Ureaplasma in women: symptoms and treatment. How is it manifested and what is ureplasma infection Urine plasma what

Infectious inflammatory disease of the genitourinary organs caused by the pathological activity of ureaplasmas. In 70-80% of cases, the disease occurs in the form of asymptomatic carriage. It can be manifested by non-specific dysuric symptoms, an increase in the amount of clear vaginal discharge, pulling pains in the lower abdomen and impaired reproductive function. For diagnosis, bacterial culture, PCR, ELISA, PIF are used. Etiotropic treatment involves the appointment of antibacterial drugs - macrolides, tetracyclines and fluoroquinolones.

General information

Ureaplasma was first isolated from a patient with non-gonococcal urethritis in 1954. To date, the pathogen is considered a conditionally pathogenic microorganism that exhibits pathological activity only in the presence of certain factors. Bacteria carriers are 40-50% of sexually active healthy women. The microorganism is detected on the genitals in every third newborn girl and in 5-22% of schoolgirls who do not live sexually. Although, according to the results of various studies, ureaplasmas were the only microorganisms found in some patients with infertility and chronic diseases of the urogenital area, ureaplasmosis is not included as an independent disease in the current International Classification of Diseases.

Causes of ureaplasmosis in women

The causative agent of the disease is ureaplasma - an intracellular bacterium without its own cell membrane, which has a tropism for the cylindrical epithelium of the genitourinary organs. Of the 6 existing types of ureaplasmas, pathogenic activity was detected in two - Ureaplasma urealyticum and Ureaplasma parvum. Infection occurs through unprotected sexual contact or during childbirth. Convincing evidence of the contact-household method of transmission of ureaplasmosis does not exist today.

In most cases, the carriage of ureaplasmas is asymptomatic. The main factors contributing to the development of the inflammatory process are:

• dishormonal states. The causative agent can exhibit pathogenic activity during pregnancy, in violation of the endocrine function of the ovaries.
• Decreased immunity. Inflammation of the urogenital tract occurs more often in women with diseases that reduce immunity, and against the background of taking immunosuppressive drugs (in the treatment of oncopathology) .
• Vaginal dysbacteriosis. Violation of the normal microflora of the vagina with irrational antibiotic therapy and hormonal imbalance activates opportunistic microorganisms, including ureaplasmas.
• Invasive interventions. In some cases, the starting point for the development of ureaplasmosis is abortion, instrumental medical diagnostic procedures (hysteroscopy, urethro- and cystoscopy, surgical methods for treating cervical erosion, etc.).
• Frequent change of sexual partners. The bacterium is activated in association with other STI pathogens that enter the genitals of a woman during unprotected sex with casual partners.

Pathogenesis

The pathogenesis of uroplasmosis in women is based on the adhesive-invasive and enzyme-forming properties of the microorganism. When it enters the mucous membrane of the genitourinary organs, the bacterium attaches to the cell membrane of the cylindrical epithelium, merges with it and penetrates into the cytoplasm, where it reproduces. The microorganism produces a special enzyme that breaks down immunoglobulin A, thus reducing the immune response to infection. With an asymptomatic course, local inflammatory and destructive changes are poorly expressed. An increase in the pathogenic activity of the pathogen under the influence of provoking factors leads to the development of inflammation - a vascular reaction, an increase in tissue permeability, and the destruction of epithelial cells.

Classification

The main criteria for the selection of clinical forms of ureaplasmosis in women are the nature of the course and the severity of pathological manifestations. In particular, specialists in the field of gynecology distinguish between:

• Carriage of ureaplasmas. In most women, during the examination of which this microorganism is detected, there are no signs of inflammatory processes.
• Acute ureaplasmosis. It is observed extremely rarely, accompanied by clinically pronounced signs of damage to the genitourinary organs and general intoxication.
• Chronic ureaplasmosis. Signs of acute inflammation are absent or appear periodically in the presence of provoking factors, reproductive dysfunction and chronic inflammation of the organs of the urogenital tract are possible.

Symptoms of ureaplasmosis in women

In 70-80% of cases, there are no clinical manifestations indicating infection of the body with ureaplasmas. The disease has no specific symptoms and during periods of exacerbations it manifests itself with signs characteristic of inflammatory processes in the genitourinary system. A woman may complain of discomfort, cramps, burning, pain when urinating. The volume of transparent vaginal discharge slightly increases. With the ascending development of infection with damage to the internal reproductive organs, aching or pulling pains in the lower abdomen may disturb. In acute course and during periods of exacerbations, the temperature rises to subfebrile numbers, the patient notes weakness, fatigue, and decreased performance. Chronic ureaplasmosis may be indicated by treatment-resistant urethritis, vaginitis, endocervicitis, adnexitis, inability to become pregnant, spontaneous termination or pathological course of pregnancy.

Complications

With a long course, ureaplasmosis in women is complicated by chronic inflammatory processes in the uterus and appendages, which lead to infertility, miscarriages and premature births. The situation is aggravated by the infection of the partner, who, against the background of the disease, may develop male infertility. In some cases, inflammation, vascular and autoimmune processes in the endometrium cause primary placental and secondary fetoplacental insufficiency with a violation of the normal development of the fetus, the risk of anomalies and an increase in perinatal morbidity. Since pregnancy is a provoking factor for the activation of the microorganism, and the treatment of an infectious disease involves the appointment of drugs that can affect the fetus, it is important to identify the pathogen in a timely manner during reproductive planning.

Diagnostics

The data of vaginal examination, bimanual examination and the clinical picture of the disease are nonspecific and, as a rule, indicate the presence of an inflammatory process. Therefore, a key role in the diagnosis of ureaplasmosis in women is played by special research methods that allow to detect the pathogen:

• Tank. culture for ureaplasma. When sowing biomaterial (discharges, smears) on a nutrient medium, ureaplasma colonies are detected, after which their sensitivity to antibacterial drugs is determined.
• PCR. Using the polymerase chain reaction, the genetic material of the pathogen can be detected in the patient's biomaterial within a day.
• Serological study. In the course of immunofluorescent analysis (ELISA) and direct fluorescence (DIF), antibodies to bacteria are detected in the woman's blood, and their titer is determined.

In differential diagnosis, it is necessary to exclude infection with other pathogens - chlamydia, Trichomonas, gonococci, mycoplasmas, etc. The basis for the diagnosis of ureaplasmosis is the presence of inflammatory processes in the genitourinary organs of a woman in the absence of any other STI pathogens, except for ureaplasmas. Along with the gynecologist, a urologist is involved in counseling the patient.

Treatment of ureaplasmosis in women

The key objectives of therapy for ureaplasma infection are to reduce inflammation, restore immunity and normal vaginal microflora. Patients with clinical signs of ureaplasmosis are recommended:

• Etiotropic antibiotic therapy. When choosing a drug, it is necessary to take into account the sensitivity of the pathogen. Usually prescribed 1-2-week course of tetracyclines, macrolides, fluoroquinolones.
• Sanitation of the vagina. The introduction of suppositories with an antibiotic and an antifungal drug complements the antibacterial treatment.
• Immunotherapy. To restore immunity, immunomodulating and immunostimulating agents, including those of plant origin, are indicated.
• Normalization of vaginal microbiocenosis. The use of probiotics locally and orally allows you to restore the vaginal microflora, which inhibits the pathological activity of ureaplasmas.
• Enzyme preparations. Enzymes have an anti-inflammatory effect and enhance the processes of tissue regeneration.
• vitamin therapy. With a general strengthening purpose in the complex treatment of ureaplasmosis in women, multivitamin and vitamin-mineral complexes are used.

It is important to note that indications for the appointment of etiotropic anti-ureaplasma treatment are limited. As a rule, antibiotics are used when ureaplasmas are detected in patients with treatment-resistant chronic inflammatory processes and reproductive disorders in the absence of other STI pathogens. Also, an antibacterial course is recommended for ureaplasma carriers who are planning a pregnancy.

Forecast and prevention

The prognosis of ureaplasmosis in women is favorable. Etiotropic treatment allows you to completely get rid of the bacteria, however, due to the lack of passive immunity and the high prevalence of the pathogen, re-infection is possible. Since ureaplasma is a conditionally pathogenic microorganism, a rational sleep and rest regimen, seasonal maintenance of immunity, reasonable prescription of invasive methods for diagnosing and treating diseases of the female genital area, and the use of barrier contraception are important for the prevention of inflammation. To prevent pathological activation of the pathogen during a planned pregnancy, women with Ureaplasma carriers are recommended prophylactic antibiotic therapy.

Most people, having undergone an examination in a regular clinic, are perplexed to find out that they have ureaplasmosis. Since the course of the disease is almost asymptomatic, people want to know if ureaplasma is a sexually transmitted disease or not? What can they expect from the disease, and what consequences can it bring to them?

Despite the fact that the disease does not manifest itself in the initial stages, I want to immediately open my eyes to reality: ureaplasmosis is a sexually transmitted disease of an infectious nature. The main way of infection: sexual contact, oral sex and the vertical route, that is, from the mother to the fetus.

The ureaplasma bacterium is a separate type of microorganism that got its name from its ability to break down urea. When infected, the bacteria multiply in women in the mucosa of the urethra and vagina, in men - in the mucosa of the prostate and urethra.

Ureaplasma is a sexually transmitted disease, but the course of this disease largely depends on how strong the body's defenses are. In the event that the immune system is healthy, then the special signs of the disease will not appear, since the infection will subside without demonstrating its biological activity. This form of the disease is inherent in most infected people.

If the body's immune system is significantly lowered and there are damage to the microflora of the genital tract and associated hormonal or sexually transmitted diseases, ureaplasmosis will rapidly begin to develop and manifest itself with obvious symptoms.

In women, the clinical picture is as follows:

• Itching, painful sensations when urinating, as well as urethritis, a feature of which is transparent, slight discharge from the urethra.
• Inflammation of the lining of the vagina, called vaginitis. Sexual relationships are painful.
• In the case of oral contact, there is a sore throat, redness of the mucous membrane of the pharynx, an increase in regional lymph nodes, discomfort during swallowing.

In men, the signs of infection with ureaplasma are as follows:

• Urethritis, characterized by slight clear discharge from the urethra.
• Discomfort when urinating, pain. There is damage to the testicles, epididymis and spermatic cords. Accordingly, intimate functions are violated.

The fact that ureaplasmosis is a sexually transmitted disease suggests that the disease must be treated immediately, since its long-term non-treatment leads to infertility and rheumatic lesions in the body.

Ureaplasmosis is one of the most common diseases of the urogenital area in both women and men.

It is caused by a special type of microorganism called ureaplasma. Given the fact that ureaplasmosis is a relatively "young" disease, since it was discovered only in the 70s of the last century, it causes a lot of conflicting opinions regarding diagnosis and treatment.

The causative agent and causes of ureaplasma

The causative agent of ureaplasmosis is a bacterium belonging to the Micoplasmataceae family.

In everyday life, she is known under the name ureaplasma, although in medical circles two varieties of this microorganism are known that can cause a disease, namely Ureaplasma urealyticum and. Due to its microscopic size, ureaplasma is an intermediate state between a virus and a bacterium.

In the body of a healthy person, ureaplasma can be in a small amount and not cause any pathology. However, with any disturbances in the functioning of human vital systems, a pathogenic increase in the number of this bacterium can occur. This, in turn, provokes disturbances in the functioning of the genitourinary organs, causes various kinds of symptoms, and can lead to a number of complications.

Ureaplasmosis belongs to contagious diseases and can be transmitted from person to person through several ways. The most common route of infection is sexual, during traditional intercourse or oral sex. However, most people with good immunity will be carriers of the disease that they pass on to their partners.

But already in the latter, the presence of the same microorganisms can provoke. Also, ureaplasma is transmitted from mother to child in the prenatal period of the baby's development. Most often, infection occurs during natural childbirth.

Some experts believe that a person can become infected with ureaplasmosis through a household transmission route, namely through the use of personal hygiene products, a shared toilet or bathroom. However, this statement does not have practical and theoretical confirmation, therefore, the vast majority of doctors do not consider this method of infection.

Symptoms of ureaplasma

The clinical picture with ureaplasmosis has common features with such a disease as.

At the same time, there are significant differences between the symptoms in the male and female parts of the population.

In the female part of the population, ureaplasmosis often causes many inflammatory processes, both in the uterus and in the appendages. - the internal tissue of the uterus, can become a significant obstacle to the normal implantation of a fertilized egg. This in turn provokes infertility or miscarriage.

Prevention

Since ureaplasmosis is most often transmitted sexually, the best prevention of this disease is to observe the culture of sexual relations. Doctors recommend to beware of casual or promiscuity.

To avoid re-infection, doctors usually attribute treatment to both partners at once. In this case, the entire period of therapy is recommended to avoid sexual intercourse, even with the use of contraception, up to a complete cure.

After recovery, doctors advise, for the purpose of prevention, to strengthen the immune system, improve your diet with the help of fortified foods.

A bacterial infection called ureaplasmosis began to be diagnosed only after the advent of enzyme immunoassay and polymerase chain reaction technologies.

The microorganism is a unique representative of the microbial environment and occupies a place in the classification between viruses and bacteria. 14 serotypes of the pathogen have been identified, but only the following species cause diseases in humans:

• Ureaplasma parvum - 4 serotypes;
• Ureaplasma urealiticum - 10 serotypes.

The development of molecular biology has made it possible to identify new types of pathogen, but they have not yet been sufficiently studied. The predominant habitat of microorganisms is the urogenital area, but the bacterium is also detected in the lung tissue and in the kidney area.

A disease caused by microorganisms is called ureaplasmosis. It occurs more often in women, and in men it is hidden, as it does not cause acute symptoms. For the appearance of pathological changes, the presence of an infectious agent is not enough. In order for inflammation of the urinary tract to occur, the presence of provoking factors is also necessary:

• Diseases of the genitourinary system;
• Decreased immunity;
• Chlamydia, bacterial vaginosis, gonorrhea;
• Prostatitis.

With late detection of the microorganism, carriage is formed. In such a situation, it is difficult to cure the pathology, since the infection becomes resistant to most drugs.

Ureaplasmosis of the cervix can cause infertility in women. It can be detected only with specific diagnostic tests (ELISA, RIF, PCR), but studies are expensive and inaccessible to perform in peripheral district hospitals.

Consider the types of pathogens. Common variants that cause disease in humans are Ureaplasma urealyticum and parvum. In women, only one pathogen is detected. However, there are cases when both types of pathogen are found in the representative of the fair half. In such a situation, a conclusion is established about the presence of Ureaplasma spp, which means the presence of two types of ureaplasma at once (parvum and urealiticum).

How is ureaplasmosis transmitted?

We must not forget that this is a sexual infection. It is obvious that the route of penetration of Ureaplasma into the genitourinary system and uterus is ascending. During unprotected intercourse, microbes enter the ureter, and from there they are able to penetrate the kidneys. Transmission of infection with blood from mother to fetus is possible.

1. Inflammation of the urethra;
2. Itching and burning of the urethra;
3. Changes in the tissue of the epididymis (epididymitis);
4. Prostatitis.

The danger of ureaplasma infection in men is the violation of spermatogenesis and the formation of kidney stones.

Transmission of ureaplasmosis

There are 2 ways:

1. Sexual;
2. Non-sexual.

The infection passes in a vertical way in 85-90% of cases. 5% is due to the spread of the pathogen with the blood from the mother to the fetus. A smaller percentage of infection is typical for anal and oral contacts. For the household method - less than 1%, but it exists and there are proven facts.

Young people ask: “is ureaplasmosis transmitted through a kiss”, since there is no reliable information on the topic in the global network. We answered this question above - there is a contact path.

Ureaplasma is attached to the mucous membrane at the site of penetration. If it is fixed in the oral cavity, it provokes a sore throat.

Answering whether ureaplasma is transmitted through saliva, it must be said that such a probability exists when the oral cavity comes into contact with the genitals of a person who is infected or is a carrier of the bacterium.

non-sexual transmission

We highlight the following aspects:

1. Infection of the newborn from the mother;
2. Household way.

The latter option is considered unproven, but there are clinical facts that against the background of nervous stress and anxiety, the risk of ureaplasmosis increases.

Blood diseases are among the most serious disorders, since blood is involved in the work of all organs and tissues, providing a connection between different body systems. Every component of the blood is vital. Their correct structure, precise functioning and the necessary proportion are the three elements of healthy blood. Disturbance of any part of this balance is a hematological disease. In addition to the actual blood cells, the cause of the disease can also be plasma (the liquid "base" of blood). Some blood particles do not have certain quantitative norms, since their appearance and concentration depend on the conditions in which the body enters. These are, for example, antibodies, antitoxins, immunoglobulins.

Consider blood diseases (causing changes in the structure and ratio of blood cells), for which there are normative indicators.

Anemia- a decrease in the amount of hemoglobin or its transporting particles - erythrocytes. The consequence of this disease is a weakening of the oxygen supply to tissues and organs. Anemia can be caused by a violation of the shape of red blood cells, a decrease in their production, accelerated destruction or a lack of iron and a number of vitamins in the body. Some diseases of this group are genetic in nature, others are acquired during life. Signs of reduced hemoglobin: pallor, drowsiness, shortness of breath, fatigue, headaches and heart rhythm disturbances.

Polycythemia- production of an excessive number of red blood cells. The consequence of this is a synchronous increase in the content of other blood cells, which carries the danger of blood clots, since the blood thickens greatly.

Thalassemia- accelerated death of erythrocytes associated with a failure in the synthesis of hemoglobin. This is a hereditary disease that involves only symptomatic medical care.

Lymphoma A disease in which malignant white blood cells attack the lymphatic system. Reproducing uncontrollably, they crowd out healthy white blood cells. At the same time, the altered blood cells themselves are no longer able to perform the necessary functions.

Leukemia. Bone marrow cancer caused by a mutation in stem cells. As a result, the production of healthy leukocytes is disrupted, which are gradually replaced by cancerous ones. There are acute course (leukemia) and chronic (leukemia).

Leukopenia. This is a symptom characterized by a decrease in the content of leukocytes in the blood. Leukopenia can be temporary and be a reaction to some internal and external factors (infections, received radiation, vitamin deficiency). Rarely occurs as an independent disease.

Leukocytosis- Too much leukocytes in the blood. Distinguish between physiological and pathological increase in the number of white blood cells. The first is possible under certain conditions, loads, infections.

Pathological leukocytosis manifests itself in severe diseases (oncological, inflammatory, autoimmune). With leukocytosis, weakness, subcutaneous hemorrhages, pain in the limbs, weight loss, and visual impairment are observed.

Most diseases associated with a violation of the number of leukocytes are oncological. The treatment is carried out by bone marrow transplantation, chemotherapy and radiation therapy.

3. Platelets

Thrombocytopenia occurs as a result of diseases of the bone marrow or due to too intense destruction of platelets in the spleen. A lack of platelets causes bleeding of mucous membranes, nosebleeds, subcutaneous hemorrhages, internal bleeding (which is very dangerous). Some diseases associated with a decrease in the number of platelets are of a hereditary origin.

thrombocytosis- an excessive number of platelets in the blood. There are primary thrombocytosis (excessive production of platelets by the bone marrow) and secondary (reactive increase in platelets due to infections, injuries, somatic and infectious diseases).

4. Blood plasma

Blood plasma diseases are no less serious than a shortage or excess of blood cells. Some of them develop so rapidly that the patient can be difficult to save. Blood plasma is disturbed in the following diseases:

Sepsis- infection of the blood itself, designed to fight infections in organs and tissues. Sepsis is very dangerous, because the infection covers the entire body with blood flow at once.

Hemophilia- a hereditary disease that affects only men. The absence of certain proteins in the blood plasma makes the blood almost incapable of clotting. With hemophilia, the slightest bleeding turns into a large blood loss, which is difficult to stop.

von Willebrand disease- a protein necessary for blood clotting is produced and present in the plasma, but it does not perform its functions. This disease is also dangerous bleeding.

Multiple myeloma. A malignant change in blood plasma cells, as a result of which various organs are affected and important functions are impaired.