- General information about the pathogen
- Ways of transmission
- Causes of activation of ureaplasma
- Forms and effects of ureaplasmosis
Until now, there is no consensus among doctors and scientists regarding the status of ureaplasma – is this microorganism pathological, requiring treatment, or opportunistic, in the presence of which a person is considered clinically healthy. However, medical practice shows that in men ureaplasma infection not only often causes urethritis, but also causes more serious pathology.
General information about the pathogen
Ureaplasmosis is an inflammatory process triggered by a microorganism dwelling in the urogenital system of a person – ureaplasma. This infectious agent has no cell walls, it easily penetrates even through the pores with a diameter of 0.22 microns. Urea is necessary for existence, which ureaplasma transforms into ammonia.
The mere presence of ureaplasma infection in a man’s body is not yet a basis for making a diagnosis of urogenital ureaplasmosis. Health problems arise from the increased activity of this microorganism, parasitizing on the membranes of spermatozoa, the epithelium of the genital organs. If the analysis did not reveal other pathogenic pathogens that may cause inflammation, then ureaplasmosis is considered confirmed.
Until 1989, ureaplasmosis was not listed as an independent disease in the International Classification of Diseases. Only urethritis were described , the cause of which was indicated by a certain type of pathological agent.
There are several types of ureaplasma, but inflammatory reactions in the male body are provoked mainly by Ureaplasmaurealyticum, biotype 2, which was first identified in 1954 during the examination of a patient with urethritis.
Ways of transmission
Since 2000, ureaplasmosis has been excluded from the list of exclusively sexually transmitted infections, since this agent is detected not only in sexually active persons, but also in the elderly and children. But the main risk group is young people from 20 to 35 years.
A man can become infected with ureaplasma in two ways:
- Sexually . This is the most common variant of transmission of this infection, and the type of contact is not decisive. It can be not only traditional sex, but any contact of the mucous membranes with the genitals. What is important is not the fact of the presence of an infection in a partner, but the density of dissemination of the genitals by it. With a single sexual intercourse with a carrier, the probability of getting ureaplasma is 40%. In monogamous couples, the infection is fixed 8 times less.
- Transplantation . When an organ transplant or implant is implanted, the risk of introducing ureaplasma is theoretically present, but the percentage is extremely small.
Not proven, but the probability of infection through public toilets is allowed, since efficient pathogens of ureaplasma were found on toilet seats. Through bed linen or water (when swimming in pools, natural ponds), the infection is not transmitted.
If a man has sex with a woman who has had more than one partner for a year, she smokes, uses oral contraceptives, then the risk of infection with ureaplasma increases significantly. And only for women is characterized by persistent carriage. In men, the infection is usually transient, but they can infect their partners in a given period.
Causes of activation of ureaplasma
Infection is able to exist peacefully in the body without causing any symptoms. That is why many doctors tend to consider it opportunistic pathogen. So far, no specific reason has been found for which the ureaplasma goes into an active state. The provoking factors include:
- HIV infection;
- violation of the barrier function of the genitals. In men, it is a local immunity, as well as a zinc-peptide complex produced by the prostate gland. This explains the fact that ureaplasma is usually activated against the background of chronic prostatitis. It can provoke urethritis and excessively frequent washing of the urethra with antiseptics;
- the presence of other infectious agents ( trichomoniasis , gardnerella, candida ), damage to the urethral region by chlamydia or gonococcus. This factor is relevant in 25% of cases.
All of the above circumstances can serve as a catalyst, but are not a prerequisite for the development of ureaplasmosis.
Forms and effects of ureaplasmosis
Ureaplasmosis can be both acute and chronic recurrent nature. There is also a carrier state, in which the infection does not attack the “owner”, but is actively transmitted to the partner, when appropriate.
The incubation period is on average from 3 to 7 days, but can be as long as two months. The more men of other pathogens in the body, the faster the process of activation of the ureaplasma.
The acute form of ureaplasmosis usually lasts no more than 2 months. During this period, men experience all signs of urethritis:
- frequent urination , accompanied by rezami, burning;
- occasionally dull pains in the lower abdomen and in the perineum;
- mucous and sometimes purulent discharge from the urethral canal;
- possible insignificant increase in overall temperature.
Such symptoms are usually not left unattended by men. Seeing a doctor can cure the infection quickly and without consequences.
Asymptomatic chronic disease is dangerous with its consequences. Often, men ignore doctors and self-medicate with the help of various pharmaceutical means, thereby not destroying, but periodically driving the ureaplasma into a latent state.
The peculiarity of the fight against ureaplasma is that not all antibiotics act on it. The activity of most of these funds is based on the destruction of the cell walls of an alien microorganism, and since they are not present in ureaplasma, there is nothing to destroy.
The infection after some time will begin to move upwards, penetrating into the prostate, the vas deferens, testicles. The prostate gland becomes the main target in 75% of cases.
In men, the complications against the background of chronic urogenital ureaplasmosis begin to appear in about a year. Almost always there is a negative impact on sexual health:
- retrograde ejaculation (sperm is not released from the urethra, and goes into the bladder);
- premature or difficult ejaculation;
- the absence of morning erection characteristic of healthy young men;
- loss of attraction to the opposite sex, difficult and quickly disappearing arousal.
Often there is an inexplicable weight gain.
The main percentage of cases of ureaplasmosis in men is detected when going to a doctor for diseases caused by infection:
- epididymitis (inflammation of the epididymis);
- orchiepididymitis (synchronous inflammation of the testicles and epididymis);
- prostatitis (ureaplasma disrupts the secretion gland epithelium).
All these pathologies lead a man not only to sexual dysfunction, but also to some form of infertility.
Ureaplasma adversely affects the composition of sperm:
- sperm activity deteriorates, their ability to penetrate into the egg decreases;
- changes the composition of seminal fluid due to disorders in the epithelium of the prostate;
- the number of defective spermatozoa, which are characterized by: defects in shape, abnormal trajectory of motion, immobility, underdevelopment.
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Even if there are no visible signs of inflammatory processes in the urogenital area, but there are problems with the conception of a child, the cause may well be Ureaplasma.
Chronic ureaplasmosis can cause reactive arthritis in men – inflammation in the joints, as well as trigger the development of urolithiasis.
The urologist or venereologist diagnoses ureaplasmosis in men using the following methods:
- ELISA – a method for determining the presence of antibodies to infection by a blood sample;
direct and indirect immunofluorescence reaction – a type of serum for antibodies to the pathological agent;
- bakposev on a special nutrient medium based on urine samples and secretions from the urethra;
- PCR (polymerase chain reaction method) – determination of the type of infection from a sample of any biological fluid: urine, blood, saliva.
If the infection is detected, then additional studies are conducted (at the discretion of the physician) to identify the extent and areas of damage:
- spermogram is analyzed, analyzed in dynamics;
- examines the quality and composition of prostatic secretions;
- ultrasound of the prostate (transrectal), scrotum;
- in some cases, videouretroscopy is used.
If there are no pathologies due to the presence of infection, the patient is considered ureaplasm positive. In such cases, treatment is prescribed to a man without fail if there are indications:
- preparation for conceiving a child;
- change of sexual partner (for epidemiological safety);
- the presence of partner diseases caused by ureaplasma.
However, the presence of an inactive ureaplasma in the body of a man is a kind of sword of Damocles, because the infection can be activated at any time. The main danger is that in the initial stages of ureaplasmosis can be asymptomatic, and will be detected in a chronic form.
Treatment of urogenital ureaplasmosis is prescribed by a doctor on the basis of examinations and on the basis of anamnesis (a survey of the symptoms of the subject). The dosage regimen is prescribed individually.
Treatment of ureaplasmosis in the acute form does not cause difficulties, but in the chronic course of the disease the task becomes more complicated: it is not easy for antibiotics to overcome the barrier of the prostate gland in which the infection accumulates. Rarely, but it happens that acute ureaplasmosis is spontaneously cured by activating the barrier function of the body. However, you should not expect such an outcome, it can turn into a chronic form.
To destroy the infection, drugs based on the following active substances are used:
- tetracyclines : doxycycline (Vibramycin, Medomycin), minocycline;
- macrolides : azithromycin (Sumamed, Azitral), clarithromycin (Klaxax, Klacid), josamycin (Vilprafen);
- fluoroquinolones : ofloxacin (Zanocin, Taricin), levofloxacin;
- lincosamides : dalacin, clindamycin.
Possible topical use of certain drugs – the introduction directly into the urethra.
The specific drug and the mode of its use are prescribed by the doctor based on tests for the sensitivity of the infection to antibiotics. Independently choose and apply these tools can not even with relapse, because the ureaplasma quickly develops resistance.
Since antibiotics have a number of side effects, in order to prevent them, additional drugs are included in the treatment regimen for ureaplasmosis:
- immunomodulators that activate the local and general defense mechanisms of the body: Cycloferon or Viferon. Sometimes “Genferon” candles are prescribed (rectally);
- antifungal agents that prevent thrush in men caused by microflora imbalances (Nystatin, Fluconazole);
- probiotics and prebiotics (Linex, bifidumbacterin).
Therapy lasts an average of 7-12 days. During this time, an acute infection is completely cured, which must be confirmed by test results. In chronic form, periodic repeated courses (until complete recovery) are prescribed, with associated restoration of organs and tissues damaged by ureaplasma.
At the time of treatment it is necessary to suspend sex. When an infection is found in one partner, it is necessary to examine the second partner, otherwise there will be no point in therapy.