Ureaplasmic urethritis in women treatment

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 ureaplasma 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 spread 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 surgery, 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

An 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 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.

Video: expert opinion on ureaplasmosis

Features of treatment of ureaplasma form of urethritis

The ureaplasmic type of urethritis is an acute infectious disease of the urinary canal, and therefore, a bacterial pathogen called ureaplasma enters its cavity. The infection is transmitted sexually through unprotected sexual contact, provoking ureaplasmosis. The danger of this disease lies in the fact that with a long stay of pathogenic microflora in the genitourinary organs, microorganisms destroy not only the epithelial structure of the urethra itself, but also spread throughout the body, generating local foci of inflammation. It has also been scientifically proven that ureaplasma has the ability, together with the blood flow, to penetrate into the joints of the human musculoskeletal system and becomes the cause of arthrosis. In 80% of all patients suffering from this disease, after examining the joint fluid, it was found that there was ureaplasma in it, the concentration of which exceeded all permissible norms.

Causes of illness

Urethritis caused by ureaplasma has a limited number of reasons for its origin, because the disease is conditionally specific and does not occur in medical practice as often as other forms of inflammation of the urinary canal. Therefore, it is generally accepted that ureaplasma urethritis develops due to the presence of the following causative factors.

Sexual contacts

The incidence statistics for this disease is such that in most cases urethritis is found in men whose age is in the range of 18-35 years. Almost all infected during the examination by a urologist reported that the day before they had sexual intimacy with a partner without the use of barrier contraceptives in the form of condoms. It was noted that in general, patients often have close relationships with different women. In order not to face the disease, it is enough just to protect yourself and protect yourself from the penetration of uraplasma into the urethral cavity.

Household path

Less common compared to the sexual mechanism of transmission of an infectious agent of the disease, but still there are clinical cases when uraplasmosis occurs precisely for this reason. Infection occurs as a result of the general use of objects that theoretically should have only one owner. These are washcloths for bathing, towels, hygiene products, soap, underwear. A short contact of an infected object with the external genital organs of a man or woman is enough for the fact of transmission of ureaplasma and its migration to the mucous membrane of the urethral canal.

Autoimmune diseases

This is an indirect causative factor that also affects the development of this disease. The fact is that even after infection with ureaplasma, the disease does not always progress and the person feels the painful symptoms of inflammation. In people with a strong immune system, the symptoms of ureaplasma urethritis are not observed at all, and immunity cells destroy pathogenic microorganisms even at the stage of their adaptation after entering the urinary canal. If a man or woman suffers from chronic autoimmune pathologies associated with a violation of immune cell division, then the genitourinary system becomes vulnerable to ureaplasma and the disease makes itself felt already 4-5 days from the moment of infection.

Intrauterine infection

The bacterial causative agent of urethritis caused by ureaplasma invasion has a high ability to migrate through the body of its carrier along with the bloodstream and lymphatic fluid. Therefore, if a woman carrying a child is infected with this disease, then there is an 80% chance that the child will also be born with an excess amount of ureaplasma in her blood and genital tissues. Separately, read about the symptoms of urethritis in children.

In this case, an exhaustive list of reasons is presented that directly or indirectly affect the appearance of ureaplasma urethritis in a previously absolutely healthy person. Most people know very little about this disease, so they often ask this question: is urethritis and ureaplasma the same thing? No, urethritis is the general name for a disease characterized by inflammation of the urethra, and ureaplasma is an infectious agent (bacterium) of this kind of inflammatory diseases.

The first symptoms of ureaplasma urethritis

The main sign of the presence of the disease at the very first stage of its development is persistent discomfort inside the urinary canal, which intensifies during the passage of urine through the urethra, as well as at the time of sexual intercourse. Such sensations say that the infection is still at the stage of the incubation period, which lasts 2-3 weeks, but despite this, the number of bacteria has already grown to a critical level. The following symptoms are also noted:

• the opening, which is the entrance to the urethral cavity, becomes edematous and acquires a rich red tint;
• when trying to urinate, a man feels that the passage of urine is complicated by inflammatory adhesions of its walls;
• Intimate intimacy no longer delivers pleasant sensations, but only increases the pain syndrome.

• severe pain in the urethra, which makes itself felt at any time of the day and regardless of whether urine is being excreted at the moment or the urethra is in a calm state;
• thick and viscous mucus is discharged from the urinary canal, which is completely transparent, but has a sharp unpleasant odor;
• Itching that spreads throughout the vulva, which often makes the symptoms very vague in women.

General signs include a burning sensation in the urethra, heaviness and pain in the lower abdomen, false urge to go to the toilet. As you can see, the differences from gonorrheal urethritis are immediately visible.

Diagnostics and tests

Sometimes there are such clinical cases when a patient is diagnosed with urethritis associated with ureplasma infection and the doctor conducting the initial examination of the patient doubts his suspicions and therefore prescribes the following types of tests to the patient:

A smear from the walls of the urethra for bacterial culture and further identification of ureaplasma; a biochemical study of the composition of the patient's urine, which, if a person has this disease, will certainly show an excess of an infectious agent; blood from a vein and a finger, which are mandatory for delivery and are actually standard types of tests if the patient has such complaints. In the case of a complicated course of the disease, it is possible to prescribe such diagnostic measures as ultrasound diagnostics of the genital organs, urography, ureteroscopy, MRI of the organs located in the pelvic area.

How and how to treat ureaplasma urethritis in men and women?

Treating the symptoms of urethritis in men at home is not recommended.It is better to undergo a full course of therapy in the hospital of the urological department or visit a medical facility on an outpatient basis. In this case, the doctor prescribes the following groups of drugs:

• antibiotics, which are selected by the doctor for each patient individually and based on the results of a bacteriological study of urine and a selected smear of the urethral mucosa;
• vitamin, mineral complexes and medicines designed to strengthen the overall human immune system;
• bifidobacteria and lactobacilli, which are also prescribed to the patient in order to stabilize the intestinal microflora, which affects the health of the whole organism.

At all stages of treatment, the patient is under the supervision of a doctor and after each course of therapy, he takes tests so that the doctor can track the dynamics of the disease.

Complications

It is not so easy to get rid of ureaplasma, so it is possible that the patient may develop the following complications:

• acute or chronic form of prostatitis, when the infection from the urethra penetrates into the tissues of the prostate gland;
• testicular lesions and male infertility;
• inflammation of the bladder, kidneys, and their ducts;
• arthritis, arthrosis and rheumatism of the joints;
• destruction of the valves of the heart muscle;
• various diseases of the appendages in women that lead to the inability to conceive a child, or the rejection of the fetus occurs immediately after pregnancy.

Ureaplasmosis, associated with complications of the disease, is treated for a long time and with the use of a large number of drugs of various spectrums of action.

Ureaplasmic urethritis

Sexual infections are widespread among the population, especially in reproductive age. Some of them occur as independent diseases, while others are often detected together with other STIs. Such a disease is ureaplasmosis. There are many forms of this infection, because the pathogen can be localized in different areas of the genitourinary tract. Males are often diagnosed with ureaplasma urethritis.

Causes of disease

Like any infectious disease, ureaplasmosis has its own specific pathogen. In this case, there are two such microorganisms: Ureaplasma urealyticum and Ureaplasma parvum. They used to belong to the mycoplasma family, but when their distinctive ability to ferment urea was revealed, they were isolated separately in the genus Ureaplasma. They are bacteria without a cell wall. Therefore, they are sometimes classified as intermediate forms between bacteria and viruses. Ureaplasma can invade the cell wall of the mucous membranes and parasitize on its surface. The persistence of the pathogen on the surface of the spermatozoon has also been proven.

Epidemiology

Most experts classify ureaplasma as opportunistic microorganisms. This means that not every person in whom laboratory methods have been able to identify this bacterium has clinical signs of ureaplasmosis. Statistics say that in 60% of healthy women, ureaplasma is detected as a component of the normal vaginal microbiota. Even in newborn girls, this microorganism is found in the genital tract in 30% of cases, while the disease does not develop in babies. According to some reports, infection in men is up to 50%.

However, in the practice of a venereologist, most often the percentage of asymptomatic carriage of ureaplasmas is much lower. For the latest information, up to 12% of men are infected with ureaplasma without any symptoms of the disease. Moreover, infection is directly dependent on the number of sexual partners.

Routes of pathogen transmission

Given that ureaplasma cannot exist for a long time without a human body, the probability of transmitting the pathogen in everyday life is extremely small. This is possible only when a person gives his underwear or towel for the use of other people. Therefore, there are three main ways of transmitting the pathogen in ureaplasmosis:

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• The sexual route is the most common when infected with ureaplasmosis. Moreover, it is possible to become infected with this disease with all types of unprotected sexual contacts. Individuals who have had more than two different sexual partners in a year are particularly susceptible.
• The transplantation route is implemented in donor organ transplantation. Extremely rare.
• The vertical transmission mechanism means the transmission of ureaplasmas from mother to child.It has been proven that the pathogen can infect the fetus during pregnancy by contact from the mother's genital tract to the fetal membranes. Also, the possibility of penetration of ureaplasma into the embryo through the hemato-placental barrier is not excluded. Sometimes there is a transmission of the pathogen to the child from an infected mother during labor.

The incubation period of the disease is from one to two weeks when infected through sexual contact.

Who develops the disease

Due to the fact that ureaplasma belongs to opportunistic microbes, the infection does not develop in every person. For the appearance of a clinical picture of the disease in the body, significant changes must occur in the immune, hormonal system.

The factors predisposing to the development of ureaplasmosis are:

• immunodeficiency conditions, including HIV infection;
• severe illnesses, surgeries, injuries;
• Violation of the local protection of the mucous membranes of the genitourinary organs, protection factors in men are the zinc-protein antibacterial complex, macrophages.

Clinical manifestations of ureaplasma urethritis

This disease is more common in men. Patients, in addition to local manifestations, can observe general symptoms of the disease:

• general weakness;
• fatigue;
• increase in body temperature;
• appetite reduction.

Local symptoms of ureaplasma urethritis include the following:

• itching in the area of the opening of the urethra on the head of the penis;
• burning, pain during urination in the urethra;
• discharge of a mucous or purulent nature from the mouth of the urethra (in some cases, this symptom may not be present);
• pain in the penis during sexual intercourse;
• turbidity of urine, especially its first portion, sometimes an admixture of pus and mucus is detected in it;
• redness on the head of the penis.

If the symptoms of the acute period of ureaplasmosis remain unnoticed for a person, then the disease can become chronic. Then the process extends beyond the urethra. Often, a combined course of ureaplasma urethritis is detected with prostatitis of the same etiology. To the symptoms of damage to the urethra, signs of prostatitis are added: pain in the perineum, lower abdomen, during erection and at the time of ejaculation. The phenomenon of male infertility indicates the transition of the infectious process to the spermatogenic epithelium of the testicles, which leads to a violation of their production. Also, ureaplasma can affect sperm motility, worsening the qualitative composition of the seminal fluid and lowering the reproductive capacity of a man. The exacerbation of the disease is associated with the action of a number of factors:

• hypothermia;
• alcohol abuse;
• emotional shock.

Also often there are almost asymptomatic forms of the disease. At the same time, there is a risk of revealing the disease in a neglected, complicated form.

Disease diagnosis

The diagnosis of ureaplasma-induced urethritis should be made by a urologist, gynecologist or venereologist. After questioning and clarifying the patient's complaints, a clinical examination of the organs of the genitourinary tract follows. During the examination, the doctor can take material for further laboratory diagnosis of the disease. To confirm the diagnosis, urethral discharge is taken for the purpose of:

• bacteriological examination of the material, antibiogram in case of unsuccessful treatment of ureaplasmosis;
• PCR diagnostics, which allows you to identify the pathogen at a very low concentration.

The polymerase chain reaction method is considered the most reliable for detecting ureaplasma urethritis. Limited use is made of determining the titer of antibodies to the pathogen by ELISA, PIF.

The result of bacteriological culture should be at least 10 thousand. At the same time, the titer of other microbes is approximately 10 times less.

Ureaplasma positivity is the identification of a pathogen by one or more laboratory methods in the absence of a clinical picture of the disease. There are two types of ureaplasma positivity:

• Transient, which lasts from a couple of hours to several weeks.
• Permanent, lasting from several months to tens of years.

In addition to these methods, the patient is prescribed a general urinalysis, a urine culture tank with antibiotic sensitivity, an ultrasound scan of the pelvic organs and kidneys.

Treatment of pathology

Ureaplasma positivity according to modern recommendations is not an indication for treatment. Only in the presence of a topical diagnosis of ureaplasmosis, including ureaplasma urethritis, is the disease treated.

Treatment is prescribed and controlled only by a qualified doctor. In no case should you self-medicate.

First of all, sparing diet food is prescribed with the exception of spicy, sour, fried, fatty foods. Pickles, marinades, smoked meats, alcohol, cocoa, chocolate are also prohibited. It is also necessary to avoid overwork and stress. All these activities are aimed at improving the overall resistance to the disease, strengthening the immune system.

The main link in the treatment of ureaplasma urethritis is antibiotic therapy. In the case of acute uncomplicated infections, it is carried out with drugs from the group of macrolides (Azithromycin), fluoroquinolones (Ciprofloxacin, Levofloxacin). The tetracycline group (Doxycycline) is used much less frequently due to the insensitivity of the pathogen to it.

The duration of the course of antibiotic therapy is determined by the doctor. It is necessary to convince the patient of the need to take the prescribed amount of the drug throughout the entire period of treatment. After all, premature interruption of therapy, a decrease in the dose of drugs and other initiatives of the patient regarding treatment can lead to the formation of antibiotic resistance of pathogens and to a chronic protracted course of infection. The number of prescribed antibacterial drugs and the duration of their administration may increase in the presence of concomitant STIs. In the treatment of the chronic form of the disease, one should be guided by the data of the antibiogram. After completion of the course, it is necessary to collect material for control analyses. Further laboratory control is carried out again after 1 and 3 months.

Treatment is carried out simultaneously by both sexual partners.

If one of the couple has been treated for ureaplasmosis, and the other is not, then there is a high probability of re-infection of the recovered person. This happens even if the other partner did not have positive tests for ureaplasma. Sometimes men can be self-healing from ureaplasmosis, while women have not found such a feature.

In addition to antibacterial drugs, immunomodulators and vitamins can be prescribed. Probiotics are also prescribed to improve the condition of the intestinal microflora. In men with ureaplasma urethritis, local treatment is used in the form of instillations of antiseptic solutions into the urethra. Most often, instillations are prescribed for the chronic course of ureaplasmosis. Sometimes physiotherapy is indicated.

Consequences of the disease

The most serious consequences of ureaplasma urethritis are:

• infertility in both sexes;
• reactive arthritis;
• Urolithiasis with the formation of phosphate stones.

Prolonged persistence of the pathogen in the body leads to the spread of infection to other organs. At the same time, prostatitis and urethritis can occur in the male body, seminal vesicles and testicles can be affected. All this is fraught with violations of the reproductive function.

Prevention of urethritis caused by ureaplasma

Preventive measures for ureaplasmosis do not differ from other STIs:

• Using barrier contraceptives.
• Rejection of promiscuity.
• STI screening every 6-12 months.
• Screening for infections before a planned pregnancy.
• Emergency testing for STIs in unprotected casual sex.

To these rules, you can add personal hygiene, maintaining a healthy active lifestyle, as a means of non-specific prevention of sexual infections.

Thus, ureaplasma can both lead to serious consequences and coexist peacefully with the human body. With asymptomatic carriage, no one can guarantee that the pathogen is not activated and will not cause disease. Therefore, any questions should be resolved only with the attending physician.

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