Ureaplasmosis: is it always a disease, signs, manifestations, modes of transmission, diagnosis, how to treat. Ureaplasmosis (Ureaplasma urealiticum) Can ureaplasma sleep in the body

Ureaplasma causes a pathology such as ureaplasmosis in men and women. Until 1998, the medical community classified this infection as a sexually transmitted disease, but subsequently it was decided that the pathogen belongs to the opportunistic microflora, that is, it is a microorganism that in a healthy state is found in the body in small quantities, but can cause disease when the emergence of favorable conditions for its active reproduction. Thus, despite the fact that ureaplasma is not an STD, it is still transmitted from person to person through sexual contact (in 45% of cases). But you can also become infected with it through everyday life (usually this leads to the development of ureaplasma infection in various organs). The infection is also transmitted from a pregnant woman to a child during childbirth.

Despite the fact that ureaplasma is an opportunistic microorganism, the problems it causes can be very serious. In particular, ureaplasma in men can cause pathologies such as:

• inflammatory processes in the urethra;
• inflammation in the seminal vesicles;

The microorganism colonizes the urethra and foreskin, therefore, men may experience characteristic symptoms after an incubation period after infection, which can last several weeks.

Ureaplasma in women causes even more serious health problems - from to, from the threat of miscarriage during pregnancy to fetal development abnormalities. This is why it is so important to recognize the symptoms of the disease and promptly seek medical help before pregnancy. And women who are not planning to conceive should be promptly treated for a pathology such as ureaplasma in order to avoid serious consequences.

Causes

The reasons for the development in men and women, which causes ureaplasma, is the active reproduction of the microorganism in the carrier’s body. This happens mainly when the body’s defenses are reduced, which can occur due to:

• permanent ;
• long-term use of antibacterial drugs;
• taking hormonal drugs for a long time;
• the presence of chronic foci of infection in the body;
• a history of various sexually transmitted infections;
• some diseases internal organs affecting the body's immune defense;
• in states of immunodeficiency.

In addition, a disease such as ureaplasma develops if there are some predisposing factors. For example, if a woman leads an active sex life with frequent changes of sexual partners. Also predisposing factors are:

• early onset of sexual activity;
• age up to 30 years;
• poor social and living conditions;
• disruption of the natural microflora of the vagina;
• refusal to use condoms during new sexual contacts.

Symptoms

Ureaplasma is a pathology that in most cases is asymptomatic. And while a woman may still have minor manifestations of the disease, men have no symptoms in more than 50% of cases.

The main symptoms and manifestations of the disease in women may be as follows:

• copious clear discharge, different from what is usually characteristic of a woman;
• feeling of pain in the lower abdomen;
• development ;
• development of the inflammatory process in the cervical canal.

Sometimes the body temperature may rise slightly - to subfebrile levels. Weakness, malaise, decreased performance and other symptoms of general health problems may also occur.

If we talk about the symptoms of a disease such as ureaplasma in men, these can be:

• painful sensations when urinating;
• pain in the lower abdomen, in the scrotum, in the perineal area;
• cloudy morning urine.

Sometimes, the process progresses, which can cause more serious symptoms, such as the appearance of pus in the opening of the urethra, itching and burning, redness and swelling of the area.

As already mentioned, this disease is transmitted through sexual contact, so its asymptomatic forms pose an extremely serious threat. In this case, the carrier does not know that he has ureaplasma, and can transmit it to a partner, who may or may not show symptoms of the pathology, which is why further spread occurs. Therefore, since the infection is transmitted through sexual intercourse, it is important to use condoms to prevent its further spread. This is prevention, and in most cases helps protect against the disease.

Diagnosis and treatment features

Doctors such as a gynecologist, venereologist or urologist deal with the treatment of ureaplasma. The main drugs prescribed to patients with this disease are antibiotics. Moreover, tetracycline antibiotics and macrolides are predominantly used. The course of treatment is developed individually, taking into account the patient’s symptoms and condition, but on average lasts from 10 to 14 days.

Treatment of ureaplasma in women may also include local procedures such as douching, as well as physiotherapeutic procedures. In addition, women need to use drugs that restore vaginal microflora. During treatment, the use of immunomodulators that increase the body's defenses, such as Lysozyme, Decaris and other agents, is indicated.

What does ureaplasma mean in the test results? This word in itself does not indicate a disease, but the presence of a conditionally pathogenic bacterium in the body. The concept of opportunistic means that while in the human body, ureaplasma does not necessarily cause the development of the disease. Rather, on the contrary, most of people with a certain amount of this bacterium in the body may never get sick with ureaplasmosis. This bacterium is found in every third woman when taking a smear from the vagina, who do not complain of inflammatory processes in the genitourinary tract. Focusing on this fact, many doctors say that ureaplasma does not even mean a harmful bacterium, but a part of the normal microflora that does neither harm nor benefit.

Although there is an opposite assumption, according to which this bacterium, which predominantly colonizes the mucous membrane, damages it with its metabolic products, making it more vulnerable to other infections, that is, it acts as a catalyst for other inflammatory processes of the genitourinary system. Arguments confirming or refuting this theory have not yet been provided. And what does ureaplasma mean, whether to treat it or not, everyone must decide for themselves.

Therefore, if ureaplasma is detected, but no signs of the disease are observed, then treatment is not mandatory. However, it should be borne in mind that ureaplasmosis is often difficult to distinguish from other microflora. Moreover, the bacterium is usually combined with chlamydia, gardnerella, mycoplasma and others, which means that ureaplasma may not be the cause of burning during urination and other unpleasant symptoms, which means that it is necessary to treat not for ureaplasmosis, but for something else, more serious.

As a rule, in this case, the prescribed treatment can lead to a situation in which, after successful treatment of chlamydia, all previously detected traces of ureaplazm disappear, which means that the causative agent in this case was chlamydia. It should also be taken into account that when scraping is carried out on different days of the menstrual cycle in women, you can get results that differ from each other hundreds of times, which indicates the need for repeated retakes to obtain a positive result.

If any signs of inflammation are observed, but nothing other than ureaplasmosis is found, then the test results mean ureaplasmosis and it should be treated. Otherwise, the disease may progress and affect the joints.

Among the bacteria that are causative agents of sexually transmitted diseases, gynecologists named ureaplasma as one of the most common. It belongs to the group of opportunistic 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 detected in a woman, and how does it manifest itself?

What is ureaplasma

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

The disease that this microorganism causes is called “ureaplasmosis” (one of the types of mycoplasmosis). It was diagnosed in some women suffering from infertility and chronic urogenital problems, 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 gland, 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 a surface) and enzyme-forming properties. Thanks to them, the bacterium that entered the genitourinary organs:

1. Clings to the cylindrical epithelium located on the mucosa (attaches to its cells).
2. It merges with the cell membrane and thereby gains the ability to penetrate the cytoplasm: the internal liquid environment of the cell.
3. Begins the process of reproduction and production of an enzyme that has the ability to break down immunoglobulin A.

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

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

Is it necessary to treat ureaplasma?

The hostility of the microorganism to a healthy person (when ureaplasma in women is opportunistic) continues to be discussed in modern medicine. 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 remain in a harmless state for years. If the microflora of the vagina and urinary tract is normal, this is a sufficient protective barrier that prevents inflammation. If symptoms of ureaplasmosis appear, you need to attend to the issue of treatment.

Causes of 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 transform an opportunistic microorganism into an infectious agent:

• Hormonal imbalances are the primary cause of the development of ureaplasmosis in pregnant women entering menopause and taking hormone-based medications. An equally important point is diseases of the endocrine system, especially those related to the functioning of the ovaries.
• Decreased immunity – both due to the use of immunosuppressants (drugs that suppress the body’s defenses: prescribed for the treatment of oncology), and against the background of infectious viral or bacterial diseases: influenza, ARVI, etc.
• Vaginal dysbiosis - a violation of the natural microflora of the vagina, gynecologists associate mainly with hormonal imbalance, sexually transmitted infections, violation of rules intimate hygiene. This situation provokes the activity of all opportunistic microorganisms, so candidiasis (thrush) may appear with ureaplasmosis.
• Invasive interventions - not only abortion (mainly the curettage procedure), but also the therapeutic and diagnostic manipulations of a gynecologist are dangerous: urethroscopy, hysteroscopy, cystoscopy, surgical intervention for cervical erosion.
• Frequent changes of sexual partners - unprotected sex and the constant appearance of casual sexual partners lead 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 routes

Ureaplasma occurs much more often in women than in men (they have a tendency to self-heal), so they are considered the main carriers of the infection. Among all transmission routes, sexual is the leading one - among all infected people, about 80% are people who have sexual contacts, especially without a regular partner. Transmission of the causative agent of ureaplasmosis is possible both during unprotected vaginal intercourse and during oral intercourse. Bacteria present:

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

Some doctors suggest the possibility of infection through household contact: through personal hygiene items of the patient, but the theory has not yet been properly confirmed. It is almost impossible to become infected in a bathhouse, swimming pool and other public places. In addition, there are several other ways that are relevant for childhood infection:

• During childbirth, when passing through the birth canal, small children become infected (30% of newborn girls get ureaplasmosis), even if the mother does not experience symptoms of ureaplasmosis.
• Through amniotic fluid (in utero through the placenta) - bacteria will be found in the oral cavity, nasopharynx, and 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 its manifestations, it is often divided into asymptomatic carriage and an active inflammatory process (typical of other forms). The duration of ureaplasmosis is:

• Early - is divided 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 the urinary system), subacute (transitional 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 it looks similar to carriage, but is periodically accompanied by relapses, manifesting itself as an acute form. Stress factors are often the catalyst.

Carriage

The most common option is when ureaplasma is present in women’s bodies, but does not manifest itself at all. Carriage in the absence of risk factors may never make itself felt, as in the case of a latent (hidden) course of the disease, but the bacterium is transmitted to a sexual partner. As soon as immunity decreases, a stressful situation occurs, hormonal levels become unstable, 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 occurs, after the incubation period an acute stage of infection will manifest itself, which in its clinical picture is similar to the manifestations of other sexually transmitted diseases. They may suffer from frequent urge to urinate (the process is uncomfortable), pain in the lower abdomen, discomfort during sexual intercourse, and a slight rise in temperature. Symptoms persist for no longer than 2 months.

Chronic

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

• mucous discharge mixed with bloody discharge;
• pain in the lower abdomen, radiating to the lower back;
• symptoms of cystitis (impaired urination with inflammation Bladder).

Symptoms and signs of the disease

How activated ureaplasma will manifest itself in women depends on several factors: 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 route of infection. So, women who get the disease during oral sex will experience signs of sore throat and pharyngitis. Mostly the symptoms are:

• vaginal discharge (from weak transparent to cloudy yellowish and even bloody);
• discomfort or pain when urinating and increased urge to urinate;
• cutting pain in the lower abdomen (if endometritis, adnexitis are associated);
• vaginal pain during sexual intercourse;
• weakness, increased fatigue;
• low-grade fever.

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 independent home diagnosis. If the transmission of a pathogenic microorganism occurs during sexual intercourse, symptoms will begin to appear after 2-4 weeks (incubation period), but often (more than 70% of cases) even the disease that begins in a woman does not make itself felt.

Why is ureaplasmosis dangerous in women?

The mere presence of an opportunistic bacteria in the body is not a cause for concern, but microorganisms 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 begin against the background:

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

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

• inflammatory process in the kidneys (pyelonephritis);
• pain during sexual intercourse;
• inflammatory process in the bladder (cystitis);
• formation of adhesions in the fallopian tubes;
• 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 areas;
• the appearance of stones in the kidneys or bladder;
• inflammation of the vagina (colpitis);
• menstrual irregularities;
• infertility (due to the permanent inflammatory process, it is equally possible in women and men - the latter receive an infection during sexual intercourse from a sick woman).

Ureaplasma infection during pregnancy

Gynecologists advise a woman who is planning to give birth to a child to be examined 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 fluctuations in hormonal levels and a natural decrease in immunity. There are several reasons for examination and treatment before pregnancy:

• In the 1st trimester, it is prohibited 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 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 morphofunctional disorders occur in the placenta. The result is problems with fetal development (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 bearing a child at any stage is not only premature birth, but also termination of pregnancy due to miscarriage.

Diagnostics and identification of the pathogen

Doctors say that the diagnosis is not made based on the presence of ureaplasma in the body - the more important point is the number of these microorganisms and the mass of their spread throughout 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 must be comprehensive, especially in the presence of concomitant diseases, and includes:

• Bacterial culture for ureaplasma (cultural examination) - culture of biomaterial (for women, a smear and vaginal discharge) on a nutrient medium, as a result of which it is possible to isolate bacterial colonies and subsequently determine their resistance to specific antibiotics.
• PCR diagnostics (polymerase chain reaction) – helps to track the DNA molecules of infection present in the body. This is done by taking a smear. This analysis is highly accurate; after the end of treatment, 3 weeks later it can be re-administered to check the quality of the therapeutic measures taken.
• Serological testing is considered the most significant for women suffering from infertility or having diseases that are on the list of potential complications of ureaplasmosis. It consists of ELISA (enzyme-linked immunosorbent assay) and RIF (immunofluorescence reaction) tests. They are aimed at identifying antigens to cellular composition walls of this bacterium, a smear is taken to conduct them.

Treatment regimen for ureaplasma in women

According to official medical statistics, when diagnosing ureaplasma in women, it is found together with mycoplasma and chlamydia, therefore several types of antibiotics are included in the treatment regimen. The doctor must select specific therapeutic methods, but an approximate course is as follows:

1. Impact on the pathogen - this is done by antibiotics selected for a specific microorganism through bacterial culture.
2. Elimination of concomitant diseases of the genitourinary system (groups of medications and procedures depend on the specific problem).
3. Local control of infection using suppositories that have antiseptic or antibacterial properties.
4. Restoration of the bacterial microflora of the intestines and vagina after treatment with antibiotics (probiotics are used, mainly on lactobacilli).
5. Strengthening the immune system with the help of immunostimulants/immunomodulators, vitamin and mineral complexes.
6. Repeat tests after 2-3 weeks to check the effectiveness of treatment.

Additionally, a diet that is relevant for all stages of treatment must be added here: fatty, salty, and spicy foods are excluded. The woman is advised to limit sexual intercourse and, if necessary, 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 proliferation of the pathogenic microorganism and kill it are selected during a diagnostic examination, which helps to establish the sensitivity of ureaplasma to specific antibacterial substances. Self-prescription of such medications is unacceptable! Treatment lasts 1-2 weeks. The following groups of antibiotics can influence ureaplasmosis:

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

Suppositories for ureaplasma in women

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

• Genferon is an antibacterial and antiviral agent, has an analgesic effect, and stimulates local immunity. The composition is combined (interferon, taurine, benzocaine), works systemically. Suppositories are used vaginally 2 times a day, the course of treatment is 10 days (chronic forms of the disease - 1-3 months, but use every other day).
• Hexicon - prescribed as 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 and are not used alone.

Immunotherapy

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

• Immunostimulants – give a boost to the immune system, helping to more actively produce protective cellular components. They can be stimulators of nonspecific resistance of the body (Methyluracil), humoral immune reactions (Myelopid), cellular immunity (Timoptin, Timalin). May be of plant or synthetic origin. The safest for pregnant women is Lysozyme, which has additional antibacterial properties.
• Immunomodulators (Wobenzym, Cycloferon) - are of high importance in autoimmune diseases, correcting the defense system. The function of immunomodulators is performed by probiotics, cytostatics, anti-Rhesus immunoglobulins, hormonal agents and even some antibiotics (cyclosporine, rapamycin).

Taking vitamins and probiotics

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

• To eliminate intestinal dysbiosis - Linex, Bacteriobalance, Bificol: contain lactobacilli and bifidobacteria.
• Local vaginal probiotics – Vagisan, Gynoflor, Vagilak, Bifidumbacterin.
• Vitamin and mineral complexes - Alphabet, Solutab, Biovitrum, Complivit (it is advisable to select them 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 (sanitation), 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 use:

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

If the procedure is performed in a clinic, a vacuum or ultrasound method 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 should not wash your face; you should refrain from urinating for 2.5 hours.

Physiotherapeutic procedures

Doctors call electrophoresis the most useful of all physical therapy options (prescribed for sexually transmitted diseases): it helps to deliver medications locally faster and more reliably. It is especially valuable in chronic inflammatory processes. Additionally, we may recommend:

• Magnetic therapy - can also involve the administration of medications; it is the effect of a magnetic field on the genitals.
• Laser irradiation is the effect of a special laser on the urethra to relieve pain, relieve inflammation, and stimulate local immunity.
• Exposure to dry heat - has an analgesic effect, increases lymph flow, is especially useful when cystitis occurs. In case of 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 to use a condom during sexual intercourse, including oral. Additionally, it is advisable to avoid frequent changes of sexual partners and:

• after accidental sexual intercourse, use local antiseptics (Chlorhexidine, Miramistin);
• monitor your immunity (take immunostimulants periodically in courses);
• observe the rules of personal hygiene;
• pass preventive examination see a gynecologist annually;
• promptly treat diseases of the genitourinary system.

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The causative agent of diseases of the genitourinary organs in men and women is ureaplasma urealyticum. This is a type of mycoplasma. These microorganisms cause inflammation of the vagina, urethra, prostate gland and other organs. leads to the development of infertility.

Ureaplasma in the human body

Ureaplasmosis is an infection that is sexually transmitted. It is often accompanied by other STIs (chlamydia, gonorrhea, candidiasis, trichomoniasis, syphilis). Ureaplasma urealyticum belongs to the resident microflora. It can be present on the mucous membrane of the genital tract of men and women along with other microbes. Inflammation develops in the case of uncontrolled reproduction of ureaplasma.

In 60% of healthy women, these microorganisms are found in the vagina. The diagnosis of ureaplasma infection is made when more than 10,000 CFU/ml are released during the inoculation of biological material. These microbes were discovered in the middle of the last century. The peak incidence occurs at young ages. This is due to the beginning of an active sexual life. The highest incidence rate is observed among people 14–29 years old.

Properties and structure of ureaplasmas

These microorganisms have a number of features that make it possible to distinguish them from other pathogens of STIs. These include:

In 20–40% of cases, ureaplasma contributes to asymptomatic carriage of the infection. In other people they cause inflammatory diseases. The urethra and vagina are initially affected. Under favorable conditions, microbes spread further, leading to the development of salpigo-oophoritis, endometritis, bartholinitis, prostatitis and vesiculitis.

It has been discovered that ureaplasma can cause damage to newborn babies during childbirth. This happens if the mother is sick. The causative agent of ureaplasmosis can be transmitted through amniotic fluid. These microbes contain DNA, and therefore, when making a diagnosis, a polymerase chain reaction is required, with which the genetic material of the pathogen can be identified.

Infection and risk factors

Infection with ureaplasma occurs through sexual contact. Once microbes enter the body, their growth and reproduction are controlled by the immune system. In weakened people, a specific inflammatory process develops. Up to 40% of infected people become carriers of the infection. They can easily pass it on to their partners.

A risk factor is the practice of unprotected sexual intercourse. Using a condom will protect against infection. Ureaplasma urealiticum in women and men is transmitted through vaginal, oral and anal contact. Commercial sex workers, homosexuals and people who lead promiscuous lives are most susceptible to the disease.

Signs of inflammation may appear after using someone else's underwear or towel. Infection cannot be ruled out when visiting baths and saunas. The second mechanism of infection is vertical. Ureaplasma is transmitted from a sick woman to a child at birth. Signs of infection appear when the immune status decreases.

This is facilitated by:

• exhaustion of the body;
• AIDS;
• tuberculosis;
• tumors;
• blood diseases;
• taking narcotic drugs;
• alcohol abuse.

Among the patients there are many young girls and boys.

Symptoms of infection

Symptoms in women and men are determined by the location of the inflammation. The most frequently detected pathology is:

• urethritis;
• prostatitis;
• proctitis;
• vesiculitis;
• endocervicitis;
• adnexitis;
• vaginitis

Initially, the mucous membrane of the urethra is affected. Chronic specific urethritis develops. It is manifested by pain and burning at the beginning and end of micturition. Patients experience discomfort. Painful sensations intensify during sexual intercourse. Subject to change appearance urine. Often it becomes cloudy.

Upon examination, redness of the external opening of the urethra can be detected. If a person has a frequent urge to micturate and pain in the lower abdomen, this means that cystitis has developed. The frequency of urination with cystitis reaches 10 or more. The urge to go to the toilet appears even when the bladder is partially filled.

Ureaplasma infection is manifested by mucous discharge from the genital tract. They are liquid and do not contain pus. Their volume is small. After sexual intercourse they sometimes occur. This symptom indicates the spread of ureaplasma higher up the urinary tract. A common symptom of the disease in women is dyspareunia. These are painful sexual acts.

The following symptoms indicate the development of adnexitis (salpingoophoritis) and endometritis:

• menstrual irregularities;
• abdominal pain;
• discharge from the genital tract.

If treatment is not carried out, reproductive function is impaired. Infertility develops. Frequent miscarriages are possible. In men, ureaplasma often leads to inflammation of the prostate gland. Prostatitis is manifested by pain in the perineum and anus, discomfort during bowel movements, burning sensation, decreased libido and difficulty in erections.

The appearance of pain when touching the testicle may indicate the development of orchitis. Often appendages are involved in the process. Developing. Ureaplasma can disrupt spermatogenesis, leading to male infertility. These microbes negatively affect the course of pregnancy. Miscarriages, premature birth and weight loss of the baby are possible.

Examination for the presence of ureaplasma

Treatment should begin after visiting a doctor (gynecologist or venereologist) and examination. A preliminary diagnosis is made based on a survey and examination of the sick person. Risk factors for infection are determined. The skin and mucous membranes are examined. Women need a gynecological examination.

To confirm the diagnosis you will need:

You need to prepare for a visit to the doctor. To take a smear you need:

• abstain from sexual intercourse 2 days before the study;
• do not urinate for at least 2 hours;
• stop douching;
• wash up clean water the evening before the procedure;
• temporarily abandon vaginal suppositories and gels.

Before treating ureaplasma, you need to examine the scraping. In women, material is taken from the mucous membrane of the urethra, vagina and cervix. Serodiagnosis is very informative. The doctor identifies specific ones in the blood. The genetic apparatus can be determined during a PCR study. During simple microscopy, ureaplasma smears are not visible due to their small size. Cultures are carried out to identify concomitant pathologies.

Treatment tactics

Treatment should begin with restorative therapy. When detecting ureaplasmas, the following are effective:

• physiotherapy;
• antibiotics;
• absorbable drugs;
• vitamins A, B, C and E.

To increase immunity, products such as Immunal, Immunorm, Echinacea, Estifan, Pyrogenal and St. John's wort tincture are used. Many medications cannot be prescribed while pregnant. The doctor should remember this when choosing a medicine. All patients with ureaplasma infection are recommended:

• diversify your diet;
• normalize work and rest schedules;
• drink vitamins.

Application of some folk remedies ineffective for this pathology. Along with medicines, you can use various herbs (violet, lungwort, yarrow). You need to know not only why ureaplasmosis is dangerous and what it is, but also what antibiotics are prescribed for this STI. For this pathology, drugs from the group of fluoroquinolones, macrolides and tetracyclines are effective.

Ureaplasma has become resistant to penicillins. Medicines are prescribed that are able to penetrate into cells. To combat ureaplasma, drugs such as Hemomycin, Ecomed, Azitrox, Levostar, Lefokcin, Roxithromycin DS, Rulid, Xitrocin, Roxithromycin Sandoz, Flexid, Erythromycin-Lect, etc. are used.

With a mixed infection, it is possible to use several medications at once. Antibiotics are taken orally or injected. The duration of therapy is up to 2 weeks. For the treatment of pregnant women, antibiotics are selected carefully. Tetracyclines are contraindicated. When orchitis develops, the patient needs to remain calm. Absorbable drugs and enzymes are often included in the treatment regimen.

Thermal procedures help well. The sexual partners of the sick person are also treated. All patients need to limit the consumption of carbohydrates and fats, give up cigarettes and alcohol, and change underwear and pads more often. A month after the end of therapy, repeat tests are performed. If treatment is ineffective, a repeat course of antibiotics is required. If dysbiosis is detected in a woman, eubiotics (Acilact) are prescribed.

Prognosis and prevention

The prognosis for the presence of ureaplasma in the body is most often favorable. If a person does not see a doctor and is not treated, the following consequences are possible:

• infertility;
• complications during pregnancy;
• involvement of the uterus and other organs of the reproductive system in the process.

Ureaplasma is especially dangerous for the fetus. Miscarriage, early birth, loosening of the uterus, intrauterine growth retardation and hypoxia are possible. There is no specific prevention of the disease. You can protect yourself from ureaplasma by avoiding unprotected sex. The main preventive measures are:

• using a condom;
• refusal of alcohol and drugs;
• compliance with the rules of intimate hygiene;
• refusal of casual sex.

An important aspect is increasing immunity. This is achieved by playing sports, giving up drugs, cigarettes and alcohol, healthy sleep, eliminating stressful situations, treating somatic diseases and a nutritious diet rich in vitamins.

Thus, ureaplasma negatively affects reproductive health and can lead to infertility. If you have dysuria, discharge or abdominal pain, you should consult a doctor and undergo an examination.

Content

The danger of some diseases lies in their asymptomatic course, when the patient learns about the pathology by chance, during any examination. Such diseases include ureaplasma urealiticum. When infected with a urogenital infection, the development of ureaplasmosis is not necessary, since the bacteria that are part of the healthy microflora prevent the proliferation of the pathogenic microorganism. When the beneficial flora dies, ureaplasma begins to multiply, causing an inflammatory process.

What is ureaplasma urealiticum

Ureaplasma urealyticum parvum is a microbe, a type of mycoplasma that stimulates inflammation in the organs of the genitourinary system. As the disease progresses, bacteria can penetrate the joint capsules, affecting the tissues of the joints, causing the development of an inflammatory process in them. The pathogen got its name due to its ability to break down urea, which is the main difference between ureaplasma and mycoplasma, which belongs to the same genus of bacteria. The ability to realize is a trigger for the development of urolithiasis and urate nephrolithiasis.

About 40% of people are carriers of ureaplasma urealiticum, but often do not even suspect it until they get tested. The main reason for the development of the disease is sexual contact with an infected partner. A pathogenic microorganism can live on the mucous membranes of the genitourinary tract for a long time, without clinically manifesting itself and without causing associated pathologies. The reasons for the activation of ureaplasma urealyticum in women and men include:

• pregnancy;
• promiscuity;
• weakened immunity, frequent viral infections;
• previous operations;
• exacerbation of chronic diseases.

Ureaplasma urealiticum can pass in utero from a sick mother to the fetus (girls are more susceptible to infections), affecting the respiratory tract and mucous membranes. An opportunistic microbe can cause asymptomatic carriage and manifest itself pathogenically only under certain conditions. Factors that provoke inflammation of the urogenital tract are:

1. Infection occurs through unprotected sexual intercourse with an infected person. The bacterium thrives on the surface of sperm and on the vaginal epithelium.
2. Microbes penetrate the uterus and genitourinary system in an ascending manner. Vertical transmission of infection occurs when ureaplasma penetrates from the vagina and uterine cervix into the kidneys and ureter.
3. The transmission of infection to the fetus from the mother occurs through the transplacental route. Intrauterine infection occurs through the skin, gastrointestinal tract, eyes, and organs of the urinary system.
4. During labor, mechanical infection of the child occurs.
5. Patients may become infected during organ transplantation.
6. Rarely, infection with ureaplasma occurs through oral or anal contact.
7. Contact-household transmission of infection accounts for less than 1% of cases.

What causes

According to medical standards, in women, ureaplasma urealyticum is considered an opportunistic microbe that exhibits pathogenic properties only under the influence of negative factors. In combination with other pathogenic microorganisms, ureaplasma can lead to the development of a number of pathologies that require complex treatment. As a rule, this bacterium is highly resistant to modern antibiotics and is difficult to treat. In women, the microorganism can cause:

• cervicitis;
• endometritis;
• vaginitis;
• adnexitis;
• vaginosis;
• pelvic diseases;
• cervical erosion;
• cervical insufficiency;
• infertility.

Often ureaplasma infection occurs secretly in women. The clinical picture of the disease is determined by the location of the pathological process. In this case, the symptoms are mild and go away quickly. The infection is activated by nervous tension, weakened immunity, and physical fatigue. An infected woman does not feel any effects of the bacteria on her body. Complications in the fairer sex are extremely rare. In patients with weakened immune systems, the pathologies described above appear that require antibacterial therapy.

The first symptoms of ureaplasma urealyticum in men appear about a month after infection. In this case, the bacterium provokes the development of:

• urethritis;
• epididymitis;
• orchitis;
• prostatitis;
• cystitis;
• narrowing of the urethra;
• meningitis;
• pneumonia;
• infectious arthritis;
• erectile dysfunction.

Symptoms of ureplasmosis

As a rule, the symptoms of infectious pathology in men and women are slightly different. At the same time, representatives of the fairer sex are characterized by a more vivid clinical picture. A common factor is that ureaplasmosis occurs for a long time without any symptoms. Only after the appearance of favorable conditions for the disease do signs of ureaplasma begin to appear.

Among women

More often, the pathology is diagnosed in the fairer sex. At first, ureaplasma urealyticum occurs without pronounced symptoms, and after that the woman may notice the following characteristic signs of infection:

• increased vaginal discharge at different times of the cycle, menstrual irregularities;
• burning after urination;
• cystitis, other urinary tract infections;
• pulling sensations in the lower abdomen, radiating to the perineum.

In men

Since ureaplasma urealyticum in men has an incubation period from 2 weeks to several months, symptoms may be absent for a long time, while the carrier of the infection at this time is a potential source of the bacterium. Sometimes, even after completion of the latent phase, the disease does not give a pronounced clinical picture, so the man is not aware of the presence of a problem. The main symptoms of ureaplasmosis resemble those of other inflammatory diseases of the genitourinary tract in men and can manifest themselves as:

• dysuric phenomena (frequent urination);
• scanty transparent discharge;
• burning and itching during urination and voiding;
• gluing the external opening of the urethra;
• cloudy urine color, unpleasant pungent odor;
• premature ejaculation.

A mild form of ureaplasmosis in men can be asymptomatic and go away on its own, but this does not mean that the disease has gone away completely: often, when immunity is weakened, the infection returns. Unnoticed by the patient, chronic inflammation of the bladder, urethra, testicles, and prostate develops. The danger of ureaplasma for men is that the bacterium can damage germ cells, destroying their development and leading to infertility.

Diagnosis of ureaplasma urealiticum

Examinations involve not only identifying the microorganism, but also its number, since carrier patients do not always suffer from symptoms of the pathology. When the ureaplasma urealyticum indicator is 10 to 4 degrees, the diagnosis is confirmed; a lower amount of bacteria indicates the possibility of infection of a partner or child during childbirth. The main methods for diagnosing infection are:

1. Bacterial culture from the vagina. The analysis allows you to determine the presence of a microbe and its antibiotic sensitivity.
2. Ultrasound of the pelvic organs in women and the prostate gland in men.
3. OAM and UAC. Helps detect inflammatory processes in the body.
4. PCR. The method is considered more informative because it gives the most accurate results.
5. Colposcopy. Helps evaluate changes in the uterine mucosa.

Treatment of ureaplasma urealiticum

If there are characteristic symptoms and the pathogen is isolated in an amount of 104 CFU/ml or more, the doctor prescribes treatment. In this case, patients need antibacterial therapy, which uses broad-spectrum drugs - fluoroquinols, macrolides, tetracyclines (Sumamed,. In addition, treatment of ureaplasma urealyticum includes:

• vitamin therapy;
• physiotherapy (electrophoresis, magnetotherapy, microwave intravenous laser irradiation of blood, ozone therapy, thermotherapy, laser therapy are used);
• taking immunomodulatory drugs;
• taking absorbable enzymes (Lidase, Chymotrypsin);
• treatment with antifungal agents (Fluconazole);
• normalization of microflora with the help of lactobacilli and bifidobacteria (Linex).

During therapy, the patient should abstain from sexual intercourse, drinking alcoholic beverages, sunbathing, visiting a solarium, drinking milk, mineral and carbonated water. The duration of treatment for ureaplasma ulealiticum is 10-14 days, and both partners must undergo therapy. This cannot be neglected, since ureaplasmosis leads to the development of dangerous complications, including prostatitis, pyelonephritis, infertility, etc. Additionally, the listed components of treatment include the following methods:

• hirudotherapy to improve local immunity;
• mud therapy, which helps fight inflammation;
• gynecological massage, reducing the risk of adhesions.

Drug therapy

Ureaplasmosis is treated with medications, and therapeutic tactics are based on mandatory adherence to a gentle diet, taking antibacterial agents, immunoenzyme drugs, vitamins and probiotics. Both partners must be treated at the same time. First of all, the doctor prescribes antibiotics, which are taken for 2 weeks. In 90% of cases, the infection can be destroyed with their help. Medicines with an antibacterial effect include:

1. Azithromycin. Macrolide is resistant to acidic environments, which is taken for the first 5 days at 1000 mg every 2 hours, after which they take a break for two days and resume taking the drug in the same dosage for 5 days. After another break of 5 days, take the last dose of the medicine. The advantage of Azithromycin is its effectiveness against ureaplasma, the disadvantage is the likelihood of developing allergies or other side effects.
2. Doxycycline. The drug from the tetracycline group belongs to semi-synthetic antibiotics that eliminate urogenital infections. The medication is taken once a day, after meals. The advantage of Doxycycline is its rapid action against DNA ureaplasma urealyticum (the maximum concentration of the drug in the blood is observed 2 hours after taking the tablet). The disadvantage of the medicine is that it negatively affects the esophagus, irritating the mucous membranes, so it is recommended to drink the medicine with plenty of water.
3. Ciprofloxacin. A drug from the fluoroquinol group, which is taken on an empty stomach. The big advantage of Ciprofloxacin is its maximum effectiveness against ureaplasma urealicticum. Ureaplasma parvum is no less susceptible to the action of the active substance of the drug. The course of antibiotic therapy lasts from 5 to 15 days.

An obligatory part of the treatment of ureaplasmosis is the use of immunomodulators. Drugs to improve the body's defenses help recover from illness and prevent relapse. As a rule, the doctor prescribes:

1. Viferon/Genferon. Suppositories are used to normalize local immunity. The drug is prescribed in an individual dosage, and the course of treatment lasts at least 5 days, optimally for ureaplasma urealyticum - at least 10. To treat such an infection, 2-3 courses are usually used.
2. Cycloferon. The drug has an intracellular effect on ureaplasma urealiticum due to its molecular biological properties. The medicine is taken at the same time every day to achieve the maximum therapeutic effect. The standard dosage is 250 mg (administered by injection), and the course of treatment is 10 days.
3. Immunal/Immunomax. Especially effective drug to correct weakened immunity. Intramuscular injections for ureaplasma urealiticum are prescribed simultaneously with antibacterial therapy. The drug is taken in a course of 10 days.
4. Pyrogenal. Available in the form of suppositories and solution for injection. May be prescribed to prevent relapse after the main course of treatment for ureaplasma urealyticum. It is prohibited to take Pyrogenal for blood diseases.