Trichomoniasis (trichomoniasis) – the sexually transmitted infection causing an inflammation of bodies of urinogenital system. It is shown by signs of a colpitis, an uretrit, cystitis, a proktit. It is often combined with other genital infections: clamidiosis, gonorrhea, mycoplasma, candidiasis etc. In a sharp stage plentiful allocations from a vagina, an itch and burning – at women and morbidity are noted at an urination – at men. In the absence of adequate treatment passes into a chronic form and further can serve as the reason of prostatitis, infertility, the complicated pregnancy and childbirth, children's pathology and mortality.
Trichomoniasis (or a trichomoniasis) urogenital is a disease of exclusively urinogenital system of the person. The causative agent of trichomoniasis – a vaginal (vaginal) trichomonad, sexually transmitted.
Trichomoniasis target organs at men are an urethra, a prostate, testicles and their appendages, seed bubbles, and women have a vagina, a vaginal part of the tservikalny canal, an urethra. The vaginal trichomonad is found in women more often because of more expressed displays of trichomoniasis and more frequentation of the doctor in the preventive purposes. Generally women of reproductive age from 16 to 35 years get sick with trichomoniasis. At the time of delivery infection with trichomoniasis of the newborn from sick mother occurs approximately in 5% of cases. At newborns trichomoniasis proceeds benign because of features of a structure of an epithelium and is capable to samoizlechivatsya.
Usually, presence of trichomonads does not cause obvious symptomatology of trichomoniasis in men, they often are carriers of trichomonads and, without testing an obvious indisposition, transmit an infection to the sexual partners. Trichomoniasis can be one of the reasons of a negonokokkovy uretrit, chronic prostatitis and an epididymite (a small egg appendage inflammation), to promote development of male infertility because of decrease in mobility and viability of spermatozoa.
Infection with trichomoniasis generally occurs at sexual contacts. In the household way - trichomoniasis is transmitted through the linen polluted by the patient, towels, bathing suits extremely seldom.
The number of the diseases connected with trichomoniasis is big. Trichomoniasis often comes to light with other STD activators (gonokokka, hlamidiya, ureaplasmas, sort mushrooms Candida, herpes viruses). Now consider that trichomonads promote development of diabetes, mastopathy, allergy and even oncological diseases.
Biological features of the causative agent of trichomoniasis
Causative agents of trichomoniasis – trichomonads (Type Protozoa, Zhgutikovye's Family) – monocelled anaerobic organisms – parasites, are widespread in the nature. In a body of the person 3 species of trichomonads parasitize: vaginal (the largest, active, pathogenic), oral and intestinal. Thanks to zhgutika of a trichomonad are very active and mobile. Trichomonads of a bespola are also omnivorous, quickly breed in optimum conditions – in the absence of oxygen and at t of =35-37 °C.
Trichomonads are fixed in cells of a mucous membrane of an urinogenital path and cause inflammatory process there. Waste products of trichomonads poison a human body, reduce its immunity.
Trichomonads can live in genitals and even in the blood course where they get in lymphatic ways, intercellular spaces by means of enzyme - gialuronidaza. Trichomonads are extremely adapted for existence in a human body: can change a form, mask under cells of plasma of blood (platelets, lymphocytes) - that complicates diagnosis of trichomoniasis; "to cling" on itself other microbes and this way to evade from the immune attack of an organism.
Microorganisms (gonokokk, ureaplasmas, hlamidiya, sort mushrooms Candida, herpes viruses, a cytomegalovirus), getting in trichomonads, find protection against the effect of drugs and immune system of the person there. Mobile trichomonads can carry other microbes on urinogenital system and on blood vessels. Damaging an epithelium, trichomonads reduce its protective function, and facilitate penetration of microbes and viruses, sexually transmitted (including HIV).
Though the modern venereology owns effective medicamentous methods of treatment of the majority of sexually transmitted infections, to get rid of trichomoniasis completely extremely difficult even today. The matter is that the nonprotein cover of a trichomonad does not react to action of antibiotics and can be destroyed only by special antiprotozoan medicines.
Clinical picture of trichomoniasis
Usually incubatory period of trichomoniasis lasts from 2 days to 2 months. If trichomoniasis proceeds in the erased form, then the first symptoms can be shown in several months after infection at decrease in immunity or an exacerbation of other chronic infections.
Trichomoniasis (depending on expressiveness of symptoms and duration) can proceed in sharp, arrange, chronic forms and as a trikhomonadonositelstvo.
Clinical displays of trichomoniasis at men and at women are various. Trichomoniasis at women proceeds with more expressed symptoms, male trichomoniasis usually exists in the form of a trikhomonadonositelstvo.
- considerable foamy allocations of yellow, green color, with an unpleasant smell;
- reddening and irritation mucous genitals (itch, burning), dermatitis of an internal surface of hips;
- damages mucous genitals (erosion, sore);
- discomfort at an urination, a dizuriya;
- unpleasant feelings at sexual contact;
- sometimes pains in the bottom of a stomach.
Trichomoniasis symptoms at women amplify before approach of monthly.
At children's age trichomoniasis is observed infrequently, as a rule, at girls. Infection occurs not sexually from sick mothers through use objects, linen. Trichomoniasis at girls is shown in the form of a vulvovaginit at whose sharp current symptoms are similar to an adult form of a disease.
Trichomoniasis at men proceeds in the form of a trikhomonadny uretrit (the urethra is surprised) and is followed by mucopurulent allocations, a slight itch, burning right after sexual intercourse or an urination. At inspection solid infiltrates, a striktura of an urethra are observed. Trichomoniasis can affect a prostate gland and appendages of testicles, to cause prostatitis (in 40% of cases) and an epididymite. Very seldom at trichomoniasis at men erosion and sores mucous, an inflammation of a median seam are observed.
Character and the number of allocations depends on a stage of inflammatory process: at chronic trichomoniasis the insignificant number of mucous allocations is noted. Over time they can abate, but recovery does not occur.
Fresh trichomoniasis, in the absence of treatment, passes into a chronic form (if from the moment of infection there passed more than 2 months) or into a trikhomonadonositelstvo. Chronic trichomoniasis can proceed for years with small symptomatology (~ at 4% is followed by a dizuriya and small pain, ~ at 5-8% sexual frustration).
Trikhomonadonositelstvo is allocated as a trichomoniasis form at which the activator is revealed laboratory, but displays of a disease are absent. This division is conditional as I can pass different forms of trichomoniasis each other. The erased forms of trichomoniasis play a large role in spread of a disease. The activator living in urinogenital system is a source of infection of the partner at sexual intercourse and own repeated infection.
Trichomoniasis is dangerous by the complications since it increases risk of transfer of other infections (including HIV), pregnancy pathologies (premature birth, a still birth), development of infertility (men's and women's), cancer of a neck of a uterus, chronic diseases of urinogenital system. In the presence of similar symptoms and even in the absence of them it is necessary to be examined on trichomoniasis, and perhaps other STD. It is important for the women planning pregnancy for sexual partners - trikhomonadonositel and patients with trichomoniasis; for everything, conducting active sexual life.
Self-treatment of trichomoniasis can result in opposite result: trichomonads pass into more aggressive form, begin to breed more actively, the disease at the same time gets the latent or atypical forms. Trichomoniasis in this case is much more difficult to diagnose and treat.
Diagnosis of trichomoniasis
Diagnosis of trichomoniasis consists in detection of the activator by means of various methods.
On the basis of complaints of patients and survey it is possible to suspect existence of trichomonads. At survey at patients with trichomoniasis of women inflammation signs — hypostasis and hyperaemia of a vulva and vagina are observed. When carrying out a kolposkopiya the symptom of "a strawberry tserviks" can be observed: reddening mucous with dot and focal hemorrhages on a uterus neck. The epithelium dysplasia is noted, emergence of atypical epitelialny cages is sometimes possible.
Authentically trichomoniasis comes to light by means of laboratory methods:
- microscopy of the studied material (women have dabs from a vagina and an urethra, men have dabs from an urethra);
- cultural (microbiological) method with use of artificial nutrient mediums;
- immunological method;
- PTsR – diagnostics.
Trichomoniasis is diagnosed for men more difficultly, due to the lack of symptomatology, besides trichomonads at such course of a disease are in an atypical amebovidny form. Before planning of pregnancy both the man, and the woman have to undergo full inspection on STD, including on trichomoniasis.
Treatment of trichomoniasis
Treatment of trichomoniasis is carried out by venereologists, gynecologists and urologists. It it is necessary to carry out at any forms of a disease regardless of existence or lack of manifestations. Treatment of trichomoniasis needs to be carried out at the same time for sexual partners (even in negative analyses of one of them). Treatment of trichomoniasis only at one of sexual partners is inefficient since there can be repeated infection after treatment. Development of antibodies against the causative agent of trichomoniasis does not form resistant immunity, after treatment it is possible to ache again at repeated infection.
Treatment of trichomoniasis needs to be combined with treatment of other STD which often accompany a disease.
Need of treatment of trichomoniasis at the pregnant woman is defined by the doctor, it is possible to appoint it only in the second trimester of pregnancy. Because of tolerance of trichomonads to antibiotics, at treatment of trichomoniasis appoint anti-parasitic therapy: use medicines of group 5 of nitroimidazoles. Treat them , metronidazole, , , . At treatment of trichomoniasis it is forbidden to take alcohol even in small quantities as all medicines except for an ornidazol cause an antabuspodobny syndrome (influence exchange of alcohol in an organism). If trichomoniasis proceeds in an uncomplicated sharp (subsharp) form, treatment consists in intake of antiprotozoan medicines. At the complicated and chronic course of trichomoniasis the stimulating therapy is appointed previously. Symptomatic and local treatment is applied according to indications. Only local treatment of trichomoniasis (ointment, a candle) will be inefficient. In the presence of the mixed infection (hlamidiya, ureaplasmas, gonokokk, a cytomegalovirus, Candida) together with anti-parasitic medicine the antibiotic is appointed.
Trichomoniasis is considered izlechyonny when the activator at diagnostics does not come to light, and clinical symptoms are not observed. Sex life during treatment is excluded. It is necessary to report to the sexual partner about existence of trichomoniasis and other STD, about need of inspection and treatment.
The result of treatment of trichomoniasis depends on normalization of microflora of urinogenital system and an organism in general. At women for this purpose use a vaccine against from the inactivated acidophilic lactobacilli. Purpose of immunomodulatory medicines is possible.
Sometimes stability of trichomonads to a certain medicine of group 5 of nitroimidazoles meets (usually partial), but change of a dose, duration of reception or replacement of medicine of the same group yield positive result in treatment of trichomoniasis. To avoid development of stability of trichomonads to anti-parasitic medicines, taking a therapy course, it is necessary to observe all recommendations of the doctor strictly.