Ureaplasma parvum in women - what is it?
Urepalasma parvum belongs to representatives of conditionally pathogenic microflora, which, in a normal state of immunity, does not cause the development of the disease. These microorganisms constantly live in the woman’s genital tract, but only under certain circumstances lead to inflammatory processes.
The latter include:
- Urethritis is an inflammatory process affecting the urethra;
- Cystitis – damage to the bladder;
- Vaginitis – inflammation of the vaginal walls;
- Cervicitis is an inflammation of the cervical epithelium and submucosal layer, externally manifested as erosion.
Is it necessary to treat ureaplasma parvum in women?
The frequency of detection of ureaplasma in inflammatory processes of the female genital organs reaches 80% (average frequency - 50-60%). But even in the absence of such diseases, these microorganisms are identified in 20% of healthy women.
Therefore, the detection of ureaplasmas without inflammatory signs (confirmed clinically and laboratory) is not a reason to carry out antibacterial therapy.
Ureaplasma infection causes the appearance of a variety of nonspecific symptoms of ureaplasma parvum in women. First of all, these are vaginal discharge, which is mucopurulent in nature and periodic low-intensity bloody discharge (“spotting”) that occurs outside of the menstrual cycle. Other symptoms:
- Dyspareunia – painful sexual intercourse;
- Dysuria – pain during urination;
- Itching and burning sensation of the labia, vagina and urethral area;
- Minor pain and discomfort localized in the lower abdomen.
During an objective examination, the doctor can identify certain signs inherent in ureaplasma infection (however, they are not strictly specific and can be observed in various diseases):
- Redness and swelling of the mucous membrane, determined in the area of the urethra, its external opening;
- The presence of discharge in this area, which is mucopurulent in nature;
- Swelling and redness of the vagina and vulva, while a pathological secretion (mucopurulent) is released from the cervix.
If such symptoms and signs are present, ureaplasma parvum must be treated - I think this is understandable, and the question “why?” will not be.
Diagnosis of ureaplasma parvum in women
Additional examination to detect ureaplasma in women should be carried out in specific clinical cases:
- Clinical and laboratory signs characteristic of inflammation of the genitourinary system, when a standard examination does not identify pathogens;
- Patients suffering from infertility (lack of conception within a year of regular intimate life without protection);
- Miscarriage;
- A history of premature birth, especially before 34 weeks.
To diagnose ureaplasma infection in women, 1 of 2 methods can be used:
- , aimed at identifying characteristic RNA and DNA fragments inherent in Ureaplasma parvum.
- Cultural analysis - inoculation of discharge on media with certain substances and study of the nature of the grown colonies of microbes.
Microscopic analysis of discharge from the genital and urinary organs is a simple diagnostic test that allows one to identify inflammatory lesions of the genitourinary organs. It can help answer a number of questions:
- What is the degree of leukocyte reaction (white blood cell count)?
- What is the condition of the epithelium of the genital organs?
- Are there concomitant sexually transmitted infections (gonorrhea, trichomoniasis)?
- What is the state of normal microflora in the vagina?
According to microscopic examination, urethritis in women is diagnosed if 10 or more leukocytes are detected in the urethral discharge in the field of view. The diagnosis of vaginitis is made when the ratio of leukocytes to the number of squamous epithelial cells is 1:1 or more.
A diagnostic sign of cervicitis in women, according to microscopy, is 10 or more leukocytes in the field of view. This sign must be combined with the presence of mucopurulent secretion from the cervix.
It is important!
Studies that determine the level of antibodies to Ureaplasma parvum should not be used, because do not provide reliable information. In this case, there is a high risk of false-positive results, which is the reason for prescribing unindicated antibiotic therapy.
Is it necessary to treat ureaplasma parvum in women? To a certain extent, I have already tried to answer this question.
Not all cases of detection of this pathogen in the body are an indication for starting therapy. Detection of only a high titer of ureaplasma (10,000 CFU/ml or more), not combined with the presence of clinical and laboratory signs of inflammation, does not require treatment.
It is indicated only if there are inflammatory signs according to laboratory and clinical examination. In this case, it is necessary to exclude the presence of other pathogens that can cause an infectious process - gonococci, genital mycoplasmas, etc.
Exceptions when antibacterial therapy is prescribed in the absence of inflammation when a high titer of ureaplasma is detected are:
- There is a history of episodes of miscarriage;
- There is a death of a child in the perinatal period.
Treatment for a partner living with a woman who has been diagnosed with ureaplasma is prescribed only if he has signs of inflammation (laboratory or clinical). In this case, it is necessary to exclude another nature of inflammation in the male genital and urinary tract.
Drugs, prescribed for the treatment of ureaplasma parvum in a woman should lead to the achievement of certain goals:
- Complete clinical recovery;
- Relief of laboratory-determined inflammation;
- Prevention of complications.
Antibiotics play a crucial role in the treatment of infection caused by Ureaplasma parvum. Currently, doctors prescribe one of two drugs - Josamycin or Doxycycline.
The duration of therapy is 10 days, but can be increased to 14 days depending on the clinical and laboratory response. Only Josamycin is used to treat pregnant women. Its effect on the fetus is minimal, unlike Doxycycline.
Grade therapeutic effectiveness is based on the relief of clinical and laboratory signs of the inflammatory reaction. The absence of detection of ureaplasma in the discharge of the genital and urinary organs is not a requirement for treatment. Repeated tests should be carried out one month after taking the last tablet.
If there is no effect from antibiotics, then:
- Additionally, tests are prescribed to identify other possible pathogens;
- The antibiotic is changed to a drug from another group, to which ureaplasma is sensitive;
- The duration of treatment is increased to 2 weeks.
Ureaplasma parvum in women during pregnancy
Ureaplasma parvum during pregnancy, when physiological suppression of the immune system is observed (this is necessary for the normal development of the fetus, so that it is not rejected, since half of it contains genetically foreign paternal antigens) lead to various complications:
- Miscarriages;
- Developmental defects;
- Premature birth.
To date, there is no reliably proven data on the absolute causal role of ureaplasmas in the development of spontaneous miscarriages or recurrent miscarriage. However, there is no contrary evidence.
Therefore, women with a history of pregnancy terminations are recommended to conduct diagnostic tests to detect ureaplasmas. If the study results are positive, appropriate eradication treatment is recommended.
Ureaplasma parvum can also cause inflammatory processes in the postpartum and post-abortion period (most often this is).
24.06.2017
Ureaplasma parvum is a causative agent of genitourinary tract infections in adults and children. These are microbes that are small in size.
What it is ? The microbe ureaplasma parvum occupy a place between bacteria and viruses.
These microbes are part of the microflora of the female body, have no effect on the body and do not provoke disease for a long time. Under the influence of certain factors, these microbes multiply intensively, causing an inflammatory process, which provokes ureaplasmosis in women.
Reasons why microorganisms multiply quickly Ureaplasma parvum:
- low immunity;
- antibiotic treatment;
- sexual infections that exist in the body;
- oral sex during sexual contact;
- anal sex;
- many changing sexual partners.
Symptoms and signs in the body of the microorganism ureaplasma parvum
Microorganism ureaplasma parvum in women, is the causative agent of a sexually transmitted infectious disease - ureaplasmosis. This disease belongs to the category of the most dangerous and difficult to treat diseases.
Ureaplasmosis There can be two types: a chronic type of disease and an acute type of disease. In this case, the microorganism Ureaplasma parvum provokes inflammatory processes in any organs of the genitourinary system.
The main indicator of Ureaplasma parvum infection in the female body is urethritis.
Symptoms of ureaplasmosis:
- burning at the time of urination;
- frequent urination;
- difficulty urinating;
- redness and swelling of the urethra;
- copious amounts of leucorrhoea;
- purulent particles appear in the urine;
- vaginal discharge. The norm is clear discharge; if discharge appears yellow and dark in color and has a putrid odor, then this is the first signal that there is an inflammatory process in the body;
- cramps in the lower abdomen give a signal that ureaplasma parvum has entered the uterus, and an inflammatory process has begun in it;
- swelling of the labia and redness of the genitals;
- unpleasant sensations and discomfort in the vagina during sexual intercourse and pain, blood after it.
This is a manifestation of an acute form of ureaplasma disease. Due to the fact that this disease occurs in a silent form, many are simply unaware of its existence, and some signs that appear soon disappear. With insufficient treatment or no treatment of ureaplasmosis at all, this disease enters the chronic stage of development.
Ureaplasma parvum in the female body
With good immunity, this infection does not cause obvious signs and does not pose a threat to the female body. In this situation, the woman is a carrier of the infectious microbe Ureaplasma parvum.
Reproduction of ureaplasma parvum occurs in an organism weakened by stress and improper nutrition. Pregnancy is an additional burden on the female body, therefore, if a woman was a carrier of ureaplasma parvum before the moment of conception, then during the period of bearing a child, the disease ureaplasmosis will begin an inflammatory and destructive process in the body.
In women, this the microorganism affects the uterus, appendages and vagina.
Ureaplasma parvum in the female body leads to infertility, but only if the inflammatory process has been prolonged. The infection spreads from the urethra to the uterus if a woman has low immunity. The first symptoms of infection in the uterus are menstrual irregularities, bleeding between menstrual cycles, and purulent vaginal discharge.
Inflammation of the fallopian tubes leads to ectopic pregnancy and infertility.
Ureaplasma parvum infection has no effect on the fetus itself during pregnancy, does not cause defects in the developing organism in the womb, and does not infect the child.
But if this infection is in the body of a woman who is carrying a child, then in this case there may be complications during pregnancy, such as miscarriages and premature birth. Testing for ureaplasma parvum is a mandatory test before pregnancy and during pregnancy.
In a situation where a woman gives birth to a child naturally, then when the child passes through the birth canal, he becomes infected with a disease that is in the mother’s body. As a consequence of infection with this disease, the child may develop urethritis and pneumonia, which is provoked by ureaplasma parvum.
Diagnosis of ureaplasma parvum in the body
Before starting treatment, it is necessary to diagnose and be tested for Ureaplasma parvum infection. External examination of the patient cannot guarantee the diagnosis. In order to establish the correct diagnosis, it is necessary to conduct a number of studies:
- serological studies;
- microbiological tests;
- undergo a genetic probe method;
- analysis for the content of immunoenzymes;
- PCR is a diagnostic test.
To identify at what stage the inflammatory process is, which could activate the proliferation of ureaplasma parvum, it is necessary to conduct an examination.
Microscopic examination allows us to identify the inflammatory process in the reproductive system and determine the condition of the reproductive organs of the female body.
Also, for an accurate diagnosis, it is necessary to undergo a bacterial culture. This analysis provides a complete picture of the presence of pathogenic microflora and its number in the body, as well as the reaction of these bacteria to antibiotics.
Based on the results of bacterial culture, it is possible to calculate the exact dose of medication for treatment and select the most suitable antibiotics for treatment.
To carry out bacterial culture, the following is taken from the woman:
- serum;
- urine;
- blood
- scraping from the urethra;
- vaginal discharge.
Culture for Ureaplasma parvum is carried out both to establish the correct diagnosis and to check for the curability of the disease after a two-week course of therapy.
Consequences of ureaplasmosis in the female body
Any disorder or pathological change in the female organs requires compliance with preventive measures, diagnosis and timely effective treatment. If left untreated, ureaplasma parvum causes many complications. Having passed ureaplasma parvum into the chronic state of the disease ureaplasmosis, ureaplasma parvum will manifest itself from time to time and destroy the genitourinary system. Consequences include:
- chronic inflammatory diseases of the female genital area;
- chronic diseases of the mucous membranes of the vagina and uterus;
- chronic inflammation affecting the ovaries, fallopian tubes, female genital appendages;
- systematic termination of pregnancy;
- infertility.
Untreated and chronic ureaplasmosis affects the development of the fetus in a sick pregnant woman, causing low birth weight of the child, and developing meningitis and pneumonia in the infant.
Drug treatment methods for ureaplasma parvum
Many women believe that ureaplasma parvum is found in the body of many representatives of the fair sex, therefore ureaplasma parvum is the norm in the female body. Ureaplasmosis is a disease that is caused by pathogenic microorganisms, ureaplasma is parvum, which means that it is not safe for the comfortable state of the body and must be treated.
Treatment of ureaplasma parvumIn women, it is necessary to start by correcting the immune system first. Without a healthy immune system, it is impossible to cure infectious diseases, including ureaplasmosis. In parallel with raising immunity, they also include a medicinal effect on the causative agent of the disease ureaplasma parvum. How to treat ureaplasma parvum and how to treat prescribed by a venereologist. Also, to treat the disease, consultation with a urologist (for sick men) and a gynecologist for women with ureaplasmosis is necessary.
The most effective medications for the treatment of ureaplasmosis are:
- drugs based on tetracycline;
- macrolides;
- lincosamides;
- drugs with immunomodulatory properties;
- multivitamins;
- probiotics;
- hepatoprotectors.
If necessary, the patient is prescribed extracts of medicinal herbs: echinacea, eleutherococcus, aralia. The duration of drug treatment is at least 21 days.
Ureaplasmosis in the female body must be treated with drugs that have antibacterial properties. Tablets for ureaplasma are prescribed in courses. Treatment regimen for ureaplasmosis:
- Doxycycline - course 10 days, 100 mg 2 times a day after meals;
- Josamycin - course 10 days, 500 mg 3 times a day after meals;
- Erythromycin - 0.5 mg taken 4 times a day after meals.
- Azithromycin is a 4-day course, on the first day you need to take 500 mg, and then 250 mg once a day after eating.
The following drugs are also used in treatment: Ofloxacin, Clarithromycin, Midecamycin.
For women who are pregnant, only Josamycin can be taken.
Women who have ureaplasma parvum in the genital area are prescribed douching and vaginal antiseptic tampons along with medicinal drugs.
Symptoms and treatmentsUreaplasma diseases are the same for both sexes. When diagnosed with ureaplasmosis, treatment both sexual partners pass through.
The treatment regimen for ureaplasma parvum and the selection of drugs is prescribed only by the attending physician based on the diagnostic results.
During treatment for ureaplasma parvum, sexual intercourse, smoking and drinking alcohol are prohibited, and you must also exclude spicy foods from your diet.
It is very important to maintain hygiene when treating this disease.
Preventive measures to avoid infection with ureaplasma parvum
Ureaplasma parvum is an infection that gives rise to the disease ureaplasmosis, which is easier to avoid than to cure after infection.
Preventive methods for ureaplasmosis are:
- regular sexual partner;
- using a condom during sexual intercourse;
- avoid anal and oral sex;
- douche with antiseptics after sexual intercourse;
- when planning a pregnancy, mandatory examination of both partners;
- abstain from sex during antibiotic treatment;
- healthy lifestyle;
- properly balanced diet;
- maintaining intimate hygiene;
- regular examination by a gynecologist.
An interesting fact is that doctors know how to treat ureaplasma, but is it worth doing? Among all genitourinary tract infections, it occupies an intermediate position between normal and pathological. Paradox? Now let's figure it out!
Ureaplasma parvum
Ureaplasma has the ability to break down urea into ammonia, thereby maintaining inflammation in the affected organ. It also destroys immunoglobulin A, which protects mucous membranes from infections. Ureaplasma parvum is classified as opportunistic microorganisms throughout the world and is normally found in small titres on the mucous membranes of the genital organs (even in virgins). Only under unfavorable conditions (weakened immunity, concomitant infections, long-term inflammation) does ureaplasma begin to actively multiply and lead to the appearance of clinical symptoms.
A prerequisite for starting therapy is pathological symptoms in the absence of other sexually transmitted infections or unexplained infertility.
Among the routes of transmission are:
- Sexual (most often)
- vertical (during childbirth),
- intrauterine (from a sick mother),
- oral-genital (not confirmed),
- transplantation (during transplantation of donor organs),
- household (through personal items) - extremely rare.
Once in the body, ureaplasma parvum can cause an acute disease, but more often the disease is chronic, asymptomatic or as a carrier state. All this depends on age, sensitivity to infection, activity of the immune system, concomitant diseases, and entry points. The inflammatory process is usually local, in the area of the urethra, bladder, vagina or cervix in women. Dissemination of the pathogen occurs in weakened premature infants or patients with immunodeficiencies.
In addition, ureaplasmas are capable of depleting nonspecific body defense factors (compliment, immunoglobulins, phagocytosis activity), multiplying on the surface or inside the host cell. That is why chronic asymptomatic forms are often encountered, requiring complex and long-term treatment for ureaplasma parvum.
Symptoms of infection with ureaplasmosis
As mentioned above, ureaplasma parvum may not manifest itself in any way for a long time, however, with an increase in the titer of mycoplasma, clinical symptoms appear.
Discharge from the genital tract or urethra often occurs: mucous, leucorrhoea or purulent. The latter lead to swelling and inflammation of the urethra, bladder, vagina and cervix in women. All this is manifested by burning, itching, frequent urination, and menstrual cycle disorders.
Later, constant nagging pain in the pelvic region and lower abdomen occurs. In advanced cases, due to prolonged inflammation of the fallopian tubes, adhesions appear, which leads to infertility, miscarriages, and ectopic pregnancy.
In men, ureaplasma parvum affects sperm. Actively multiplying on their surface, mycoplasma sharply reduces motor activity, damages the cell genome, and over time leads to a decrease in the number of sperm per 1 ml of sperm.
During an objective examination, the doctor can see swelling of the internal genital organs, pathological discharge, and rarely erosion of the mucous membrane. Sometimes nothing can be detected visually, so laboratory diagnosis of ureaplasma parvum is necessary.
Diagnostic methods
So, to whom and in what cases is examination to detect ureaplasma indicated?
- All women suffering from secondary infertility.
- A history of miscarriages.
- Signs of inflammation of the genitourinary tract in the absence of other infections.
- Premature birth.
The most accurate diagnostic method is PCR (polymerase chain reaction), which detects the DNA or RNA of a bacterial cell in a tissue sample. To do this, a special brush is used to collect material from the urethra and vagina of women. The result is released after a few days. Using this reaction, the mycoplasma titer (concentration) is also determined. At high titers, treatment should be started as quickly as possible.
Serodiagnosis. A common method, but for the detection of ureaplasma it is not decisive, unlike PCR. The essence of this diagnosis is to detect specific antibodies against ureaplasma parvum in the patient’s blood. Detection of the latter may indicate both an acute process and a previous disease.
Ureaplasma parvum (ureaplasma parvum) is a causative agent of sexually transmitted infections in adults and children. These microbes are small in size and occupy an intermediate position between viral particles and bacteria.
Ureaplasma parvum freely persists on the mucous membranes of the genitourinary organs in healthy women, without causing the development of pathology and clinical symptoms. Under the influence of negative factors, the pathogenic activity of ureaplasma increases, they begin to destroy mucosal cells and cause an inflammatory process.
Ureaplasma parvum is an opportunistic microorganism that is part of the vaginal biocenosis. The microbe has urease activity, a special life cycle and is highly contagious. When urea is broken down, ammonia is formed, an excess of which can cause inflammation of the vagina, urethra, cervix, and fallopian tubes.
Decreased immunity due to infection of the genitourinary tract is the main reason., are able to reduce the general resistance of the body and local protection. These microbes and other pathogens of sexually transmitted infections are often detected during laboratory diagnosis of ureaplasmosis.
Ureaplasma parvum
This representative of the mycoplasma family, together with ureaplasma urealiticum, was named “ureaplasma spp”. Both of these microbes can cause similar diseases and provoke similar symptoms. Ureaplasma parvum is diagnosed mainly in men, and ureaplasma urealiticum - in women. Ureaplasma parvum is more pathogenic and leads to the development of severe genitourinary infections. The disease lasts a long time with periods of exacerbation and remission.
Ways of spread of ureaplasma infection:
- Infection with ureaplasmosis occurs during sexual intercourse with a sick person or a bacteria carrier. Persons who have promiscuous sexual intercourse and neglect barrier contraception are at risk of contracting ureaplasmosis. In addition to traditional sexual intercourse, infection can occur during kissing, oral and anal sex.
- Less common, but relevant, is the vertical route of infection of the fetus and child during pregnancy and childbirth.
- The infection spreads through contact and household contact in public places - transport, swimming pools, toilets.
- Infection can also occur during organ transplantation.
Symptoms
Ureaplasma parvum is the cause of an acute or chronic inflammatory disease, the clinical symptoms of which are determined by the location of the microbe.
Pathological signs that occur in sick women:
The disease caused by ureaplasma parvum is characterized by a long-term and often asymptomatic course. If treatment is not started in a timely manner, quite severe consequences can develop. In order not to miss pathology, women are recommended to undergo regular examinations by a gynecologist and undergo appropriate tests. During pregnancy, physiological suppression of the immune system occurs. This is a normal reaction of the body necessary for the development of the fetus, which contains genetically foreign antigens from the father. That is why ureaplasma quickly multiplies in the body of pregnant women and exhibits its pathogenic properties. Ureaplasma parvum has a negative effect on the fetus, causing the development of dystrophy and infecting the fetal membranes. Meningitis and pneumonia often occur in newborns. Ureaplasmosis can lead to miscarriages, malformations, and premature birth. All pregnant women must undergo a series of diagnostic tests to detect ureaplasma parvum.
In the absence of adequate treatment, ureaplasmosis can result in the development of severe complications in women - inflammation of the ovaries and uterus, and the inability to conceive. In men, ureaplasma attaches to sperm and destroys them. The mobility of male germ cells gradually decreases, and the general resistance of the body is suppressed. At the same time, the quality of sperm deteriorates, its viscosity increases, and the number of sperm in the seminal fluid decreases.
Diagnostics
A number of diagnostic methods are used to detect ureaplasma parvum:
- Serodiagnosis- linked immunosorbent assay. The patient's blood is taken from a peripheral vein for examination on an empty stomach. Antibodies of various classes to Ureaplasma parvum are determined in the blood: IgG, IgA, IgM. A negative test result indicates the absence of infection in the body, and a positive test result indicates that the patient is infected with ureaplasma.
- . PCR allows you to detect even one bacterial cell in clinical material. This is a qualitative method for identifying characteristic RNA and DNA fragments inherent in Ureaplasma parvum. Positive result – ureaplasma parvum (half colony) DNA detected. A negative result means the absence of U. parvum DNA in the test sample. If ureaplasma DNA is detected in the analysis, this means that there is a sexually transmitted infection, ureaplasmosis.
- clinical material. Culture culture is one of the most effective diagnostic methods. First, biomaterial is collected. Typically, vaginal discharge, urethral discharge, blood, and urine are examined. The material is inoculated on special nutrient media, the crops are incubated in a thermostat for several days, and the grown colonies are analyzed. Colonies of each type are counted. To isolate a pure culture, they are subcultured onto accumulative media. After studying the tinctorial, cultural, biochemical and antigenic properties of the isolated microorganism, its sensitivity to antibiotics is determined. A diagnostically significant number of microbes is more than 10 to 4 degrees CFU/ml. If ureaplasma parvum is detected in high concentrations, treatment should be started immediately.
If the infection is not clinically manifested, and laboratory tests do not show a diagnostically significant titer of the pathogen, antibiotic therapy is not carried out, but the immune system is strengthened. Material for examination from the cervical canal or urethra must be collected in the morning on an empty stomach with a special brush.
The following women are subject to examination to identify ureaplasma pavrum:
- Suffering from chronic inflammatory diseases of the genitourinary system,
- Those who are unable to get pregnant within a year of regular intimate life without protection,
- who do not carry a pregnancy to term,
- Who had a history of preterm birth before 34 weeks.
Treatment
Many people wonder whether it is necessary to treat ureaplasma parvum? When the concentration of microbes in the test material exceeds 10 to 4 CFU/ml and clinical signs appear, therapy must be started.
Treatment of ureaplasmosis caused by ureaplasma parvum involves the use of etiotropic drugs - antibiotics, as well as immunostimulants, NSAIDs, vitamins, adaptogens.
Comprehensive treatment of the pathology using all recommended groups of drugs will relieve symptoms and ensure a quick recovery. If the pathology re-exacerbates, patients are prescribed other antibiotics. Ureaplasmas quickly adapt to antimicrobial agents. The treatment regimen must be adjusted each time there is an exacerbation, adding stronger drugs each time. Only by following all the recommendations outlined above can you be completely cured of ureaplasmosis.
Sexually transmitted diseases are difficult to treat. It's better not to get infected with them. Prevention of ureaplasmosis consists of following the rules of personal hygiene, using a condom, douching with antiseptics after sexual intercourse, and engaging in sexual activity only with a regular partner.
Ureaplasma parvum is a dangerous microbe for a woman’s body that causes various forms of inflammatory processes in the genitourinary system. Most pathologies caused by ureaplasma parvum manifest themselves with mild symptoms and are diagnosed late. That is why women should regularly visit a gynecologist and undergo all necessary tests. Treatment of ureaplasmosis should be prescribed by a doctor, taking into account the individual characteristics of the patient.
Video: specialist about ureaplasma
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Introduction
Ureaplasmosis is one of the most common and so-called “commercial” diagnoses in urology and gynecology, which is often used by unscrupulous doctors. This diagnosis can be made to almost half of men and 80 percent of women.But is ureaplasmosis so dangerous? Does it need to be treated? And where does it actually come from? Let's try to figure out all these questions.
What kind of beast is ureaplasma?
Ureaplasma was first discovered in 1954 by the American doctor Shepard in the secretions of a patient with nongonococcal urethritis. Further research has shown that most people who are sexually active are carriers of ureaplasma. However, it is not at all necessary that they will have any external signs of infection. Ureaplasma can remain in the human body for years and even decades and not manifest itself in any way.Ureaplasma is a tiny bacterium, which in the microbiological hierarchy occupies an intermediate position between viruses and single-celled microorganisms. Due to the multilayer outer membrane that surrounds the bacterium on all sides, it is very difficult to detect under a microscope.
In total, five varieties of ureaplasma are known, but only two of its types are dangerous to humans - Ureaplasma urealyticum and Ureaplasma parvum. They are the ones who have a special weakness for epithelial cells located in the genitourinary tract. Ureaplasma is almost never found in other parts of the body.
By the way, the closest “relative” of ureaplasma is mycoplasma. Due to the great similarity in structure and preferences, both microorganisms are often colonized in the genital tract at the same time, and then doctors talk about mixed infections, i.e. diseases caused by mixed microflora.
Where does ureaplasma come from?
Normally, a huge number of microorganisms live in the human genitourinary tract, and all of them, to one degree or another, take part in maintaining the cleanliness of the vagina or urethra. As long as immunity is at the proper level, microorganisms do not pose a danger. But as soon as the body’s resistance decreases, the microflora of the genital tract is disrupted, some microorganisms begin to multiply rapidly, and then they become dangerous to human health. The situation is exactly the same with ureaplasma. Many people live with it for a long time and do not even realize that they are carriers of this bacterium. It is most often discovered by chance, when the patient consults a doctor for some completely different reason, and sometimes simply out of curiosity. For a full examination, the doctor sends smears to the laboratory. And this is where the fun begins. The analysis reveals ureaplasma, and the patient is immediately treated. And even the fact that a person has no complaints does not stop some doctors from taking active steps aimed at “expelling” the microbe from the human body.
The main argument in favor of urgent treatment is that in the absence of it, a man or woman will (possibly!) suffer from infertility, and the likelihood of giving birth or conceiving a child will become zero. And a long battle with ureaplasma begins. Carriers undergo multiple courses of drug treatment, which leads to many side effects. They, in turn, are often attributed to the manifestation of other hidden infections, etc. This can be many years of, and, unfortunately, useless running around in a vicious circle.
By the way, foreign specialists have long stopped treating ureaplasma as an absolute evil. They do not refute the fact that a microorganism can cause disease, but only in cases where the biocenosis in the genital tract is disrupted and the acidic environment characteristic of a healthy person has changed to alkaline. In other cases, ureaplasma should be considered as a conditionally dangerous cohabitant, and nothing more. Taking care of your health, a well-ordered sex life, proper nutrition and physical activity are the key to well-being in the genitourinary area.
After many years of scientific discussions, it was decided that only those people who have symptoms and complaints from the urogenital tract need treatment, and the presence of other pathogens is excluded. In other cases, no active influence on the microflora is required.
What does it mean? For example, a patient comes to the doctor with complaints of frequent cystitis (inflammation of the bladder). The doctor prescribes a series of tests aimed at identifying the cause of the disease. If studies have not revealed any other pathogens, then ureaplasma, and sometimes mycoplasma, is considered the root cause of the disease. In this situation, targeted treatment of ureaplasma is really necessary. If there are no complaints from the patient, then the prescription of any treatment remains at the discretion of the doctor.
There is still a lot of debate about the involvement of ureaplasma in secondary infertility, miscarriage, polyhydramnios and premature birth. Today, this issue remains debatable, because not a single specialist has been able to reliably confirm the guilt of ureaplasma in these pathologies. Of course, if you need to identify ureaplasma in the genitourinary tract, then this is quite simple to do. As stated above, the carrier of this microorganism is the sexually active population, and therefore, if desired (or necessary), it is not difficult to sow ureaplasma.
Some researchers still try to prove the pathogenicity of ureaplasma, using as arguments its frequent presence in diseases such as urethritis, vaginitis, salpingitis, oophoritis, endometritis, adnexitis, etc. However, in most cases, treatment aimed only at eliminating ureaplasma does not give a positive result. From here we can draw a completely logical conclusion - the cause of inflammation of the pelvic organs is a different, more aggressive flora.
How can you become infected with ureaplasma?
Ureaplasma is very unstable in the environment and dies very quickly outside the human body. Therefore, it is almost impossible to become infected in public places, for example, saunas, baths, swimming pools, public restrooms.For infection, close contact with a carrier of ureaplasmosis is necessary. Infection is most likely to occur during sexual intercourse, which one - oral, genital or anal - does not matter significantly. However, it is known that slightly different ureaplasmas live in the oral cavity and rectum, which are dangerous to humans in much rarer cases.
The detection of ureaplasma in one of the sexual partners is not a fact of treason, because a person could have become infected many years ago, and sometimes during fetal development, or during childbirth from his own carrier mother. By the way, another conclusion follows from this - the infection can be detected even in infants.
Some people believe that ureaplasma is a “bad” sexually transmitted infection. This is fundamentally incorrect; ureaplasma itself does not cause sexually transmitted diseases, but it can accompany them quite often. It has been proven that the combination of ureaplasma with Trichomonas, gonococcus, and chlamydia really poses a serious danger to the genitourinary system. In these cases, inflammation develops, which almost always has external manifestations and requires immediate treatment.
How is ureaplasmosis treated?
Strictly speaking, such a disease as ureaplasmosis does not exist in the international classification of diseases. As a result, we will talk about what drugs ureaplasma bacteria are sensitive to. Antibiotics against ureaplasma
All microorganisms are “afraid” of antibiotics to one degree or another, and ureaplasma in this case is no exception. Unfortunately, not every antibacterial agent is able to suppress the activity of bacteria, because Ureaplasma lacks a cell wall. Drugs such as penicillin or cephalosporins have virtually no beneficial effect. The most effective antibiotics are those that can affect the synthesis of protein and DNA in the microbial cell. Such drugs are tetracyclines, macrolides, fluoroquinolones, aminoglycosides, Levomycetin.The best indicators for ureaplasma infection are Doxycycline, Clarithromycin, and in the case of ureaplasma infection in a pregnant woman, Josamycin. These antibiotics, even in minimal doses, can suppress the growth of bacteria. As for other antibacterial drugs, they are used only if ureaplasma is sensitive to them, which is determined during a microbiological study.
Indications for treatment
To prescribe antibacterial treatment, at least one of the following conditions must be present:- The presence of obvious symptoms and convincing laboratory signs of inflammation of the genitourinary system.
- Laboratory confirmation of the presence of ureaplasma (ureaplasma titer must be at least 104 CFU/ml).
- Upcoming surgery on the pelvic organs. In this case, antibiotics are prescribed for prophylactic purposes.
- Secondary infertility, provided that other possible causes are completely excluded.
- Repeated complications during pregnancy or recurrent miscarriage.
Drugs affecting ureaplasma
There is an opinion among some doctors that the growth of ureaplasma can be suppressed with a single dose of Azithromycin in the amount of 1 g. Indeed, the instructions for the drug and medical recommendations for the treatment of sexually transmitted infections indicate that Azithromycin effectively affects non-gonococcal and chlamydial urethritis nature in men and chlamydial cervicitis in women. However, numerous studies have proven that after Azithromycin taken in such a dosage, the destruction of ureaplasma does not occur at all. But taking the same drug for 7-14 days is almost guaranteed to get rid of the infection.Doxycycline and its analogues - Vibramycin, Medomycin, Abadox, Biocyclinde, Unidox Solutab - are recommended drugs for the treatment of ureaplasma infection. These drugs are convenient because they need to be taken orally only 1-2 times a day for 7-10 days. A single dose of the drug is 100 mg, i.e. 1 tablet or capsule. It must be borne in mind that on the first day of treatment the patient must take double the amount of medication.
The best results from taking Doxycycline were obtained in the treatment of infertility due to ureaplasmosis. After the treatment course, in 40-50% of cases, a long-awaited pregnancy occurred, which proceeded without complications and ended successfully in childbirth.
Despite this high effectiveness of the drug, some strains of ureaplasma remain insensitive to Doxycycline and its analogues. In addition, these drugs cannot be used in the treatment of pregnant women and children under 8 years of age. It is also worth noting quite frequent side effects, primarily on the part of the digestive system and skin.
In this regard, the doctor may use other drugs, for example, from the group of macrolides, lincosamines or streptogramins. Clarithromycin (Klabax, Klacid) and Josamycin (Vilprafen) have proven themselves to be the best.
Clarithromycin does not have any negative effects on the gastrointestinal tract and can therefore be taken with or without food. Another advantage of the drug is its gradual accumulation in cells and tissues. Thanks to this, its effect continues for some time after the end of the course of treatment, and the likelihood of reactivation of the infection sharply decreases. Clarithromycin is prescribed 1 tablet twice a day, the course of treatment is 7-14 days. During pregnancy and children under 12 years of age, the drug is contraindicated; in this case, it is replaced with Josamycin.
Josamycin belongs to the group of macrolides and is able to suppress protein synthesis in ureaplasma. Its effective single dosage is 500 mg (1 tablet). The drug is taken 3 times a day for 10-14 days. Josamycin has the ability to accumulate, so at first it has a depressing effect on ureaplasma, preventing its reproduction, and upon reaching a certain concentration in the cells it begins to have a bactericidal effect, i.e. leads to the final death of the infection.
Josamycin practically does not cause side effects and can be prescribed even to pregnant women and children under 12 years of age, including infants. In this case, only the form of the drug is changed; not a tablet drug is used, but a suspension for oral administration. After such treatment, the threat of miscarriage, spontaneous abortions and cases of polyhydramnios are reduced by three times.
In cases where the development of ureaplasma inflammation in the urogenital tract occurs against the background of reduced immunity, antibacterial agents are combined with immunomodulatory drugs (Immunomax). Thus, the body’s resistance increases and the infection is more quickly destroyed. Immunomax is prescribed according to the regimen simultaneously with taking antibiotics. A single dose of the drug is 200 units, it is administered intramuscularly on days 1-3 and 8-10 of antibacterial treatment - a total of 6 injections per course. It is also possible to take tableted immunomodulatory drugs - Echinacea-Ratiopharm and Immunoplus. They have a similar effect, but are taken 1 tablet daily during the entire course of antibacterial treatment. At the end of such combined treatment, in almost 90% of cases, ureaplasma goes away irrevocably.
Naturally, if, in addition to ureaplasma, another pathology of the genitourinary tract was found, then additional treatment aimed at eliminating concomitant diseases may be required.
When to treat ureaplasma - video
Conclusion
As a summary, I would like to emphasize the following: ureaplasma is transmitted mainly through sexual contact with a bacteria carrier or a sick person. Moreover, his infection could occur at any time period of life, starting from the moment of birth.Ureaplasma affects the epithelial cells of the genitourinary system and tends not to manifest itself for a long time. With a decrease in immunity, hormonal imbalances, malnutrition, frequent stress, hypothermia, the likelihood of activation of ureaplasma increases with the development of symptoms characteristic of inflammation of the vagina or urethra.
