Ureaplasma in a smear in women, treatment. Ureaplasma in women - symptoms and treatment, causes, drugs, prevention

Infectious diseases of the genitourinary system are quite common among women. The cause of the development of such pathologies are pathogenic microorganisms, which, after entering the body, provoke the development of inflammatory processes in the pelvic organs.

One of the few, but at the same time quite common diseases, is ureaplasmosis, which is most often transmitted sexually, is difficult to diagnose, and requires long-term treatment. A peculiarity of this disease is the fact that ureaplasma in women has mild symptoms, and treatment does not always completely get rid of this disease. What is ureaplasma, what are the symptoms of ureaplasmosis in women, how to identify it, whether it is necessary to fight this disease and what treatment will save a woman from this disease? Let's try to figure it out!

What is ureaplasma?

Ureaplasmosis – infectious disease affecting the genitourinary tract. The causative agent of this disease is the bacterium ureaplasma, which is classified as an opportunistic microorganism present in normal microflora vagina in women and urethra in men. It is known that about 70% of women are carriers of ureaplasma, but not in all cases this bacterium becomes aggressive and provokes the development of ureaplasmosis. In most cases, the presence of ureaplasma in the body does not cause any symptoms, which in turn does not require therapeutic therapy. In cases where, under certain conditions, the amount of ureaplasma increases and exceeds the norm, then treatment is mandatory, since an inflammatory process develops, characterized by severe symptoms.

The ureaplasma bacterium has a unique ability - it penetrates inside the cell, where it continues to reproduce. This action does not allow the immune system to independently fight the microorganism, and taking antibacterial drugs does not always give a positive result.

Ureaplasma symptoms in women may be absent for many years, and the trigger for the proliferation of bacteria is often a decrease in immunity or development concomitant diseases in the body. The ureaplasma bacterium can exhibit pathological activity at any time, especially against the background of other diseases or conditions: abortion, childbirth, insertion or removal intrauterine device, as well as manifestations of inflammatory diseases of the genitourinary system. As a separate disease, ureaplasmosis in women is quite rare. Most often it is diagnosed accidentally or together with other diseases of the genitourinary system: mycoplasmosis, chlamydia.

Routes of transmission of ureaplasma

The ureaplasma bacterium does not have cell walls or DNA. After penetration into the body, it affects the epithelial cells of the genitourinary organs, less often the intestines or respiratory tract. The main route of infection with the bacterium is sexual contact with a carrier of the disease. When ureaplasma enters, it enters the epithelial cells of the genitourinary organs, where it actively multiplies, causing a number of symptoms or triggering the development of other diseases.

IN in rare cases, ureaplasma is transmitted in utero, from mother to fetus. In addition, infection can also occur through household means, through hygiene items, or through close contact with a carrier of the infection.

Reasons for the development of ureaplasmosis

After ureaplasma penetrates the human body, it long time may not cause any discomfort. Activation of the bacterium occurs only against the background of physiological or pathological factors that provoke its reproduction with the subsequent development of the inflammatory process. The main causes and predisposing factors to the development of ureaplasmosis in women are:

• Reduced immunity;
• Chronic diseases;
• Stress, nervous tension.
• Hypothermia of the body.
• Postoperative period;
• Early onset of sexual life.
• Pregnancy.
• Sexually transmitted diseases are caused by gonococci, trichomonas, chlamydia.
• Intestinal dysbiosis.
• Lack of personal hygiene.
• Long-term use of certain medications.
• Promiscuous sexual intercourse.
• Unbalanced and low-quality nutrition.
• Bad habits.

In addition to the above reasons that can cause ureaplasmosis in women, there are others that can become a trigger for the activation of the bacterium.

Ureaplasmosis clinic

There are no symptoms of ureaplasmosis in 60% of women. In such cases, the bacterium is diagnosed by chance during a routine examination by a gynecologist. If nothing bothers a woman, then you need to wait with treatment and under no circumstances self-medicate or use folk remedies, which are not at all effective in combating this disease. In the case when ureaplasma in a woman’s body exceeds the permissible norm, treatment is mandatory, since the disease can become chronic.

The first signs of ureaplasmosis may appear 20–30 days after infection. At the beginning, the symptoms are not specific and often resemble other diseases of the genitourinary system. Ureaplasmosis symptoms in women are accompanied by:

• sensation of cutting and pain during urination;
• burning during urination;
• Vaginal discharge is clear in color and without a distinct odor.
• cutting pain in the lower abdomen;
• discomfort during sexual intercourse;
• slight increase in body temperature.

If ureaplasma has entered the body orally, then in addition to the above symptoms, a sore throat may appear, and plaque on the tonsils may appear, which reminds many of a common sore throat. Ureaplasma in men - there are practically no symptoms and is most often diagnosed accidentally during scheduled or unscheduled examinations.

The clinical picture of ureaplasmosis is quite similar to other diseases of the genitourinary system, therefore, without examination results, the pathogenic bacterium cannot be identified.

Possible complications of ureaplasmosis

Despite the fact that ureaplasma is an opportunistic bacterium and can be present in the body for a long time without causing any discomfort, it can cause the development of complex diseases. Ureaplasma can cause a number of diseases and disorders in the whole body:

• colpitis;
• endometritis;
• cervicitis;
• cystitis;
• pyelonephritis;
• urolithiasis;
• arthritis.

Ureaplasmosis, which is not diagnosed in a timely manner, leads to the development of a chronic form of the disease. Chronic ureaplasmosis over time causes the formation of adhesions in the uterus and its appendages, which directly leads to the development of infertility.

How to diagnose the disease

To diagnose a ureaplasma infection, it is not enough for a doctor to examine the patient and collect an anamnesis, so examinations cannot be done without. The main methods for detecting ureaplasmosis are:

• PCR analysis.
• Immunofluorescence.
• Enzyme immunoassay.
• Microbiological analysis.
• Serological examination.

The results of the examination will allow the doctor to identify the pathogenic pathogen, create a complete picture of the disease, and select an effective treatment regimen. During examinations, the doctor often identifies other pathogenic pathogens that have become the reason for the activation of ureaplasma infection. If the amount of ureaplasma is no more than 10 per 1 ml of biological material, then treatment is not prescribed. In cases where the norm is exceeded, treatment must be carried out immediately.

It is important to note that the woman’s sexual partner must also be tested for ureaplasmosis, otherwise even proper treatment will not be able to protect the woman from re-infection.

Treatment of ureaplasma

The treatment plan for ureaplasmosis is prescribed individually for each woman and directly depends on the severity of the disease, concomitant diseases and other characteristics of the female body. The main treatment for ureaplasma infection is broad-spectrum antibiotic therapy. Most often, the doctor prescribes the following drugs:

• Macrolides.
• Lincosamides.
• Tetracyclines.

These antibiotics have the ability to penetrate the cellular structure, where they effectively cope with pathogenic bacteria. To treat ureaplasma, you should not take antibiotics from the penicillin or cephalosporin groups, since this pathogen is not at all sensitive to these drugs, and treatment with them will further worsen the situation. The course of antibiotic treatment is prescribed by a doctor, but usually lasts up to 14 days.

In addition to antibacterial therapy, women are also prescribed other medications:

• Immunomodulators: “Lysozyme”, “Timalin”.
• Vitamin complexes.
• Bifido and lactobacilli.
• Rectal suppositories with anti-inflammatory effect.

In addition to conservative therapy, a woman is advised to monitor her diet. Avoid fatty, smoked and salty foods. During the treatment period, sexual intercourse is prohibited; you need to monitor your body hygiene and lifestyle. If ureaplasma is diagnosed in a sexual partner, then the man also needs treatment under the supervision of a doctor. Lack of treatment for ureaplasmosis in representatives of the stronger sex can also cause the development of infertility or other complications.

After completing the course of treatment, you must be tested again for ureaplasma. If the treatment is successful, then the number of microorganisms will decrease to normal or completely disappear from the body. If ureaplasma remains in the woman’s body in the same amount or its amount has increased, the doctor prescribes a second course of treatment.

The prognosis after treatment of ureaplasma in women is not always favorable, since in many cases, despite proper treatment, it is impossible to completely remove ureaplasma from the body. In such cases, a woman needs to undergo periodic examinations, monitor her lifestyle, and refuse bad habits, regularly visit a urologist, venereologist, infectious disease specialist or gynecologist. Each of these specialists can treat ureaplasma.

• • Pain in a woman's lower abdomen

• • Discharge from the urethra

Ureaplasmosis, or mycoplasmosis, is a disease that is transmitted exclusively through sexual contact. The specific pathogen is a group of bacteria collectively called Mycoplasmataceae.

In this case, it means genital ureaplasmosis.

Currently, the Mycoplasmataceae family is divided into the genus Mycoplasma (about 100 species) and the genus Ureaplasma (3 species). A person can only be a carrier of certain species. The following bacteria have pathogenic properties: M. genitalium, M. fermentans, M. hominis, M. pneumonie, Ureaplasma urealyticum.

Prevention of ureaplasmosis consists of undergoing periodic medical examinations, protected sexual intercourse and avoiding casual sexual intercourse and promiscuous sexual behavior.

Ureaplasmosis is the second, not entirely correct name for the disease, but more popular, which appeared due to the fact that a number of representatives of this family of bacteria use urea as an energy substrate for their vital activity, breaking it down (urolysis).

The causative agent of ureaplasmosis is a tiny bacterium that occupies an intermediate position between single-celled organisms and viruses. The similarity with viruses is achieved due to the absence of a complete cell membrane (there is only a three-layer cell wall), small size and a small amount of genetic material. It is similar to unicellular organisms by the presence of a nucleus and some cellular organelles.

A feature of ureaplasmas is their ability to penetrate a cell and multiply there. Thanks to this, bacteria are practically unreachable by the immune system and most modern antibacterial drugs.
On the other hand, many researchers do not classify ureaplasma as an obligatory pathogenic bacteria. Representatives of this species can remain in the human urinary tract for many years without causing any symptoms. Experts agree that the ability of ureaplasma to cause disease largely depends on the state of the immune system and the presence of concomitant diseases in a particular person.

Ureaplasmosis: routes of transmission and methods of infection

The route of transmission of the disease is predominantly sexual. Ureaplasma in women is found in the vaginal secretion, cervical canal, urethra; in men - in the secretion of the prostate, seminal vesicles, actually in sperm and cells of the urinary tract. Transmission occurs through unprotected sexual intercourse, including non-traditional types of sex.

Ureaplasmosis has other methods of infection: through the birth canal during the birth of a child or infection of the fetus during pregnancy through the placenta. In such cases, ureaplasma is found in the child’s oral cavity, nasopharynx, and conjunctiva.

Ureaplasmosis: symptoms and treatment

If infection has occurred, the first signs of the disease may appear either after 4-5 days or after 30-35. On average, ureaplasmosis has incubation period about 20-24 days. All this time, bacteria actively multiply and are released, the person becomes a carrier of the disease.

The first symptoms are signs of inflammation of the urethral mucosa:

• unexpressed painful urination, increasing at the beginning or at the end;
• burning, scanty discharge from the urethra of a mucous-transparent color, which in most cases is odorless.

Ureaplasmosis as a genitourinary infection begins with a sore throat if the infection occurs during oral sex. In 50% of cases, the signs of the disease are erased and remain unnoticed by the person. If no treatment is carried out within a month, the process becomes chronic and the symptoms may go away. In such cases, women may be prompted to undergo examination only by unsuccessful treatment of thrush or nonspecific colpitis, aggravated by ureaplasmosis.

The progression of the disease caused by ureaplasma occurs in conditions when a person’s immunity weakens: after colds, taking antibiotics, hypothermia, stress.

At this time, ureaplasma begins to penetrate the prostate gland (sluggish prostatitis occurs), seminal vesicles and testicles (causes orchitis) in men. The danger is that, in addition to inflammation of the listed organs, ureaplasma can directly damage germ cells and disrupt their maturation processes.

In women, the bacterium penetrates the vaginal wall (with the development of colpitis), the cervix (cervicitis) and the inner lining of the uterus (endometritis), less often - into the wall bladder(with the development of acute and chronic cystitis) with subsequent ascending kidney damage (pyelonephritis), often causing severe pain lower abdomen. That is why the most dangerous consequence of the disease is secondary infertility in women and men. Quite often, the inability to get pregnant is the only reason for testing for ureaplasma.

Diagnosis of ureaplasmosis is not very difficult. However, the interpretation of the results obtained requires the doctor not only to detect ureaplasma, but also to have a clinical picture and complaints from the patient.
Currently, the most accurate detection method is the cultural method (application of biological material - scrapings, urine, secretions). prostate gland, sperm, sputum, synovial fluid on nutrient media). In this case, it is possible not only to accurately determine the fact of infection, but also to determine the number of bacteria in 1 ml of material. The method is expensive and time consuming.

The most common method is PCR diagnostics. Thanks to this method, the presence of bacterial genetic material in the biological materials under study is determined.

It should be noted that if ureaplasma is detected in the analysis, it is too early to sound the alarm. Detection of U.urealyticum can be considered a sign of disease, while the presence of U. Parvum requires determination of their quantity (more than 10 4 per ml) and a thorough medical examination.

Treatment of ureaplasmosis is necessary in 2 cases:

1. The detected number of pathogens does not correspond to the norm.
2. Planning pregnancy in the presence of ureaplasma.

During treatment, you should abstain from sexual activity or be sure to use a condom. It is necessary to follow a diet (exclude spicy, salty, fried, spices, alcohol).

Control tests are carried out a week later and the first and second month after treatment (in women before their next period). If all tests are negative, the goal of treatment has been achieved. If the answer is positive in at least one analysis, repeated courses of therapy are necessary.

Symptoms of ureaplasmosis

The course of ureaplasmosis is most often asymptomatic or has minor clinical picture, which gets almost no attention. In these cases, the disease manifests itself late, in chronic form, signs of ureaplasmosis periodically appear and fade depending on the body’s defenses. However, with the development of a mixed infection (a combination of chlamydia, gardnerella, gonococcus, etc. with ureaplasma), the symptoms of the disease become pronounced and the course becomes violent.

The first and only sign of the development of ureaplasmosis in men can most often be a burning sensation and pain in the urethra during urination. Sometimes you may be alerted by a sharp inflammation of the urethral sponges, which become bright red - but these signs are not permanent. However, unlike gonococcus damage, the picture of urethritis (inflammation of the urethra) is blurred and not expressed. There may be a slight urination disorder (feeling of incomplete emptying of the bladder, false urge to go to the toilet). These symptoms quickly pass, and ureaplasmosis becomes chronic. With further progression of the disease, which can occur within six months, when the prostate, seminal vesicles and testicles are involved in the inflammatory process, symptoms of prostatitis, orchitis and inflammation of the epididymis come to the fore. In such cases, ureaplasmosis manifests itself in a man as periodically occurring, “flying” pain in the testicles, groin or nagging pain in the lower abdomen, constant need to visit the toilet at night. Problems appear in the sexual sphere: rapid ejaculation, dilution of sperm, etc. may cause men to turn to appropriate specialists. But, with a detailed examination, gross structural manifestations of diseases are not detected, and the problems are attributed to the psyche. If the testicles are damaged, long and unsuccessful attempts to have a child may come to the fore. Ureaplasma has the ability to directly damage germ cells and disrupt sperm motility.

In women, in addition to the development of urethritis, the possible development of mild inflammation of the vagina with characteristic itching. Discharge from ureaplasmosis is scanty in quantity and does not have a specific odor, is transparent or has the color of whey. Most often, the infection rises higher, affecting the uterus and fallopian tubes, ovaries, causing chronic asymptomatic inflammation with frequent exacerbations, pain at the end and middle of menstruation. Ureaplasma also has a damaging effect on female germ cells, disrupting the processes of their maturation, passage through the fallopian tubes and preventing fertilization.

To summarize, it should be noted that ureaplasmosis does not have any specific symptoms that can immediately and directly identify the disease. In most cases, the disease is latent, long-term, and asymptomatic.

Read also about “Urogenital ureaplasmosis”.

Complications of ureaplasmosis

Common complications (typical for both men and women) include:

1. secondary infertility (develops as a result of prolonged inflammation and disruption of the patency of the ducts both in the testicles, epididymis, vas deferens in men, and in fallopian tubes, cervix in women). Obstruction can be diagnosed as a complication after ureaplasmosis that has been adequately treated.
2. chronic urethritis (inflammation of the urethra), cystitis (inflammation of the bladder);
3. ascending pyelonephritis (infection rises along the urinary tract, affecting the kidneys);
4. disorders in the sexual sphere (in men – premature ejaculation (ejaculation), erectile dysfunction; in women – vaginosis (a painful condition in which sexual intercourse is accompanied by pain), menstrual irregularities;

Separately, there are such consequences of ureaplasmosis as damage to the testicles (orchitis) and the epididymis (epididymitis) in men. In women, the development of chronic adnexitis (inflammation of the epididymis) and ooritis (inflammation of the ovaries itself).

Read also about urogenital ureaplasmosis and discharge from the urethra and traditional methods treatment of male diseases, including urethritis.

Ureaplasmosis in pregnant women

According to modern ideas, this topic is very relevant. The identification of ureaplasma as an independent species occurred in 1954, when its connection with miscarriage and severe lung pathology in newborns was established. However modern research cannot confirm this fact with complete certainty.

Currently, ureaplasma is a conditionally pathogenic bacterium, which is widespread and only under certain conditions realizes its pathogenic properties. It has been established that the frequency of pregnancy complications due to ureaplasmosis occurs with impaired immunity and/or massive colonization of the urogenital tract with ureaplasma (bacteria content<10 4 /мл биологического материала). Таким образом, чтобы избежать осложнений требуется постоянное наблюдение у врача. И строго соблюдать его рекомендации.

When planning a child, screening for ureaplasmosis is necessary for timely treatment. Both future parents are examined. During pregnancy, examination is indicated in the following cases:

1. the presence of signs of an inflammatory process in the urogenital tract in the absence of other pathogens;
2. history of miscarriage, infertility, etc.;
3. complicated real pregnancy, suggesting infection of the fetus.

Ureaplasmosis in pregnant women is subsequently detected in approximately 30% of cases of negative test results.

To detect the disease, laboratory diagnostics take the leading place, since signs of ureaplasma inflammation are most often not expressed. The only symptom (with a normal pregnancy) is slight discharge without a specific odor. If a delay in fetal development is detected, a violation of its nutrition or the presence of signs of circulatory insufficiency of the placenta in the absence of other reasons is also a sign of the disease.

Treatment of ureaplasmosis in pregnant women has strict indications that are similar to those during examination (clinical picture of inflammation of the genitourinary organs in the absence of other pathogens, miscarriage in the past, complicated course of the current pregnancy, etc.). To this we only need to add the planning of surgical intervention or invasive research in the area of ​​the urogenital tract, as well as the presence of high titers of the pathogen in the tests.

Treatment of ureaplasmosis during pregnancy usually begins in the second trimester of pregnancy. The drug of choice is the macrolide, josamycin, which is regulated in various recommendations and treatment protocols.

Only a doctor should treat you; you should not self-medicate!

At the same time, immunostimulants, adaptogens, and vitamin complexes are actively prescribed. With complex treatment, the probability of curing the disease with one course of therapy is up to 97%. In other cases, repeated therapy is necessary.

The goals of therapy are the complete removal of ureaplasma from the pregnant woman’s body, but also, otherwise, a reduction in their number to normal values ​​against the background of relief of inflammation and the bacterial landscape of the vagina.

Prevention does not have any special recommendations. The basic provisions are similar to those for other sexually transmitted infections.

Ureaplasmosis during pregnancy is not a death sentence and, with timely diagnosis and treatment, has a favorable prognosis.

Read also the article about ureaplasmosis in men.

Diagnosis of ureaplasmosis

There are 4 main methods for diagnosing ureaplasmosis:

1. bacteriological, which consists of applying biological material, which may contain ureaplasma, onto nutrient media for bacterial growth. Vaginal secretions and scrapings from the urethra or cervix are used. This method is unique in that it provides a 100% guarantee of establishing the fact of infection by the pathogen, allows you to determine the sensitivity of ureaplasma to antibiotics, determine the titer (quantity) of bacteria in 1 ml of material (with a titer of about 10 4, a person is a carrier, and most often does not require treatment; when titer more than 10 4 – drug therapy is necessary). The method is expensive and requires quite a lot of time (about 7-10 days);
2. polymerase chain reaction (PCR). Diagnosis of ureaplasmosis using this method is the most common method for diagnosing ureaplasmosis. Using PCR, the presence of genetic material in biological material is determined, upon detection of which it is 100% possible to confirm the presence of ureaplasma in the body. The method is fast, accessible and relatively cheap. The disadvantages include the impossibility of determining the titer of the pathogen and its sensitivity to antibiotics;
3. a serological method that determines the presence of specific immune proteins (antibodies) to ureaplasma. The method is quick, but it has only approximate value, since antibodies in a person’s blood can be detected both during an acute illness and after recovery;
4. the DIF (direct immunofluorescence) method and ELISA (immunofluorescence analysis) also determine the presence of antibodies to ureaplasma and are of approximate value. Diagnosis of ureaplasmosis by this method is accessible and relatively cheap. The accuracy is only 50-75%.

Typically, material for analysis is taken in the morning before urination (with retained urine), and in women - before menstruation. After treatment, control tests are carried out after 7 days, 1 and 2 months (in women, also before the next menstruation).

Treatment of ureaplasmosis

Effective treatment of ureaplasmosis, both in men and women, is carried out individually and requires constant monitoring. Depending on the nature of the disease, treatment tactics are different. Acute ureaplasmosis, treatment of which is achieved by prescribing one antibacterial drug, is the easiest to choose treatment tactics. Subacute forms can be cured with a combination of medications and local therapy. Chronic ureaplasmosis requires complex treatment with the prescription of drugs from various groups.

The goal of treatment for ureaplasmosis is to completely remove the causative agent of the disease from the body, and if this is not possible, to reduce the frequency and severity of exacerbations of the chronic inflammation caused by it.

Basic rules:

1. Ureaplasmosis should be treated exclusively by a doctor;
2. both sexual partners are treated;
3. during treatment you should abstain from sexual activity (protected sexual intercourse or protected oral sex is allowed);
4. During treatment, it is recommended to follow a diet (no smoking, alcohol, spicy, salty, spicy foods, exotic dishes);
5. The treatment regimen for ureaplasmosis requires strict adherence.

There are 3 main approaches to the treatment of ureaplasmosis. Firstly, this is the prescription of adequate antibacterial therapy. This is achieved by the fact that antibiotics for ureaplasmosis are used only after determining the sensitivity of ureaplasma to antibacterial drugs and prescribing them in the maximum therapeutic dosage. There is no single drug for ureaplasmosis.

Antibacterial therapy

Currently, 3 main groups of drugs are used:

1. Fluoroquinolones. Among them are Ciprofloxacin (Tsiprobay), Moxifloxacin (Avelox);
2. Macrolides. The most famous is Azithromycin (Sumamed). However, recently its effectiveness has been decreasing (ureaplasma develops resistance to it). "Josamycin" ("Vilprafen") is a modern drug that is effective in the treatment of ureaplasmosis. Modern therapy for ureaplasmosis also uses Clarithromycin (Klacid), which has minimal side effects;
3. Tetracyclines. The most effective in treating the disease is Doxycycline (Unidox Solutab). Due to its widespread and uncontrolled use, this drug is falling out of practice.

The drugs are prescribed both in tablets and in the form of various powders, emulsions, and suppositories.

Along with antibiotics of one of the groups, drugs of the metronidazole series (Metronidazole) are prescribed, and, if necessary, antifungal drugs (Diflucan, etc.).

Immunotherapy

Secondly, ureaplasmosis develops with reduced general and local immunity. This requires parallel administration of immunostimulants. Most often, preference is given to drugs of the interferon group (Cycloferon, Neovir).

Regenerative therapy

Thirdly, optimization of treatment is achieved by prescribing adaptogens (Estifan, etc.), antioxidants (Antioxicaps, etc.), drugs that restore mucous membranes (Methyluracil, etc.), biostimulants (aloe extract, Plazmol etc.), enzymatic preparations (Wobenzym, etc.).

Ureaplasmosis and treatment with folk remedies is a topic that is actively debated. But modern medicine is skeptical about this.

Read also about “Urogenital ureaplasmosis” and traditional methods of treating male diseases, including urethritis.

Causes of ureaplasmosis

Ureaplasmosis is a disease that is transmitted exclusively sexually and the specific pathogen of which is a large group of bacteria from the genus Ureaplasma of the Mycoplasmataceae family.

It should be noted that ureaplasma is normally found in the human genital tract and urinary tract. This bacterium is a conditionally pathogenic microorganism, which only under certain conditions can cause the development of disease. Ureaplasmosis has 2 main causes:

1. the number of ureaplasmas exceeds normal values ​​(the content of bacteria in 1 ml of biological fluid (sperm, prostate or vaginal secretions, urine, etc.) exceeds 10 4);
2. the body has a low level of immunity. Relative immunodeficiency develops after cold viral diseases, operations, stress, physical overtraining, etc. Absolute immunodeficiency - as a result of cancer, complete damage to the bone marrow during acute radiation sickness, etc.

Ureaplasmosis and other causes of its development are being closely studied. It has been established that in approximately 50% of cases of gonorrhea, 38-43% of chlamydia diseases and 35-41% of cases of trichomoniasis, increased levels of ureaplasma are found in biological fluids. Thus, ureaplasmosis can occur in the presence of a concomitant urogenital infection (so-called mixed infections), and in some cases creates conditions for its occurrence.

Ureaplasmosis is widespread among the population. About 50% of the entire sexually active male population is a carrier of ureaplasma. In about 36% of women, when examining vaginal secretions, increased titers of ureaplasma are determined. To determine among the population groups at increased risk of ureaplasmosis, risk factors are identified, which are presented below:

1. early age of onset of sexual activity (before 18 years);
2. promiscuity, promiscuous sexual behavior and representatives of the sex industry;
3. past diseases of the reproductive system, diseases that are sexually transmitted;
4. age 14-19 and 23-29 years;
5. ignoring the use of means of protection against sexually transmitted infections.

Ureaplasmosis in women

The prevalence of ureaplasmosis among the female population who are of sexually active age is about 36%. It should be noted that the detection of ureaplasma is not yet a painful condition. Currently, the concentration (titer) of the pathogen up to 10 4 units per 1 ml of biological material (vaginal secretions, urine, scrapings from the urethra, etc.) is considered acceptable and does not require treatment. At the same time, a diagnosis of “ureaplasmosis” is made in a woman if signs of the development of the disease are determined, the presence of other urogenital infections (chlamydia, gonorrhea, trichomoniasis, etc.) or an increase in titer of more than 10 4 - and requires the most active treatment.

Signs of ureaplasmosis in women

The disease does not have any clear specific symptoms, and the symptoms are similar to those of other sexually transmitted infections (STIs). Ureaplasmosis occurs gradually and quickly becomes chronic. This condition can last for years without manifesting itself.

Among the signs, one can note only periodic moderate itching and burning in the genital area, somewhat painful sexual intercourse. At the onset of the disease, ureaplasmosis can be characterized by scanty whey-colored discharge without a distinct odor. However, if another infection occurs (development of mixed infections), the color and smell of the discharge may change.

In the absence of clear signs of the disease, its complications come to the fore (see “Consequences of ureaplasmosis”). The picture of the disease is disguised as the clinical picture of another pathology. Signs of chronic inflammation of the pelvic organs, kidney damage (pain in the lower abdomen, back, when urinating, menstrual irregularities, etc.) become the reason for visiting a doctor. Often, a patient comes in for long-term, worsening concomitant diseases of the urogenital tract, the cause of which cannot be determined. These include nonspecific colpitis, cervicitis, inflammation of the uterine appendages, etc. Often, a woman suffers from the inability to conceive a child or repeated miscarriages.

Thus, laboratory diagnostic methods are of decisive importance in diagnosing the disease (in more detail - “Diagnostics of ureaplasmosis”).

Treatment of ureaplasmosis in women

Treatment goals:

1. reducing the frequency of exacerbations and severity of inflammatory processes in the affected organs, ideally - complete removal of the pathogen from the woman’s body.

Only a doctor should treat ureaplasmosis.

Complex therapy is carried out with the simultaneous use of non-medicinal agents (garlic extracts, echinacea; interferon, etc.) and medications.

The treatment regimen for ureaplasmosis in women using antibacterial drugs is as follows:

1. the duration of treatment is from 7 to 14 days;
2. Antibacterial drugs are prescribed taking into account the sensitivity of ureaplasma:
   • macrolides (eg: josamycin)
   • tetracyclines (eg: doxycycline)
   • fluoroquinolones (eg: ofloxacin)

At the same time, antifungal drugs (fluconazole, etc.) and drugs of the metronidazole series (metronidazole), enzyme preparations (eg Wobenzym©) are prescribed. In order to cure a woman, therapy is necessary for both sexual partners, and often a repeat course.

The effectiveness of treatment is assessed 2 weeks after treatment. Upon receipt of negative results, further preventive examinations are carried out once a year (in more detail - “Prevention of ureaplasmosis”).

The incidence of ureaplasmosis in women is much higher than in men. It is women who often act as asymptomatic carriers of the pathogen. For many, ureaplasma is a component of the natural microflora, which is activated in conditions favorable to it.

What is ureaplasmosis

Ureaplasmosis is a disease that is sexually transmitted and affects the genitourinary system. The causative agents are tiny ureaplasma bacteria that can be found on the mucous membranes of the genital organs. When immunity decreases, bacteria begin to actively multiply. They then attach to the epithelium or leukocytes and penetrate the cytoplasm, while destroying cell membranes.

Ureaplasmosis can be not only acute, but also chronic. Most often, this disease is combined with gynecological infections, such as trichomonas, chlamydia, and gardnerella.

Reasons

There are several ways of transmitting ureaplasmosis.

• Sexual, with unprotected contact with a carrier of the disease.
• Household, for example, through shared towels or linen.
• From an infected mother to her child during pregnancy or childbirth.

The presence of ureaplasma in the body does not always indicate a disease. Microorganisms can develop only in conditions favorable to them: with chronic diseases, constant stress, hypothermia, surgery. Most often, women aged 14 to 30 years suffer from ureaplasmosis. The cause of the disease can be a sharp decrease in immunity during pregnancy.

Ureaplasmosis can be provoked by dysbacteriosis caused by taking antibiotics or hormonal drugs. Radioactive radiation also provokes the rapid proliferation of ureaplasma. In addition to the above, a deterioration in a woman’s quality of life, bad habits, an unbalanced diet, and poor personal hygiene can contribute to the onset of the disease.

Symptoms

Symptoms of ureaplasmosis do not always manifest themselves clearly in women. They are nonspecific and may suggest other diseases.

• First of all, among the signs, vaginal discharge is yellow or green with an unpleasant odor.
• With chronic ureaplasmosis, there is a regular increase in body temperature, rapid breathing, headaches and muscle pain, cramps, nausea, sleep and appetite disturbances, decreased blood pressure and other signs of intoxication of the body.
• A cutting pain in the lower abdomen may appear - this signals the beginning of an inflammatory process in the uterus and appendages.
• Symptoms of sore throat often occur, such as sore throat, suppuration of the tonsils. These signs appear if the disease was transmitted orally.
• In the presence of ureaplasmosis, the urge to urinate becomes more frequent, which is accompanied by a burning sensation and pain in the lower abdomen. There is also discomfort during and after sexual intercourse.

At the same time, many do not notice changes in the menstrual cycle, pain or characteristic vaginal discharge.

Diagnostics

Diagnosis of the disease includes examination of the cervix and vaginal walls. An ultrasound of the uterus is performed and urine sediment is examined. Ureaplasmosis can be diagnosed by several clinical methods.

By using molecular biological method The presence of ureaplasma in the analyzed sample is determined. The disadvantage of this method is that it cannot be used to determine the number of these bacteria. Therefore, it is combined with other studies.

Serological method is aimed at detecting antibodies in a woman’s body. It is usually performed to identify the causes of infertility, miscarriage or inflammatory diseases after childbirth.

Bacteriological analysis considered the most accurate. It is also called cultural. This diagnosis is based on growing ureaplasma in laboratory conditions. In this case, the material to be studied is taken from the vaginal vault and the urethral mucosa. It is bacteriological diagnostics that makes it possible to determine the amount of ureaplasma.

In addition to the above studies, there are also enzyme immunoassay, polymerase chain reaction, direct and indirect immunofluorescence.

Treatment

Ureaplasmosis is treated with antibiotics. The name and dosage are selected by the doctor individually for each patient. Cephalosporins and penicillins are not suitable for treatment. Doctors often resort to a combined treatment regimen: oral administration of drugs and their local use (douching or suppositories). At the same time, immunomodulators and eubiotics, drugs with lactobacilli and bifidobacteria are prescribed. Taking them prevents the appearance of dysbacteriosis. Antifungal and antiprotozoal drugs are also prescribed. During treatment, along with other measures, vitamin therapy is carried out.

Ureaplasmosis is treated with antibiotics. The doctor selects the drug and dosage individually for each patient.

The standard treatment regimen includes diet. Fried, salty and spicy foods and alcohol are excluded from the diet. During therapy it is necessary to abstain from sexual intercourse. During pregnancy, treatment for ureaplasma begins from the 23rd week. On average, therapy lasts 2–4 weeks. To prevent recurrence of the disease, it is necessary that the sexual partner also undergo a treatment course. Then a follow-up examination is scheduled, on the basis of which the patient is declared healthy or continues treatment.

Prevention

Since the main route of infection with ureaplasmosis is sexual contact, it is important to ensure that it is always protected. It is advisable to have only one permanent partner. An important preventive measure is strengthening the immune system. 4.4444444444444

4.44 out of 5 (9 Votes)

Ureaplasmosis is one of the most common diseases of the genitourinary system, affecting both men and women.

Let's figure out what the symptoms of ureaplasmosis may be.

Main signs of ureaplasmosis

Ureaplasmas are opportunistic microorganisms that are part of the normal microflora. The disease develops against the background of their excessive reproduction, due to:

• malfunctions of the immune system;
• hormonal imbalances associated with excessive use of oral contraceptives, pregnancy, childbirth;
• the presence of infections in the body;
• manipulations and operations on the organs of the genitourinary system.

Signs of ureaplasmosis differ in men and women.

In men

Immediately after infection, the disease in men shows practically no symptoms. The asymptomatic course of the disease continues until the bacteria begin to multiply rapidly and start destructive processes in the organs of the urinary and reproductive systems.

The main manifestations of male ureaplasmosis, which occurs in acute form, are:

• clear discharge from the glans penis with an unpleasant odor;
• problems with urine excretion - difficulties in its outflow due to an increased need to go to the toilet;
• itching, burning and redness of the genitals;
• increased temperature in the affected area due to the presence of inflammatory processes;
• pain when urinating, localized in the urethra;
• a feeling of fullness in the bladder area, aggravated by sudden movements;
• deterioration in health – slight increase in temperature, loss of strength.

If treatment is untimely or incorrectly selected, the disease becomes chronic and its symptoms disappear. In the future, the disease will be accompanied by manifestations of other pathologies that have developed against its background. So, men may experience:

• urethritis - inflammation of the walls of the urethra;
• prostatitis - a lesion of the prostate that is inflammatory in nature;
• epididymitis - inflammation of the epididymis.

Urethritis is usually characterized by the following symptoms:

• purulent yellow-green discharge from the glans penis;
• slight increase in body temperature and general malaise;
• increased urge to empty the bladder and painful urination;
• swelling, itching and pain in the urethra;
• the appearance of droplets of blood at the end of urination.

As a rule, there is no general deterioration in health. The transition of pathology to the chronic stage significantly reduces the severity of symptoms and distorts the clinical picture of the course. In the vast majority of cases, only a feeling of discomfort and itching in the urethra remains, which intensifies during an exacerbation.

Prostatitis usually begins with high fever, heat and chills. Urination becomes difficult and painful. The prostate swells, which in some cases can lead to acute urinary retention. Pain appears in the perineum, radiating to the groin. In the future, men experience the following symptoms:

• difficulty urinating (it becomes intermittent);
• erectile dysfunction – prolonged erections, rapid ejaculation, blurred orgasms, decreased potency;
• burning in the urethra and perineum;
• increased urge to defecate;
• lingering discharge from the urethra;
• foreign inclusions in the urine;
• deterioration in general health, increased fatigue;
• state of anxiety and depression.

Chronic prostatitis generally has mild symptoms and is practically asymptomatic. Men may be concerned about:

• decreased erection and libido;
• weakening of the stream during urination;
• mild aching pain in the sacrum, perineum, rectum;
• discomfort and burning sensation in the urethra.

The exception is periods of exacerbation, accompanied by:

• feeling of pressure in the perineum and anus;
• dull pain radiating to the sacrum, rectum, perineum, groin.

Epididymitis usually develops suddenly. On the first day of the disease (if the vas deferens are infected), men experience pain and discomfort in the scrotum, groin and lateral abdomen. Then the bacteria descend down and penetrate the appendages, which is accompanied by:

• swelling and soreness of the scrotum (within a few hours the appendage can double in size) - pain can radiate to the groin, lower back, iliac region;
• pain when emptying the bladder;
• the appearance of blood in the urine;
• mucous or purulent discharge;
• redness and increased temperature of the scrotum;
• nausea, loss of strength, feverish conditions (in some cases the temperature may rise slightly);
• a feeling of fullness in the testicles;
• enlarged inguinal lymph nodes;
• pain throughout sexual intercourse and during ejaculation, as well as pain during urination, defecation and walking;
• premature ejaculation;
• the appearance of droplets of blood in the semen.

In women

Just like in men, ureaplasmosis in women can occur in several forms, each of which has its own symptoms:

• asymptomatic;
• acute;
• chronic.

The asymptomatic form develops against the background of strong immunity. In this case, the woman does not experience any unpleasant sensations, however, she becomes a carrier of the disease, capable of infecting her sexual partners.

The acute form develops against the background of decreased immunity and the activation and growth of a colony of pathogenic bacteria. The disease in this period is accompanied by clearly expressed symptoms.

The chronic form of the disease develops due to penetration of the pathogen deep into the tissue and is accompanied by a gradual course.

Symptoms of ureaplasmosis in acute form are caused by damage to the vagina and vulva (vulvovaginitis) and urethra (urethritis) and is accompanied by:

• itching in the genital area, swelling and redness;
• burning sensation, the severity of which intensifies during emptying of the bladder;
• mucous vaginal discharge with a foul odor;
• pain and unpleasant sensations that appear during sex;
• the appearance of a small amount of cloudy mucus when pressing on the urethra.

Untimely treatment of the pathology results in the disease becoming chronic and the development of concomitant diseases. In the future, the symptoms of ureaplasmosis will depend on the affected organ.

So, with bartholinitis (inflammation of the Bartholin glands located near the vaginal opening), which developed against the background of ureaplasma, the following may be observed:

• disturbances in the outflow of mucus produced by the glands;
• the appearance of protrusion and redness in the lower part of the labia, caused by an increase in the size of the gland due to the accumulation of secretions;
• pain and discomfort during movement;
• an abscess due to a bacterial infection.

When the pathogen penetrates into the upper parts of the female reproductive system, pathologies such as endometritis (inflammation of the inner layer of the uterus - endometrium) and adnexitis (inflammation of the ovaries and fallopian tubes) develop.

Endometritis, as a rule, has a sluggish course and is accompanied by:

• nagging pain in the lower abdomen and lower back;
• menstrual irregularities – heavy menstruation and increased duration;
• bloody discharge during the intermenstrual period;
• miscarriages and infertility with significant damage to the endometrium.

Adnexitis (salpingoophoritis), as a rule, is characterized by a latent course. The main manifestations of pathology in women are:

• discomfort during sex and during significant physical exertion;
• heaviness in the lower abdomen;
• hormonal disorders when the ovaries are involved in the pathological process;
• infertility due to damage to the fallopian tubes caused by their obstruction.

In addition, ureaplasmosis quite often leads to the development of inflammation of the cervix (cervicitis). The pathology, as a rule, is accompanied by increased frequency of urination (at the same time it becomes painful and intermittent). The diagnosis is made after a complete examination of the woman, including examination of a smear from the cervical canal.

During pregnancy

Speaking about, first of all, it is worth noting that the incubation period of the disease can range from several days to several months.

At the beginning of the development of the disease, its clinical manifestations are usually absent or mild. This feature leads to the fact that pathology is detected precisely during pregnancy when a woman undergoes examinations prior to registration.

If manifestations of the disease are still present, they usually resemble the symptoms of inflammation developing in the pelvic organs.

So, a pregnant woman may experience:

• mucous vaginal discharge, which is often attributed to pregnancy;
• itching and burning in the labia area;
• discomfort during sex;
• frequent, painful urination;
• nagging pain in the lower abdomen, which is usually attributed to increased uterine tone.

In children

The signs do not have specific features - as a rule, they are similar to the manifestations of other inflammatory processes developing in the organs of the genitourinary system. The symptoms of the disease in this case will be closely related to which organs were affected. When local immunity in a child decreases, other bacterial infections may join the disease.

In the active stage in girls, the disease is accompanied by:

• nagging pain in the lower abdomen;
• mucous vaginal discharge;
• burning and pain when emptying the bladder;
• signs of general malaise.

In boys, the disease manifests itself:

• pain and burning when emptying the bladder;
• discharge from the urethra;
• increased urge to empty the bladder;
• deterioration in general health.

In addition, ureaplasmosis in children has some features, namely:

• multifocal infection of internal organs - as a rule, the lungs and urogenital tract are affected;
• high probability of concomitant infections;
• absence of obvious symptoms;
• a high percentage of complications, including infertility in girls.

Diagnostic procedures

The level of modern medicine is so high that it allows us to identify almost any sexually transmitted infection. However, diagnosing the disease can be significantly difficult. This is explained by several reasons.

Firstly, the pathogen is a representative of opportunistic microflora, and therefore can be present in the body of absolutely healthy people. Thus, the detection of mycoplasma does not always indicate the presence of the disease.

Secondly, the main role in the diagnosis of ureaplasmosis is played not by the presence of pathogenic microflora itself, but by its quantitative indicator. The diagnosis is made only if the subjects show signs of the disease, and the material being studied contains a large amount of the pathogen.

Diagnosis can be made by:

• cultural research;
• PCR method (polymer chain reaction);
• serological blood test.

Cultural research is based on the collection and subsequent study of material taken from the genitourinary tract. For women, the test is performed by a gynecologist, and for men, by a urologist. The collected biomaterial is placed in a nutrient medium and remains in it for several days. The result of the study is information about the amount of the pathogen in the body and its sensitivity to antibacterial agents.

The PCR method is one of the most modern diagnostic tools that allows you to identify the genetic code of the pathogen in the collected material and determine its quantity. Blood, smears, serum, scrapings, discharge from the urethra and vagina are subject to examination.

Serological blood testing allows you to identify antigens and specific antibodies to them. Such an analysis is prescribed, as a rule, for recurrent forms of the disease, as well as to identify the causes that led to infertility.

In the vast majority of cases, these methods are used in combination.

Ureaplasma urealyticum – the causative agent of ureaplasmosis

Causes of ureaplasmosis in women and risk factors

The main causes of ureaplasmosis in women are early onset of sexual activity, promiscuous sexual intercourse, a history of sexually transmitted diseases, and gynecological diseases. Ureaplasmosis is transmitted primarily through sexual contact; in addition, infection can occur through household contact, transplacental transmission in the prenatal period, or from mother to child during childbirth.

In case of carriage of ureaplasma, the activation of the infectious-inflammatory process is facilitated by the following factors:

• secondary infection;
• endocrine system disorders;
• immune system disorders;
• pregnancy and childbirth;
• surgical interventions;
• radiation therapy, chemotherapy;
• stress; etc.

Forms of the disease

Depending on the nature of the inflammatory process, ureaplasmosis in women is classified as follows:

• sluggish;
• subacute;
• spicy;
• chronic.

In addition, carriage of ureaplasma is possible (and more common).

Chronic ureaplasmosis can over time lead to narrowing (stricture) of the urethra, cervical erosion, inflammation and adhesions in the fallopian tubes.

Symptoms of ureaplasmosis in women

When ureaplasma is carried and the disease is latent, there are no signs of ureaplasmosis in women; the pathology can also be asymptomatic. The clinical picture of ureaplasmosis resembles other sexually transmitted infectious diseases. The main symptoms of ureaplasmosis in women are:

• slight clear or cloudy vaginal discharge;
• burning and itching in the external genital area;
• frequent urge to urinate;
• pain and/or burning sensation when urinating;
• feeling of discomfort and pain in the lower abdomen;
• pain during sexual intercourse.

The general condition, as a rule, does not suffer.

Diagnostics

To make a diagnosis, an objective examination and history taking are not enough, since the clinical picture of the disease is nonspecific. The most informative method for diagnosing ureaplasmosis is the polymerase chain reaction (PCR). The method is indicated primarily for asymptomatic disease, when planning pregnancy (the study is carried out for both spouses), pregnancy (especially in the case of ectopic), infertility, as well as during monitoring the effectiveness of treatment of ureaplasmosis. The materials for the study are vaginal smears and urine. In some cases, PCR may produce false positive (when the sample is contaminated) or false negative (when taking antibacterial drugs) results, so this study needs to be confirmed.

In addition to PCR, if ureaplasmosis is suspected in women, a cultural research method is used (bacteriological inoculation of the obtained biological material on a nutrient medium). Discharge from the mucous membrane of the cervix, urethra, rectum, as well as urine is used as biological material for analysis. The cultural research method is highly accurate.

Also, for the purpose of diagnosing ureaplasmosis in women, enzyme-linked immunosorbent assay and direct immunofluorescence method are used. For these studies, samples of the patient's blood are used. The accuracy of these methods is 50–70%.

The patient should adhere to the rules for collecting biological material for research. Blood sampling is carried out on an empty stomach in the morning. For urine testing, the first morning sample is collected. Before taking a urogenital smear or scraping, you should abstain from sexual intercourse for two to three days.

If ureaplasmosis is detected, the diagnosis should also be carried out on the other sexual partner.

With ureaplasmosis in women, the vagina, uterus, fallopian tubes and ovaries are most often affected.

Differential diagnosis of ureaplasmosis is necessary in women with diseases such as urethritis, cystitis, endometritis, urolithiasis, arthritis of infectious etiology, pneumonia, meningitis, wound infections (both surgical and non-surgical), bacteremia, etc.

Treatment of ureaplasmosis in women

Treatment of ureaplasmosis in women is carried out using conservative methods. Simultaneous treatment of a regular sexual partner is indicated. Antibacterial therapy is prescribed, usually antibiotics of the tetracycline group, macrolides, aminoglycosides and fluoroquinolones are used to treat ureaplasmosis. In the presence of a mixed infection (gonococci, trichomonas, chlamydia), the primary infection is treated first (ureaplasmosis in this case is considered secondary). Tetracyclines are contraindicated in pregnant women, therefore, for ureaplasmosis during pregnancy, preference is given to antibacterial drugs of the macrolide group. Treatment in this case usually begins in the second trimester of pregnancy in order to minimize possible harm to the fetus.

Antibacterial drugs are prescribed orally; in addition, they are used during local treatment in the form of ointments, gels, solutions and vaginal suppositories.

In chronic ureaplasmosis, antibacterial therapy is longer; the administration of several antibacterial drugs simultaneously may be indicated.

When treating ureaplasmosis in women, antibiotic therapy is supplemented with immunomodulatory drugs, vitamin complexes, hepatoprotectors, antifungal and antiprotozoal agents, and in the chronic form of the disease - physiotherapeutic procedures.

Diet shown. From the diet you should exclude fatty, fried foods, smoked foods, spices, alcohol - all those foods that irritate the digestive tract and are difficult to digest.

During treatment, it is necessary to abstain from sexual intercourse or use barrier methods of contraception.

A control study of the effectiveness of therapy is carried out over three menstrual cycles using the culture method and/or PCR.

Possible complications and consequences

In the absence of the necessary treatment, ureaplasmosis can become chronic, recurring from time to time. Chronic ureaplasmosis can over time lead to narrowing (stricture) of the urethra, cervical erosion, inflammation and adhesions in the fallopian tubes. The latter, in turn, can cause ectopic pregnancy and secondary infertility. In pregnant women, ureaplasmosis can provoke pregnancy pathologies (including placental insufficiency, miscarriage and premature birth), intrauterine infection of the fetus or infection of the child during childbirth.

The main causes of ureaplasmosis in women are early onset of sexual activity, promiscuous sexual intercourse, a history of sexually transmitted diseases, and gynecological diseases.

In the postpartum period, ureaplasmosis in women can contribute to the occurrence of an acute inflammatory process in the inner mucous layer of the uterus (endometritis).

In addition, ureaplasmosis in women can be complicated by inflammation of the joints.

Forecast

With timely diagnosis and adequate treatment, the prognosis is favorable.

Prevention

In order to prevent the occurrence of ureaplasmosis in women, as well as to prevent relapses of the disease and the development of complications, it is recommended:

• avoid casual, especially unprotected, sexual contact;
• in case of sexual contact with a casual sexual partner, use barrier methods of contraception;
• If you suspect a sexually transmitted infection, consult a doctor promptly;
• if the diagnosis is confirmed, inform sexual partners about it;
• undergo treatment for all sexual partners at the same time;
• undergo screening for ureaplasmosis when planning pregnancy.

Video from YouTube on the topic of the article: