How to treat trichomonas urethritis in women

Diagnosis and treatment of trichomonas urethritis in women

Trichomonas urethritis in women is one of the most common urogenital diseases. The infection is transmitted exclusively through sexual contact, so this disease is classified as an STD. Trichomonas vaginalis is a flagellate parasite, men are most often only carriers of the infection, and women after infection suffer from it with all the ensuing consequences and complications.

What is Trichomonas?

Trichomonas is a parasite that ingests urethral and vaginal epithelial cells, bacteria and red blood cells. Trichomonas is a unicellular organism, but its structure is quite complex. The parasite is not able to independently produce many nutrients, therefore, it receives them by destroying the host cells (from epithelial cells in the first place).

Trichomonas outside the human body quickly lose their viability and die. Very often exacerbation of genital infections, including trichomonas, occurs during menstruation. The woman's body is weakened at this time, so pathogenic organisms take the opportunity to multiply and grow.

Menstrual discharge partially flushes out pathogenic microorganisms from the vagina, but Trichomonas and some other types of microbes are able to firmly attach to epithelial cells and use the iron in the menstrual blood to their advantage.

Features and symptoms of trichomonas infection

The vaginal secret of the vagina is an excellent nutrient medium for the development and growth of Trichomonas, which multiply by dividing, provoking an inflammatory process in the body. Gradually, the infection from the vagina spreads to the urethra. Trichomonas vaginitis and urethritis often develop almost simultaneously.

Most of the patients are asymptomatic. But if the infection makes itself felt, in women it has more pronounced symptoms than in men, and therefore it is much easier to diagnose. The incubation period can last from 10 days to 2 months after infection. In most cases, a woman is concerned about frothy or watery discharge from the vagina with a sharp unpleasant odor that irritates the skin of the labia and inner thighs. Also, a woman feels serious discomfort during intercourse and urination.

Trichomonas infection during pregnancy can cause premature birth and rupture of the membranes. During childbirth, the infection can be passed from mother to newborn. It is not advisable to plan pregnancy during the period of treatment and control of recovery from Trichomonas urethritis.

Diagnosis and treatment

Diagnosis of trichomonas infection causes some difficulties, as it is often asymptomatic. In addition, the parasite can change its appearance and mobility. An effective diagnostic method in this case is light microscopy. An experienced doctor, observing the behavior of Trichomonas under a microscope, can determine the nature of the disease.

Sowing on the flora is also used - a bacteriological method of research. The most accurate results are obtained by PCR diagnostics, which makes it possible to identify other pathogens of urethritis: chlamydia, ureaplasmas, mycoplasmas.

Basic principles of quality diagnostics:

The basis of the treatment of Trichomonas urethritis is taking metronidazole.

A prerequisite for effective therapy is the treatment of both sexual partners, otherwise the infection will occur again. For the period of treatment, it is necessary to refrain from sexual activity until the moment of complete recovery of both partners. The basis of the treatment of trichomonas infection is the use of drugs based on metronidazole: trichopol, flagyl, metronil. It can also be nitazol and tinidazole.

Since the infection in most cases affects the vagina and urethra at the same time, vaginal suppositories containing anti-inflammatory and antibacterial components are used to restore the microflora of the vagina and genital organs.

The most effective and popular treatment for Trichomonas infection for many years is taking metronidazole by mouth. Local treatment is usually not enough, as the infection often affects the vagina, urethra, and Bartholin ducts at the same time.

Numerous studies have shown that the use of a shock single dose of metronidazole gives the same result as other treatment regimens (3-5-7 days of therapy). It is important that within 2 days after taking the drug, alcohol is contraindicated for the patient, since such a combination leads to unpleasant side effects (nausea, vomiting, palpitations, general malaise).

It is important to seek medical help in a timely manner at the first alarming symptoms. Since trichomonas infection is often asymptomatic, like other forms of urethritis, women need to undergo regular check-ups with a gynecologist.This will allow you to identify the infection in the early stages and start its treatment in a timely manner.

If you start trichomonas urethritis, it will turn into a chronic form, which is very difficult to treat. Ultimately, trichomonas can cause infertility.

How to protect yourself from infection?

Prevention of trichomonas infection is a healthy sex life and the use of condoms if you are not sure about the health of your sexual partner. In addition, the risk of re-infection is almost 100% if only the woman undergoes treatment, and her sexual partner refuses to undergo therapy. Be sure to use a condom throughout the course of treatment until the doctor confirms your complete recovery.

Sources:

S.V. Yakovlev: "Infections: treatment regimens", 2005.

Trichomonas urethritis: causes, diagnosis, symptoms and treatment

Trichomonas urethritis is an infectious disease of the human genitourinary system. The causative agent of this disease is a microorganism belonging to the flagellates - Trichomonas. Pathology is dangerous for its complications, so its treatment is given great attention all over the world.

Essence of pathology

Trichomonas urethritis is a sexually transmitted disease during unprotected sex. In this way, 90% of all patients become infected. However, there is also a household way of transmitting the infection, but the likelihood of such infection is extremely small. It is believed that the infection can be transmitted through towels, washcloths, toothbrushes and other personal hygiene items. It also poses a danger to someone else's underwear and bed linen. By affecting the genitourinary system, the disease can lead to infertility, both men and women.

The treatment of trichomonas urethritis is carried out in pairs. That is, if a pathology is found in one of the sexual partners, then not only he himself, but also his constant companion is subject to therapy. Otherwise, the infection will occur again and again from an untreated spouse.

Some features of the disease

Trichomonas urethritis occurs in men more often than in women, due to their psychological characteristics, namely, in the desire for close relationships with a large number of women. This behavior is due to the anthropological characteristics of the male. Accordingly, their risk of infection is several times higher than that of women.

Trichomonas urethritis tends to take a chronic form very quickly. If it is not cured within 2 weeks after infection, then all symptoms disappear, and the disease goes into a latent course. From this moment on, the patient becomes a dangerous carrier, because he thinks he is healthy and does not take any measures to protect himself during sex.

Symptoms of the disease in men

The symptoms of trichomonas urethritis in men and women differ, and in some cases the disease proceeds without any manifestations. Therefore, you need to carefully monitor your condition so as not to miss the warning signs.

If you experience one or two of the above symptoms, you should consult a doctor. Any delay can lead to complications and a chronic form of the disease.

Symptoms of the disease in women

Symptoms of trichomonas urethritis in women may not appear during the course of the disease. Pathology is detected only during a routine examination by a gynecologist. So this examination should be carried out as often as possible, preferably 4 times a year.

In most cases, the following signs of the disease occur:

Complications

For the most part, patients do not know that they have become carriers of Trichomonas, especially women in whom the pathology may be asymptomatic. In this regard, patients with urethritis develop a variety of pathologies that have become the result of their inattention.

In the female body, cystitis first of all begins. Left without treatment, it eventually degenerates into kidney failure.

Trichomonas that has entered the urinary system of the female body continues to capture all the new organs of the small pelvis. Therefore, at some stage of the disease, a woman develops cervical erosion. All this leads to incurable infertility. In other words, trichomonas urethritis in women is a direct path to infertility. Of course, if it is not cured in the first weeks after infection.

Trichomonas urethritis in the male body slowly moves up the genitourinary system, affecting all organs in its path. First, it causes inflammation of the urinary tract. Since it passes through the prostate gland, it is she who becomes the next victim of inflammation. After prostatitis, the turn comes to the testicles. Spermatozoa lose their mobility and die. A man at this stage of the disease becomes infertile, but this is not a problem.Prostatitis leads to early impotence, and the representative of the stronger sex simply does not know about his infertility.

A disease that has become chronic, from time to time is manifested by pain during urination, which, with prostatitis, also becomes weak, but frequent. Chronic urethritis is treated for a very long time and hard, so you should consult a doctor at the first symptoms of the pathology.

Disease diagnosis

First of all, the presence of Trichomonas urethritis is determined by characteristic features. During the collection of anamnesis, the doctor asks the patient about his feelings, conducts an initial examination of the genital organ.

Then the patient is sent for bacterial analysis to the laboratory. Here the type of disease and its severity are determined.

After confirming the diagnosis, a conversation is held with the patient, designed to identify all his sexual contacts. This is done so that the infection does not spread more widely. People with whom the patient had sexual intercourse are required to undergo treatment in the prescribed manner.

The treatment of trichomonas urethritis in men and women is carried out by a conservative method. The patient is prescribed one of the most effective drugs in this direction. These are Metronidazole, Tiberal and Tinidazole. Trichopolum and Azithromycin can also be used.

The type of drug, dosage and regimen is determined by the attending physician, based on the results of the diagnosis and the general condition of the patient. At the same time, therapy is carried out on the permanent sexual partner or partner of the patient.

The chronic form of the disease, in addition to traditional therapy, is treated with trichomonacidin instillations. The course of treatment is 5-6 days for 15-20 minutes.

For the entire duration of treatment and for 2 months after it, a special diet is prescribed to prevent relapse, as well as to strengthen the patient's immune system. It completely excludes fried, spicy foods, preservatives and artificial colors from the human diet. And most importantly - alcohol.

On average, the entire course of treatment takes about 30 days. During this period, the patient is advised to refrain from sexual intercourse.

Cureability criterion

On the 7th or 10th day of treatment, the patient is sent for a second bacteriological analysis. After that, the so-called provocation is carried out. This procedure allows harmful microorganisms to be activated and thereby manifest themselves. This may be an intramuscular injection of Pyrogenal or the introduction of a solution of silver nitrate into the urethra. Sometimes the patient's reproductive system is heated by induction currents. And at the dawn of the therapy of venereal diseases, a provocation with alcohol or fatty foods was performed. After this procedure, prostate secretion and urethral swabs are analyzed for 3 days.

This procedure with provocation is repeated after another 1 month. If the test results are negative, then the patient is considered cured.

It is important to understand that Trichomonas urethritis can affect the human body many times. The immune system does not produce antibodies to this type of disease.

What are the predictions

With proper and timely therapy, the prognosis is positive. The main condition for a complete recovery from trichomonas urethritis is the implementation of absolutely all the recommendations of the attending physician, up to diet and sexual abstinence.

Preventive measures

Prevention of this disease is much easier than its treatment. In order for trichomoniasis or other STDs not to ruin your life, you must follow the following rules:

From all of the above, it is clear that urethritis is dangerous for both women and men. Simple preventive actions significantly reduce the risk of infection.

Manifestation and treatment of Trichomonas urethritis in women and men

Urethritis - inflammation of the urethra - is a fairly common pathology. There are more than a hundred causal factors affecting its development, and a large group of them are sexually transmitted infections (STIs). In particular, the study of transmission routes, development mechanism, characteristic features of the course, as well as modern approaches to the diagnosis and treatment of trichomoniasis (trichomoniasis urethritis) is of great interest to the medical world.

Trichomonas urethritis is one of the most common sexually transmitted infections. The lesion of the urethra is considered a specific sign of this disease and can either be accompanied by vivid clinical manifestations or be almost asymptomatic.

Pay attention! According to WHO, about 10% of the world's population is infected with Trichomonas: 170 million new cases of the disease are diagnosed annually in the world.

Causes and factors provoking the development of the disease

It causes disease pathogenic for the human body parasitic protozoa Trichomonas species vaginalis.The size of these small unicellular microorganisms is 13-18 microns. Urogenital Trichomonas are able to live only on the mucous membranes of the urinary organs. In the environment and other parts of the body (for example, the gastrointestinal tract), they quickly die. Also negatively affect these microorganisms:

• drying;
• high temperatures (45 C and above);
• direct sunlight;
• osmotic pressure fluctuations;
• being outdoors.

The main habitat of Trichomonas in males is the urethra, seminal vesicles and prostate. In the female body, parasitic protozoa "settle" in the vagina.

Thus, the transmission of the pathogen from the source of infection - a sick person or carrier - usually occurs sexually. At the first penetration into the body, Trichomonas always cause vivid signs of urethritis.

Pathogeny of trichomonas urethritis

During unprotected intercourse, trichomonas are easily transmitted from a sick person to a healthy one. Due to the presence of flagella and a specific wavy membrane, these microorganisms are able to "cling" to the mucous membranes and make active movements. The incubation period - the time from infection to the appearance of the first signs of an infectious process - averages 2-14 days.

There are several key points in the pathogenesis of the disease:

• The direct damaging effect of Trichomonas on the integumentary cells activates the immune system: acute inflammation begins.
• Microorganisms secrete specific proteins responsible for the pathogenicity of the pathogen. For example, hyaluronidase and other enzymes cause softening and loosening of mucosal tissues. Multiple toxins disrupt the genitourinary system.
• Penetration of Trichomonas into the intercellular space - here it is more difficult to get them to antibiotics and other drugs.

If the pathogen enters the male body, it spreads throughout the urethra, causing inflammatory reactions. The entrance gate of infection in women is the vagina, and only a little later, the protozoa enter the urethra. Therefore, with trichomoniasis, the fair sex is more often diagnosed with combined lesions of the genitourinary system - vaginitis and urethritis.

Clinical signs of the disease

Trichomoniasis is a disease with high contagiousness (contagiousness), so it develops with the same frequency in both sexes. The clinical manifestations of the disease remain different, which is associated with the anatomical features of the structure of the genitourinary system in men and women.

During the course of the disease, two main forms are distinguished - acute and chronic.

Acute infection is characterized by vivid symptoms. The inflammatory process in the genitals is actively progressing, there is a tendency to destruction. If you leave the signs of acute trichomonas urethritis without attention, within 1-2 weeks the disease becomes chronic. Also contributing to this process:

• intense physical activity;
• sexual activity;
• alcohol abuse.

Pay attention! In about 25-35% of cases, the acute stage of Trichomonas urethritis is asymptomatic. It is also a predisposing factor for the transition of the disease to a chronic form.

Chronic trichomonas urethritis is characterized by a lesser severity of clinical manifestations and a sluggish course. Despite the almost complete absence of symptoms, a person will remain a source of infection, and he also has an increased risk of developing serious complications.

Trichomoniasis in men

Symptoms of an acute form of Trichomonas urethritis in the stronger sex usually appear 5-7 days after infection. Patients are concerned about acute tingling in the head of the penis, mild discomfort and burning during urination. Hemospermia - the appearance of blood in the semen at the time of ejaculation - speaks of the progression of inflammation and mechanical damage to small vessels by the pathogen.

If a man does not attach importance to painful symptoms, after 7-14 days trichomoniasis becomes chronic, which is characterized by the appearance of the following symptoms:

• constant itching and burning in the genital area, worse after urination;
• pain along the urethra;
• insomnia;
• nervousness, irritability, increased anxiety;
• hemospermia - regular bleeding during ejaculation;
• Profuse white or grayish watery discharge from the urethra.

Chronic trichomonas urethritis in men is characterized by a long undulating course, in which periods of exacerbation, usually caused by alcohol abuse, decreased immunity, or general hypothermia, are replaced by relative well-being. Ultimately, the disease leads to the formation of such complications as:

• erosion on the genitals;
• inflammation of the prostate of trichomonas etiology;
• impotence;
• asthenozoospermia - low sperm motility;
• infertility.

Trichomoniasis in women

In women, the symptoms of Trichomonas urethritis have some differences. It is believed that the representatives of the beautiful half of humanity suffer diseases more severely, and the symptoms of trichomoniasis are more pronounced in them.

If an STI affects the female body, patients complain about:

• itching, burning in the vulva and vagina;
• discomfort, soreness during intercourse and with every urination;
• yellowish or light-colored watery discharge from the vagina with an unpleasant odor;
• swelling, hyperemia of the mucosa of the external genitalia and vagina.

Trichomonas urethritis in women can be complicated:

• vulvitis - inflammation of the mucous membrane of the NGO and perineum, accompanied by swelling of the labia;
• bartholinitis;
• cystitis;
• Infertility

Special attention deserves the course of trichomoniasis during pregnancy. Although testing for Trichomonas vaginalis is not part of guaranteed medical care, it is recommended for all women planning a pregnancy.

But it also happens that Trichomonas urethritis is diagnosed after pregnancy. How will its course change in this case? Is this disease dangerous for the expectant mother and fetus?

It is important to understand that Trichomonas, as a simple microorganism, is not able to penetrate the reliable hemoplacental barrier, therefore, nothing threatens the developing child for nine months. There are also studies that note the relationship between trichomoniasis in a pregnant woman and the development of preterm labor.

Pay attention! Expectant mothers who have been diagnosed with Trichomonas urethritis are advised to undergo treatment without waiting for childbirth. Therapy with antimicrobial drugs, in particular Metronidazole, is carried out starting from the llth trimester of pregnancy.

Infection of a child can occur vertically - while passing through the mother's infected birth canal. In this case, the treatment of the newborn and the puerperal should be started as early as possible in order to avoid negative health consequences.

Principles of diagnostics

Diagnosis of trichomonas urethritis consists of several stages:

• The collection of complaints and anamnesis allows the doctor to determine the range of existing problems and draw up a plan for further action. Tell the specialist about the changes in the body that bother you, when the first complaints appeared, whether you took any treatment for this. Also, don't forget to mention any previous STIs and other illnesses.
• Medical examination. During a visual examination of the external genitalia, one can notice hyperemia, swelling, inflammatory changes in the mucous membrane of the urethra and vagina (in women). In addition, the venereologist evaluates the amount, color, smell, nature and consistency of pathological secretions.
• Laboratory tests to detect T. vaginalis in the body.

Laboratory diagnostic methods are:

• A simple microscopic examination (without staining): is carried out immediately after obtaining a pathological biomaterial - discharged from the urethra, vagina. This diagnostic test is based on light, dark field, or phase contrast microscopy techniques. It allows you to get results immediately after taking the material, but retains high accuracy only in severe forms of the disease.
• Bacterioscopic examination of Gram/Romanovsky-Giemsa stained smears. A simple and affordable diagnostic method, however, due to the subjectivity of interpretation, its reliability does not exceed 60-75%.
• Bacteriological (culture) tests are based on growing colonies of microorganisms on specific nutrient media. Suitable for diagnosing chronic and severe forms of Trichomonas urethritis.
• Enzymatic immunoassay (ELISA) is an immunological diagnostic method that consists in determining specific antibodies to STI pathogens, including trichomoniasis.
• PCR is a modern diagnostic test, during which DNA chains of the pathogen are determined in the body. It has high accuracy and does not require confirmation by other methods.

STI therapy

Treatment of trichomonas urethritis consists of several stages. At the same time, early contact with a doctor reduces the duration of therapy. Depending on the neglect of the disease, it will range from 1-2 days to several weeks or even months.

Pay attention! For the entire period of therapy, any sexual contact should be stopped.

A patient diagnosed with trichomonas urethritis is prescribed drugs based on Metronidazole for active eradication of the pathogen. Among them are:

Drug treatment is carried out with oral preparations (for oral administration), less often with the help of installations (infusion of a drug solution into the urethra). Means for topical application - vaginal suppositories and ointments - are ineffective for urethritis. It is important that the course of treatment is compiled by a doctor, taking into account the characteristics of the course of trichomoniasis and the presence of concomitant STIs. The patient must complete the initiated course of antimicrobial therapy to the end: the irregularity of taking pills can provoke a chronicity of the inflammatory process and the development of drug-resistant forms of infection.

In addition to drug therapy, the patient can be prescribed:

• immune, restorative therapy;
• prostate massage;
• physiotherapy procedures.

It is mandatory to undergo an examination and the sexual partner of the diseased. Even if nothing bothers him, Trichomonas will most likely be found in his body, and he will need complex therapy for the disease. When diagnosing Trichomonas urethritis in combination with other STIs, the venereologist draws up a treatment plan aimed at eliminating all pathogens of the pathological process. As a rule, it includes a combination of several antibacterial agents.

Prevention of the disease consists in being faithful to your sexual partner, using personal protective equipment against STIs (condoms), regular preventive examinations by a gynecologist / andrologist. Despite the high prevalence and sluggish, sometimes almost asymptomatic course, trichomonas urethritis cannot be ignored: this pathology often leads to serious complications, including impotence and infertility.