Ureaplasma infections are diseases, mainly of the genitourinary system, caused by different pathogens, but having a similar clinical picture. Men show symptoms of urethritis. In women, they cause symptoms of paraurethritis and vulvitis, the formation of pseudoerosion of the cervix. In the absence of treatment, inflammation quickly turns into a chronic form with periodic exacerbations. The internal genitals may be involved in the inflammatory process, which gradually leads to the development of infertility. Mycoplasma cystitis and pyelonephritis may develop. Mycoplasma lesions of the skin, internal organs and joints occur.
Ureaplasma infections and mycoplasmosis are diseases, the causative agents of which are the smallest microorganisms of the mycoplasma family – an intermediate link between viruses and bacteria (they do not have DNA and cell membranes). They parasitize on the membranes of other cells, in particular on the epithelial cells of the mucosa of the genitourinary, respiratory, intestinal tracts of a person, can attach to erythrocytes, spermatozoa, macrophages, fibroblasts. The Mycoplasmataceal family includes: the genus Mycoplasma (~ 100 species) and the genus Ureaplasma (2 species). Most mycoplasmas are not pathogenic. In the human body, 14 saprophytic (non-painful) mycoplasma species are isolated, and infection is caused by 4 species – Ureaplasma urealyticum (ureaplasma), Mycoplasma hominis, Mycoplasma pneumoniae, Mycoplasma genitalium.
Ureaplasmas are a special genus of mycoplasmas, they got their name because of their ability to break down urea. They can lead to an inflammatory process in the genitourinary system – ureaplasmosis. The presence of ureaplasm does not always lead to the development of ureaplasmosis. This happens under certain conditions, usually together with other pathogens (gonococci, chlamydia, trichomonas, gardnerella, herpes virus) or with dysbiosis (75-80% of cases). These are so-called mixed infections – communities of microorganisms that modify the picture of the disease and help each other to protect themselves from the effects of drugs.
Ureaplasma infections is considered a disease transmitted mainly sexually. Usually ureaplasmosis proceeds as a chronic infection. Activation of the asymptomatic course of ureaplasmosis is possible with a weakening of immunity (hypothermia, stress, surgery, chronic diseases, pregnancy), when optimal conditions are created for the settlement of the urogenital department with ureaplasmas and their active reproduction. In turn, ureaplasmas actively absorbing oxygen, provoke increased growth of anaerobic bacteria (Gardnerella, mobilinkus).
In men, the bladder, urethra, prostate, testicles are at risk of developing ureaplasmosis; in women, the vagina, uterus and appendages. With ureaplasmosis, spermatozoa can lose their motor activity (ureaplasma enzymes change the fluidity of sperm, when ureaplasma and sperm come into contact, its membrane dissolves).
As an inflammatory process, ureaplasmosis can cause infertility, ovulation disorders and spermatogenesis. Ureaplasma infections often leads to complications, miscarriage, premature birth. The causative agents of ureaplasmosis can provoke the development of acute inflammation in the uterus (endometritis) after childbirth, surgical termination of pregnancy, cesarean section. The incidence of ureaplasmosis in pregnant women is 25-30%. Ureaplasma infections provokes inflammation of the joints (rheumatoid arthritis).
Ureaplasma infections is diagnosed most often in patients aged 14 – 29 years. Usually at this age the greatest sexual activity is observed. Risk factors for the development of ureaplasmosis are the early onset of sexual life, promiscuous sexual intercourse, previously transmitted venereal diseases, gynecological problems. Ureaplasma infections is transmitted mainly sexually or through close household contact (through underwear, personal hygiene products). The intrauterine path of infection of the fetus with ureaplasmosis occurs through the amniotic fluid of a sick mother or during childbirth. The incubation period of ureaplasmosis during transmission of infection is on average 2-3 weeks.
Ureaplasmosis occurs in the form of acute, chronic infection and carrier. Women are more often asymptomatic carriers of ureaplasmosis, for some ureaplasm is a normal vaginal microflora.
Symptoms of ureaplasma infections
Manifestations of ureaplasma infections may not bother the patient much, and often do not bother at all (when carried by women). The symptoms of ureaplasmosis are similar to the manifestations of some other urogenital infections.
In men, ureaplasmosis affects the urethra and bladder, testicles with appendages, and the prostate gland. At the same time , the following symptoms are noted:
- complaints of discharge from the urethra (usually in the morning);
- painful sensations during urination (pain and burning);
- some manifestations of prostatitis;
- orchoepidymitis (inflammation of the testicle and its appendages).
Ureaplasma infections in men is most often manifested by non-gonococcal urethritis, prone to prolonged, sluggish flow (discharge from the urethra may spontaneously disappear for a while and reappear). The manifestations of ureaplasmosis in women are:
- symptoms of chronic colpitis, cervicitis: the presence of minor transparent or cloudy discharge;
- frequent urination (sometimes with pain, burning sensation);
- pain during sexual intercourse;
- pain in the lower abdomen – may periodically increase, decrease, completely disappear.
Due to the often asymptomatic course, ureaplasmosis is diagnosed late, contributing to the development of complications.
A preliminary diagnosis of ureaplasmosis cannot be made only on the basis of symptoms (they are insignificant and do not bother the patient much). It is necessary to conduct diagnostic studies.
It is impossible to make a diagnosis solely based on symptoms and external examination, since there is no clinical picture specific to this disease – ureaplasmosis. Currently, ureaplasmosis refers to the inflammatory process of the urogenital system, when ureaplasm urealyticum was detected during examination and no other pathogen was detected.
Despite the fact that today clinical venereology has a wide range of modern diagnostic methods, the diagnosis of ureaplasmosis remains difficult due to the difficulty of detecting ureaplasmas in the association of microorganisms present. According to the results of microscopy, we can only assume the presence of ureaplasmas (the number of leukocytes in the smear may be slightly increased or normal). To detect ureaplasmas, venereologists use various diagnostic techniques:
- PCR diagnostics (most informative);
- the method of genetic probes;
- the method of direct immunofluorescence, enzyme immunoassay (ELISA).
Examination and treatment for ureaplasmosis should also be carried out by a sexual partner, even if he does not have any complaints. The need for treatment when ureaplasmas are detected can only be determined by a doctor.
Treatment of ureaplasma infections
During the treatment of ureaplasma infections, it is very important to restore the normal microflora of the genitourinary system and eliminate the mixed infection (anaerobic flora and protozoa). The peculiarity of ureaplasmas is that they are insensitive to certain antibacterial drugs – penicillins, cephalosporins, etc.
Most ureaplasmas are sensitive to the following antibiotics:
- Tetracyclines: tetracycline, doxycycline (with uncomplicated forms of ureaplasmosis – urethritis, cervicitis, carriage in the absence of symptoms).
- Macrolides: macropene, roxithromycin, clarithromycin, azithromycin, erythromycin are highly effective against pathogens of ureaplasmosis.
- Lincosamides: lincomycin, clindamycin.
- Immunomodulators (thymus extract, lysozyme, levamizole, methyluracil). Pantocrine, eleutherococcus extract, tincture of aralia are also used.
In the treatment of ureaplasmosis, antiprotozoal and antifungal drugs are used. To restore normal microflora, it is necessary to take medications containing bifidobacteria and lactobacilli. It is important to manage pregnancy in women with ureaplasmosis. To minimize the risk of infection with ureaplasmosis of a child, a woman must be treated with antibacterial drugs (after 22 weeks).
During the course of treatment of ureaplasmosis, it is mandatory to follow a diet rich in lactic acid products, vitamins, restriction of fatty, smoked, fried foods, spicy seasonings and ketchups, prohibition of alcohol. During the treatment of ureaplasmosis, sexual activity is excluded. It is very useful to conduct a course of intestinal cleansing with sorbents, then a course of vitamins B and C, taking hepatoprotectors (drugs that improve liver function), choleretic herbs.
Treatment of ureaplasmosis is carried out only under the supervision of a doctor, always individually and depends on the stage of the process and the affected organ. The course lasts approximately 2 weeks. Ureaplasma infections is considered cured if no ureaplasm is detected in the results of laboratory tests after the treatment (within 1-2 months).
Treatment of ureaplasmosis with antibiotics is very effective, but it disrupts the balance of normal human microflora, therefore, the antimicrobial device “Uro-Biofon”, homeopathic methods of treating ureaplasmosis can be recommended.
Without treatment, ureaplasmosis may resume from time to time. Exacerbations can be associated with a cold, stress, the use of a large amount of alcohol, etc. Chronic ureaplasmosis (as a constantly present inflammatory process) in the absence of treatment can eventually cause stricture (pathological narrowing) of the urethra, provoke inflammation of the prostate gland.
In women, chronic ureaplasmosis without treatment with weakened immunity can cause inflammation, adhesions in the fallopian tubes (threat of infertility, ectopic pregnancy). In pregnant women, infection with ureaplasmosis can lead to pregnancy pathology, infection of the fetus. The prognosis with proper and timely treatment of ureaplasmosis is quite favorable.