transmitted infection has occurred, after the incubation period, the acute stage of the infection will manifest itself, which, according to the clinical picture, is similar to the manifestations of other sexually transmitted diseases. May be tormented by frequent urge to urinate (the process is uncomfortable), pain in the lower abdomen, discomfort during sexual contact, a slight rise in temperature. Symptoms persist no longer than 2 months.

Chronic

Symptomatics at this stage may be absent, but if the bacterium is not active during the carriage, then during the chronic course of the disease, its pathological vital activity is hidden. The transition from acute to chronic takes 1.5-2 months. Periodically, a woman may experience relapses, or develop complications on the organs of the urinary system, resulting in:

• mucous discharge mixed with bloody;
• pain in the lower abdomen, radiating to the lower back;
• symptoms of cystitis (urinary disorders with inflammation of the bladder).

Symptoms and signs of the disease

How the activated ureaplasma in women will manifest itself depends on several points: the general condition of the body, the presence of additional diseases (especially sexually transmitted diseases - diseases that provoke chlamydia, gonococcus, and other bacteria), and even the path of infection. So in women who got the disease during oral sex, there will be signs of tonsillitis, pharyngitis. Most of the symptoms are:

• Vaginal discharge (from faint clear to cloudy yellowish and even bloody);
• discomfort or pain during urination and increased urge to urinate;
• cutting pains in the lower abdomen (if endometritis, adnexitis are attached);
• Vaginal pain during intercourse;
• weakness, fatigue;
• subfebrile temperature.

The main symptoms of ureaplasma in women are similar to those that appear during other inflammatory diseases of the genitourinary system, which complicates the process of self-diagnosis at home. If the transmission of a pathogenic microorganism occurred during intercourse, the symptoms will begin to appear after 2-4 weeks (incubation period), but often (more than 70% of cases) even the disease that has begun in a woman does not make itself felt.

What is the danger of ureaplasmosis in women

The mere presence of an opportunistic bacterium in the body is not a cause for concern, but microorganisms that have settled on the walls of the vagina, uterus, and bladder can be activated at any time when one of the factors described above appears. The result will be the development of the disease, which, in the absence of timely and proper treatment, will develop into a chronic form. Relapses will start in the background:

• colds;
• hypothermia;
• third-party inflammatory processes;
• stress situations;
• active alcohol consumption;
• heavy physical activity;
• other reasons for reduced immunity.

The main consequence is a general deterioration in the condition of a woman, against which the body temperature may rise, but ureaplasmosis becomes dangerous not because of this. Against the background of a chronic inflammatory process caused by ureaplasmas, concomitant diseases and pathologies develop in the body (mainly in the reproductive system and urinary system):

• inflammatory process in the kidneys (pyelonephritis);
• pain during intercourse;
• inflammatory process in the bladder (cystitis);
• inflammatory processes in the joints;
• narrowing of the urethra (urethra);
• inflammatory process on the walls of the uterus (endometritis), in the appendages or in other parts of it;
• appearance of stones in the kidneys or bladder;
• inflammation of the vagina (colpitis);
• menstrual disorder;
• infertility (due to a permanent inflammatory process, it is equally possible in women and men - the latter get an infection during sexual intercourse from a sick woman).

Ureaplasma infection during pregnancy

A woman who plans to have a baby is advised by gynecologists to be sure to undergo an examination for the presence of ureplasma, since during pregnancy the risk of its activation is especially high. Even a small amount of these bacteria, which are in a conditionally pathogenic state, can lead to the development of ureaplasmosis - due to hormonal fluctuations, a natural decrease in immunity. There are several reasons for examination and treatment before pregnancy:

• In the 1st trimester, it is forbidden to use antibiotics (they are the only strong medicine against ureaplasma), since such therapy will negatively affect the development of the fetus. As a result, the active development of the disease will begin, which is especially dangerous for the baby directly in the first weeks - from the 2nd trimester he is less vulnerable.
• Severe inflammation associated with autoimmune processes in the endometrium can cause primary placental and secondary fetoplacental insufficiency: conditions in which morphological and functional disorders occur in the placenta. The result is problems in the development of the fetus (with an increased risk of anomalies), up to the appearance of diseases in the perinatal period.
• The most terrible consequence of ureaplasmosis in a woman carrying a child at any time is not only premature birth, but also abortion due to miscarriage.

Diagnosis and detection of the pathogen

Doctors say that the diagnosis is not made on the basis of the presence of ureaplasma in the body - the more important point is the number of these microorganisms and the mass character of their distribution throughout the organs of the genitourinary system. The symptoms that the patient complains about are necessarily taken into account, but the basis is laboratory and instrumental diagnostic methods.The check is necessarily comprehensive, especially in the presence of concomitant diseases, includes:

• Ureaplasma culture (cultural study) - sowing biomaterial (for women, a smear and vaginal discharge are used) on a nutrient medium, as a result of which bacterial colonies can be isolated and their resistance to specific antibiotics can be determined.
• PCR diagnostics (polymerase chain reaction) - helps to track the DNA molecules of an infection present in the body. It is carried out through taking a smear. Such an analysis is highly accurate, after the end of treatment after 3 weeks it can be re-appointed to check the quality of the therapeutic measures taken.
• Serological testing - is considered the most significant for women suffering from infertility, or with diseases that are on the list of potential complications of ureaplasmosis. It is an ELISA (enzymatic immunoassay) and RIF (immunofluorescence reaction) tests. They are aimed at identifying antigens to the cellular composition of the walls of a given bacterium; a smear is taken for their implementation.

Scheme for the treatment of ureaplasma in women

According to official medical statistics, when diagnosing ureaplasma in women, it is found along with mycoplasma and chlamydia, so several types of antibiotics are included in the treatment regimen. Specific therapeutic methods should be selected by a doctor, but an approximate course is as follows:

In addition, a diet that is relevant for all stages of treatment is necessarily added here: fatty, salty, spicy foods are excluded. A woman is recommended to limit sexual contacts, if necessary, to sanitize the vagina. In some situations, doctors advise undergoing a course of physiotherapy, which eliminates unpleasant symptoms and improves the penetration of drugs locally.

Etiotropic antibiotic therapy

Drugs that help stop the reproduction of a pathogenic microorganism and kill it are selected during a diagnostic examination, which helps to establish the sensitivity of ureaplasma to specific antibacterial substances. Self-administration of such drugs is unacceptable! Treatment lasts 1-2 weeks. The following groups of antibiotics can affect ureaplasmosis:

• Macrolides (Josamycin, Midecamycin, Clarithromycin, Azithromycin) are relatively safe, can be used in pregnant women from the 2nd trimester, have a minimal number of side effects.
• Tetracycline series (Unidox, Doxycycline) - prohibited for pregnant women. Ureaplasmas are insensitive to tetracycline in 10% of cases, therefore it is classified as a reserve substance.
• Fluoroquinolones (Ofloxacin, Ciprofloxacin, Ciprolet) are not recommended during pregnancy, pathologies of cerebral vessels. Additionally, the fluoroquinolone series increases the sensitivity of the skin to UV rays, so sunbathing during treatment is prohibited.
• Aminoglycosides (Neomycin, Spectinomycin) - are rarely prescribed, but work at all phases of bacterial development, are effective even in severe forms of the disease.
• Lincosamines (Dalacin, Clindamycin) are effective against mycoplasma, they are related to macrolides by the principle of action, they activate the mechanisms of nonspecific defense of the microorganism.
• Probiotics - some of them (Bifidumbacterin, Linex) have activity against pathogens, but the main purpose of their appointment is the normalization of microflora. The advantages include safety of use in pregnant women.

Suppositories for ureaplasma in women

Doctors advise to act on pathogenic microorganisms from all sides, so the local use of antiseptic and bacterial agents presented in suppository format is not superfluous. They can have a vaginal or rectal appointment and, in addition to influencing the pathogen, have a symptomatic effect: they eliminate pain, itching, burning, and minimize inflammation. Mainly assigned:

• Genferon - are an antibacterial and antiviral agent, have an analgesic effect, stimulate local immunity. Composition combined (interferon, taurine, benzocaine), works systemically. Suppositories are applied vaginally 2 times / day, the course of treatment is 10 days (chronic forms of the disease - 1-3 months, but use every other day).
• Hexicon - prescribed for a weekly course, allowed during pregnancy. Used 1 time / day, vaginally. They work on chlorhexidine, so they only have an antiseptic effect. They do not have a systemic effect, they are not used singly.

Immunotherapy

Preparations that increase the body's defenses have almost no effect on pathogenic microorganisms, but without them, firstly, even after a complete cure, a new infection is possible. Secondly, they help speed up the healing process, as they set up the body to fight on its own.For this purpose use:

• Immunostimulants - give a "push" to the immune system, help to more actively develop protective cellular links. They can be stimulators of nonspecific resistance of the body (Methyluracil), humoral immune responses (Myelopid), cellular immunity (Timoptin, Timalin). They can be of plant and synthetic origin. The safest for pregnant women include Lysozyme, which has an additional antibacterial quality.
• Immunomodulators (Wobenzym, Cycloferon) - are of high importance in autoimmune diseases, correct the defense system. The function of immunomodulators is performed by probiotics, cytostatics, anti-Rhesus immunoglobulins, hormonal agents, and even some antibiotics (cyclosporine, rapamycin).

Intake of vitamins and probiotics

Both during etiotropic treatment and after, it is required to restore the microflora of the vagina (with prolonged use of antibiotics - and intestines) and drink a course of restorative vitamin-mineral complexes. Probiotics are applied internally and externally, which will help to completely suppress the pathological activity of bacteria. Doctors advise using the following drugs:

• To eliminate intestinal dysbacteriosis - Linex, Bacteriobalance, Bifikol: contain lactobacilli and bifidobacteria.
• Local vaginal probiotics - Vagisan, Gynoflor, Vagilak, Bifidumbacterin.
• Vitamin-mineral complexes - Alfavit, Solutab, Biovitrum, Complivit (it is advisable to select with a doctor, based on the deficiency of specific elements).

Vaginal sanitation

Treatment of ureaplasma in women necessarily involves antiseptic treatment of the vaginal mucosa (sanation), which is carried out using any local means that have this property. The technique makes sense both during treatment and for the prevention of re-infection. For sanitation apply:

• ointments;
• vaginal tablets;
• suppositories;
• solutions.

If the procedure is carried out in a clinic, a vacuum method or ultrasound can be used. At home, sanitation is carried out after washing the genitals, the course of treatment lasts 2 weeks. Every day, a woman injects 10 ml of chlorhexidine into the vagina, lying on her back and slightly raising her pelvis. After the procedure, you can’t wash yourself, you should refrain from urinating for 2.5 hours.

Physiotherapeutic procedures

The most useful of all physiotherapy options (prescribed for sexually transmitted diseases), doctors call electrophoresis: it helps to deliver drugs faster and more reliably locally. It is especially valuable in a chronic inflammatory process. Additionally may be recommended:

• Magnetotherapy - can also imply the introduction of drugs, is the effect on the genitals of a magnetic field.
• Laser irradiation - exposure to the urethra with a special laser to relieve pain, stop inflammation, and stimulate local immunity.
• Exposure to dry heat - has an analgesic effect, enhances lymph flow, especially useful when cystitis is attached. With exacerbation, this technique is not used.

Prevention and prognosis

With timely and correctly carried out etiotropic treatment, it is possible to completely destroy the pathogen, but re-infection of the woman is not excluded. Due to the nature of the transmission of infection, a reliable way to protect against it (mainly from an increase in the number of bacteria in the vagina and changes in its microflora) is the use of a condom during intercourse, including oral. Additionally, it is desirable to avoid frequent changes of sexual partners and:

• after casual intercourse, use local antiseptics (Chlorhexidine, Miramistin);
• monitor immunity (periodically drink immunostimulants);
• observe the rules of personal hygiene;
• to undergo a preventive examination by a gynecologist annually;
• treat diseases of the genitourinary system in a timely manner.

Ureaplasmosis: is it always a disease, signs, manifestations, ways of transmission, diagnosis, how to treat

Ureaplasmosis is defined as an infectious and inflammatory disease of the genitourinary system, which is transmitted mainly through sexual contact and is caused by the microorganism Ureaplasma urealyticum, or Ureaplasma parvum.

In humans, these bacteria primarily affect the urethra in men and the vagina in women. Ureaplasmosis as a separate disease is rare, more often found in association with mycoplasmosis and chlamydia. Therefore, with symptoms characteristic of urogenital infections (burning during urination, mucous or purulent discharge from the urethra or vagina), along with tests for ureaplasmosis, a diagnosis of mycoplasmosis and chlamydia is always carried out.

Ureaplasmosis is isolated as a separate disease only if an inflammation pattern develops and the tests are positive only for ureaplasma (u.urealyticum or u.parvum).

Until now, there is no consensus in medicine regarding ureaplasmas. Some consider them pathogenic (pathogenic), others are confident in their complete harmlessness and classify them as normal microflora of the human body. The ways of transmission of ureaplasmosis also raise questions: almost 30% of girls who do not live sexually have ureaplasmas, and the household route of transmission has not been reliably proven. Carriage is also doubtful - in men, ureaplasmas may not be detected at all, however, in women, after sexual contact with absolutely healthy men, for some reason, these bacteria were found.

As a result, modern medicine nevertheless formulated its attitude towards ureaplasmas. The "middle way" of selecting criteria has prevailed, according to which the diagnosis and treatment of various cases of ureaplasmosis is carried out.

• Ureaplasmas are opportunistic microorganisms present in the normal microflora of the vagina in women (more than 60%) and the urethra in men (about 50%). In the majority, they do not manifest themselves in any way, do not give symptoms of inflammation, and therefore, even in the case of a positive diagnosis, such people do not need any treatment.
• The detection of ureaplasmas during pregnancy is not a cause for panic: the very fact of their presence does not threaten complications or miscarriage and does not harm the health of the baby. All complications are possible only with the development of inflammation associated with the reproduction of ureaplasmas and other pathogenic bacteria. A decrease in immune defense is the main factor that provokes the onset of the disease, and maximum attention should be paid to the general health of expectant mothers.
• Almost always, ureaplasmas are found together with mycoplasmas and chlamydia, therefore, treatment is carried out with drugs to which all these microorganisms are sensitive. Usually a combination of different antibiotics is required, the scheme is always supplemented with immunomodulators and probiotics, vitamins and diet.

Paths of transmission and causes of ureaplasmosis

It has been proven that infection with ureaplasmas occurs mainly through sexual contact, and a child can get an infection from the mother during pregnancy or during childbirth. Household (through objects, underwear) transmission routes are unlikely and practically not proven. The gates of infection are usually the vagina and urethra, less often infection occurs orally or anally. Further distribution of ureaplasmas is possible only with their active reproduction in a weakened organism. The incubation period lasts 1-3 weeks after sexual contact.

The causes of the manifestation of ureaplasmosis are considered to be a number of factors in which a decrease in the immune status of a given person is possible. The combination of several of them increases the likelihood of the transition of ureaplasmas from opportunistic pathogens to the category of pathogenic microorganisms.

The age period of 14-29 years is considered the most active, including in relation to sexual life. Hormonal levels and social freedom, confidence in one's health or no thought at all about one's vulnerability predispose to the spread of sexually transmitted infections.

During a pregnancy that occurs under conditions of physiological or moral stress, it is possible to exacerbate "dormant" infections that have never manifested themselves before. Poor nutrition, work for wear and tear, high study loads, uncertainty about the future - all affect pregnancy and its outcome.

Concomitant sexually transmitted diseases caused by gonococci, chlamydia and mycoplasmas; herpes simplex viruses, papilloma or human immunodeficiency (HPV and HIV) always contribute to the emergence and development of ureaplasmosis.

The immune system, weakened by prolonged stress or any chronic diseases, is not able to resist the reproduction of ureaplasmas. The result is the spread of infection and inflammation of the organs that make up the urogenital tract.

Weakening of the body after operations, hypothermia, a course of radioactive exposure in the treatment of cancerous tumors or due to deteriorating living conditions also contributes to the development of symptoms of ureaplasmosis.

The growth of conditionally pathogenic microorganisms is favored by uncontrolled treatment with antibiotics and hormonal agents, leading to dysbacteriosis - an imbalance of the microflora inside the human body.

Symptomatics of ureaplasmosis in women

The primary signs of the disease are associated with damage to the vagina and cervical canal, then the infection is introduced into the urethra. Symptoms of colpitis and endocervicitis develop, small mucous discharges from the cervix and vagina appear. With urethritis, a woman complains of a burning sensation in the urethra during urination, and the urge to urinate also becomes more frequent.After a few days, if the immune system is in order and there is no dysbacteriosis, the symptoms may disappear altogether and never appear again. When the body is weakened, the spread of ureaplasmas will follow the principle of ascending infection, capturing the internal genital organs, bladder and kidneys.

Chronic ureaplasmosis can lead to cervical erosion, and subsequently to epithelial cancer, which quickly metastasizes. At first, a woman is concerned about small mucous secretions, then bleeding during menstruation joins - a sign of the infection moving to the endometrium. On examination, a bright red mucosal defect with jagged edges is visible. On ultrasound, a thickening of the endometrium is determined.

Endometritis is an inflammation of the inner functional layer of the uterus, which is updated during each menstrual cycle. Normally, its thickness does not exceed 0.5 cm, with endometritis, its growth (endometrial hyperplasia) and even a violation of the characteristic structure (endometrial dysplasia) are possible. Both conditions are considered precancerous, with chronic inflammation and untreated, a transition to a malignant form is dangerous.

Symptoms are associated with pain in the lower abdomen and lower back, radiating to the inner surface of the hips. Such manifestations are characteristic of gynecological diseases: the pain is projected in the form of a belt lowered in front. Ureaplasma as a mono-infection practically does not lead to such consequences, all problems arise when combined with mycoplasmas, chlamydia, gonococci.

An ascending infection from the urethra manifests itself first as an inflammation of the bladder - cystitis, then the process passes to the ureters and kidneys (pyelonephritis). The signal is the appearance of blood in the urine; with pyelonephritis, the urine becomes dark brown, the color of beer. The same sign appears with hepatitis A, but with pyelonephritis, leukocytes, a cylindrical and squamous epithelium are present in the urine, and the feces do not discolor. The consequences of pyelonephritis are complications in the form of sepsis, the transition to chronic renal failure.

Pregnancy and infertility in ureaplasmosis

Regarding ureaplasmosis during pregnancy, doctors are careful in their conclusions, giving only numerical characteristics of the complications that arise (but not always). For example, Ureaplasma urealyticum is found in 40-65% of cases with confirmed chorioamnionitis, an inflammation of the membranes. But in 20% of healthy pregnant women, ureaplasma is also determined, and without any health consequences. The connection between premature birth and miscarriage in women infected with ureaplasmas has not been proven.

When infected with ureaplasmas during childbirth, pneumonia is observed twice as often in premature babies than in those born at term. Signs of meningitis are also found mostly in premature babies. In general, these data confirm that ureaplasma becomes dangerous if the body of a pregnant woman or a newborn is weakened.

Can ureaplasmosis cause female infertility? In combination with other sexually transmitted infections - definitely yes, if these infections are not treated for a long time. Uncomplicated ureaplasmosis, which caused inflammation of the cervix, can be cured in 3-4 weeks. The properties of cervical mucus are then restored, and pregnancy occurs without any stimulation, in a natural cycle.

The cervical mucous plug normally has an alkaline reaction, and the vaginal environment is acidic. It is important for spermatozoa to quickly get into the alkaline zone, and mucus plays the role of a kind of "elevator", moving out of the cervix during intercourse and then returning to its place. With endocervicitis, the mucus reaction shifts to the acid side, becoming another obstacle for spermatozoa

Manifestations of ureaplasmosis in men

The onset of the manifestation of ureaplasmosis in men is always associated with urethritis. Disturbed by a slight burning sensation in the urethra during urination, after 2-3 days the symptoms disappear. In 30% of men, self-healing occurs, but women can always become infected with ureaplasma after intercourse, even from healthy men. It is assumed that modern diagnostics are simply imperfect and cannot guarantee the detection of ureaplasmas in men in the absence of symptoms of inflammation.

The upward spread of mono-infection is not observed, but there are cases of the development of ureaplasma prostatitis. Inflammation is hidden, patients are concerned about the usual manifestations of the inflammatory process in the prostate gland. These include dull pain in the lower back and lower abdomen, scanty mucopurulent discharge from the urethra, erection problems and symptoms of neurosis (irritability, aggressiveness, sleep disturbances). The consequences of untreated prostatitis are the transition to purulent inflammation and sepsis, or to a chronic form with the development of infertility.

In men, ureaplasmosis is much more likely than in women to affect the joints and cause inflammation (arthritis). Localization can be any, but due to the constantly increased load, arthritis is prone to knee joints (gonarthritis).Symptoms: pain at rest and when walking, worse when climbing stairs and bending the leg; local swelling and redness, joint enlargement in volume. Differences between ureaplasma and symmetrical rheumatoid arthritis - usually only one joint becomes inflamed.

A chronic infection in the urethra, which periodically worsens, ends with strictures (narrowing) of the urethral canal. The dangerous consequences of ureaplasmosis include asthenospermia, a type of male infertility: ureaplasmas parasitize on germ cells, reducing sperm motility and viability. Serious complications of ureaplasmosis are found mainly in alcoholics, long-term drug addicts and antisocials.

In the vast majority of cases, ureaplasmas found in men do not manifest themselves in any way and remain exclusively opportunistic microorganisms.

Diagnosis of ureaplasmosis

Analysis for ureaplasmosis is recommended if patients have complaints associated with symptoms of inflammation of the urogenital organs, as well as according to indications related to statistics and risk groups for this disease. The screening technique helps to identify or exclude infection in the asymptomatic course of ureaplasmosis. As a rule, they simultaneously do tests for chlamydia and mycoplasmosis, gonorrhea and syphilis, HIV, hepatitis B, C viruses.

• Screening: pregnant; women under 25; having multiple sex partners with unprotected intercourse.
• Diseases: inflammatory processes in the pelvic organs in men and women; urethritis, cystitis and pyelonephritis; asymmetrical arthritis; conjunctivitis; inflammation of the testicles and appendages; infertility.
• To identify infected people and people from the circle of sexual contacts.

The material for analysis is taken from men - from the urethra, from women - from the cervix, vagina and urethra.

The culture method will remain the preferred method, despite the length of its execution. First, the material from the patient is sown on an artificial nutrient medium, then isolated from the grown colonies of the pathogen and determined using tests. The identification of ureaplasmas is based on their specific enzymatic activity: ureaplasma is able to break down urea. Re-seeding is carried out to determine the sensitivity to antibiotics. The results are obtained in a week or 10 days, the final diagnosis is made and adequate treatment is prescribed.

PCR diagnostics (polymerase chain reaction) helps to determine bacterial DNA that is specific for this type of microorganism. The method is 100% accurate if performed correctly and does not require other confirmation of the diagnosis.

Antibodies to ureaplasma can persist throughout life, so their definition for diagnosis does not make sense: it is impossible to distinguish between "fresh" and "old" traces of infection.

Treatment of ureaplasmosis is mandatory at the risk of complications during pregnancy, which are confirmed by objective examinations; with male and female infertility, if other causes, except for ureaplasmosis, have not been established. Ureaplasmosis is also treated if there are symptoms of inflammation of the urinary organs and tests confirm this fact. Before planned medical interventions (surgeries, invasive diagnostic methods) to prevent the spread of ureaplzm outside the infected area, short courses of antibiotics are used.

In principle, the treatment of ureaplasmosis does not differ from the treatment of other STDs.

As a basis, antibiotics are used, to which Ureaplasma urealyticum (Ureaplasma parvum) is sensitive. It is better to start with those to which chlamydia, mycoplasmas and gonorrhea pathogens are also susceptible - from the macrolide group. Midecamycin, josamycin have practically no side effects and are well tolerated by patients. Azithromycin, clarithromycin penetrate cell membranes and destroy intracellular parasites (Neisseria, Chlamydia), do not decompose in the acidic environment of the stomach. Josamycin, erythromycin are suitable for the treatment of pregnant women in the short term (in the first trimester).

Tetracycline antibiotics (doxycycline, Unidox) are absolutely contraindicated during pregnancy. The modern treatment regimen puts them in the category of reserve also due to the appearance of resistance of ureaplasmas to these drugs in about 10% of cases.

The group of fluoroquinolones (all drug names end in "-oxacin") is similar in action to antibiotics, but has no natural analogues. For the treatment of combined infections, the drugs ofloxacin, ciprofloxacin are used. The peculiarity of drugs in this group is contraindicated in children under 15 years of age and pregnant women; increase sensitivity to ultraviolet radiation and can cause skin burns, so it is not recommended to sunbathe and be treated with fluoroquinolones at the same time.

General treatment is combined with local treatment, for men it is the instillation of drugs into the urethra (solutions of protargol or collargol) and baths with antiseptics. Women are prescribed vaginal or rectal suppositories.Candles "Genferon" have an antibacterial and antiviral effect, anesthetize and restore tissues, activate the immune system. Use twice a day, a course of 10 days. Suppositories "Hexicon" x 1 / day. will help cure uncomplicated ureaplasmosis in a 7-day course. It is allowed to use them during pregnancy and lactation.

In a chronic disease, immunomodulators - methyluracil, cycloferon, thymalin and t-activin are used to activate the immune system and get a controlled exacerbation first, and then a stable improvement. Rehabilitation therapy: drugs with lacto- and bifidobacteria after a course of antibiotics; antifungal agents (fluconazole); vitamin and mineral complexes. Complete nutrition with the exception of hot spices, alcohol and fried foods, with salt restriction. Sexual contacts are excluded for the entire period of treatment.

Folk remedies

The main tasks are to strengthen the body, reduce the effects of inflammation. For these purposes, locally used herbal antiseptics (sage, chamomile, calendula) in the form of douches or baths. Prepare infusions from the calculation of 1 tbsp. a spoon (without a slide) of dry grass or flowers per 200 ml of boiling water, exposure 1 hour; then the infusion is filtered through 3-5 words of gauze. You can add a decoction of oak bark, prepared in the same proportion. Infusions are not prepared for the future, each time you need to take care of a fresh portion. The course will require 7-10 procedures.

Drinks from herbs or berries will help reduce inflammation, avoid complications of ureaplasmosis on the kidneys and joints. Tea from lingonberry leaf and St. John's wort, a decoction of lingonberry berries and raspberry leaves work perfectly. However, it is worth remembering that the diuretic effect that these drugs have can do a disservice during antibiotic treatment. Medicines will be more quickly excreted from the body, and their concentration will decrease below the therapeutic level. Therefore, all folk remedies of such action are acceptable only after the end of the main course of treatment.