Ureaplasma course of treatment. Infectious diseases of the urinary tract: ureaplasmosis. Medicines for effective therapy

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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 deal with all these questions.

What kind of animal is ureaplasma?

Ureaplasma was first discovered in 1954 by the American physician Shepard in the discharge of a patient with non-gonococcal urethritis. Further studies have shown that most people who are sexually active are carriers of ureaplasma. At the same time, it is not at all necessary that they will have any external signs of infection. Ureaplasma can be 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 unicellular 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 for humans - ureaplasma urealyticum (Ureaplasma urealyticum) and ureaplasma parvum (Ureaplasma parvum). It is they who have a special weakness for the cells of the epithelium located in the genitourinary tract. In other places of the body, ureaplasmas are almost never found.

By the way, the closest "relative" of ureaplasma is mycoplasma. Due to the great similarity in structure and preferences, both microorganisms often settle 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 purity of the vagina or urethra. As long as immunity is at the proper level, microorganisms are not dangerous. But as soon as the body's resistance decreases, the microflora of the genital tract is disturbed, some microorganisms begin to multiply rapidly, and that's when they become dangerous to human health.

The same is true with ureaplasma. Many people live with her long time and do not even realize that they are carriers of this bacterium. It is discovered most often by chance, when the patient goes to the doctor for some completely different reason, and sometimes just out of curiosity. For a complete examination, the doctor sends smears to the laboratory. And this is where the fun begins. In the analysis, ureaplasma is detected, and the patient is urgently treated. And even the fact that a person does not have any 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 probability of giving birth or conceiving a child will become equal to zero. And a long struggle 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 latent infections, etc. It can be a long-term, and, unfortunately, useless running around in a vicious circle.

By the way, foreign experts have long ceased to treat 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 disturbed 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 no more. Taking care of your health, an orderly sex life, proper nutrition and physical activity are the key to well-being in the urogenital area.

After many years of discussion at the scientific level, 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 appointment of any treatment remains on the conscience of the doctor.

There is still a lot of controversy about the involvement of ureaplasma in secondary infertility, miscarriage, polyhydramnios and premature birth. To date, 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 mentioned 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 are still trying 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 this we can draw a completely logical conclusion - the cause of inflammation of the pelvic organs is another, more aggressive flora.

How can you get infected with ureaplasma?

Ureaplasma is very unstable in the environment and dies very quickly outside the human body. Therefore, it is almost impossible to get infected in public places, for example, saunas, baths, swimming pools, public restrooms.

Infection requires close contact with a carrier of ureaplasmosis. The most likely infection during sexual intercourse, which one - oral, genital or anal, does not matter. However, it is known that slightly different ureaplasmas live in the oral cavity and rectum, which are dangerous to humans in much more rare cases.

The detection of ureaplasma in one of the sexual partners is not a fact of treason, because a person could become infected many years ago, and sometimes during prenatal development, or during childbirth from their own carrier mother. By the way, another conclusion follows from this - the infection can be detected even in infants.

Some people believe that ureaplasma refers to the "bad" sexually transmitted infections. This is fundamentally wrong, 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, 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, in the international classifier of diseases, such a disease as ureaplasmosis does not exist. As a result, we will talk about which drugs ureaplasma bacteria are sensitive to.

Antibiotics against ureaplasma

All microorganisms are more or less "afraid" of antibiotics, 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 do not actually have any positive effect. The most effective are those antibiotics 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 in Doxycycline, Clarithromycin, and in case of detection of ureaplasma 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 there is a sensitivity of ureaplasma to them, which is determined during a microbiological study.

Indications for prescribing treatment

To prescribe antibiotic 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 reasons completely excluded.
• Repeated complications during pregnancy or recurrent miscarriage.

You need to know that if ureaplasma is detected, the prescribed treatment must be completed by both sexual partners, even if one of them has no signs of infection. In addition, it is recommended to use condoms during the entire treatment period to prevent cross-infection.

Drugs that affect ureaplasma

Among some doctors, there is an opinion that the growth of ureaplasma can be suppressed with a single dose of Azithromycin in an amount of 1 g. Indeed, in the instructions for the drug and in medical recommendations for the treatment of sexually transmitted infections, it is indicated that Azithromycin effectively affects non-gonococcal and chlamydial urethritis nature in men and chlamydial cervicitis in women. However, numerous studies have shown 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 eliminate the infection.

Doxycycline and its analogues - Vibramycin, Medomycin, Abadox, Biocyclind, Unidox Solutab - are among the recommended drugs for the treatment of ureaplasma infection. These drugs are convenient in that they need to be taken by mouth 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 twice the amount of the drug.

Most good results from taking Doxycycline were obtained in the treatment of infertility against the background of ureaplasmosis. After the treatment course, in 40-50% of cases, a long-awaited pregnancy occurred, which proceeded without complications and successfully ended in childbirth.

Despite such a high efficiency of the drug, some strains of ureaplasma remain insensitive to Doxycycline and its analogues. In addition, these drugs should not 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 from the digestive organs and skin.

In this regard, the doctor may use other medications, for example, from the group of macrolides, lincosamines or streptogramins. Clarithromycin (Klabaks, Klacid) and Josamycin (Vilprafen) have proven themselves best.

Clarithromycin does not adversely affect the gastrointestinal tract and therefore can be taken with or without food. Another advantage of the drug is its gradual accumulation in cells and tissues. Due to this, its action continues for some time after the end of the course of treatment, and the likelihood of re-activation of the infection is sharply reduced. 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 which case it is replaced by 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 acts depressingly 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 tableted agent is used, but a suspension for oral administration. After such treatment, the threat of termination of pregnancy, spontaneous abortions and cases of polyhydramnios are reduced by three times.

In cases where the development of ureaplasma inflammation in the urogenital tract occurred against the background of reduced immunity, antibacterial agents are combined with immunomodulatory drugs (Immunomax). Thus, there is an increase in the body's resistance and a faster destruction of the infection. Immunomax is prescribed according to the scheme simultaneously with antibiotics. A single dose of the drug is 200 IU, it is administered intramuscularly on the 1-3rd and 8-10th days of antibacterial treatment - a total of 6 injections per course. It is also possible to take tableted immunomodulating agents - Echinacea-Ratiopharm and Immunoplus. They have a similar effect, but are taken daily, 1 tablet during the entire course of antibacterial treatment. At the end of such a combined treatment, in almost 90% of cases, ureaplasma goes away forever.

Naturally, if, in addition to ureaplasma, another pathology of the genitourinary tract was found, then additional treatment may be required to eliminate concomitant diseases.

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 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 disruptions, malnutrition, frequent stress, hypothermia, the likelihood of ureaplasma activation increases with the development of symptoms characteristic of inflammation of the vagina or urethra.

The question is how to treat ureaplasma in women What antibiotics are used in the treatment of ureaplasmosis in women remains an urgent problem of modern practical medicine.
Treatment regimens are repeatedly reviewed at congresses and councils, which is due to the fact that ureaplasma is not a foreign microorganism to humans, and its presence in certain quantities is the norm.

Therefore, questions such as:

• In what cases is therapy necessary, and when it simply does not need to be applied?
• Which antibiotics and their combinations can be used, and which should not?
• What to do if ureaplasma has acquired resistance to the drug of choice?

It is necessary to prescribe therapy with a weighted analysis of the effectiveness and risk that accompanies treatment with any drug. Because sometimes the complications that are expected are more dangerous than the primary disease!

On this moment, the generally accepted method of drug therapy are antibiotics.

What is the main goal of treating ureaplasma in women:

1. Reducing the amount of ureaplasma
2. Elimination of clinical signs of inflammation
3. Elimination of laboratory signs of inflammation
4. Enhance immunity/

Treatment of ureaplasma is carried out using antibiotics, to which it is highly sensitive.

What antibiotics are used in the treatment of ureaplasmosis in women?

In this case, use rows of antibiotics:

1. Macrolides
2. Tetracyclines

Among macrolides The best therapeutic effect is observed in the following antibiotics:

1. Josamycin (Vilprafen Solutab)
2. Azithromycin
3. Erythromycin
4. Clarithromycin
5. Roxithromycin

It should be noted that josamycin has a beneficial effect on the microflora of the gastrointestinal tract, since it does not have a bactericidal property against enterobacteria!

Among tetracyclines:
1. Doxacycline (Unidox Solutab)
2. Doxycycline
3. Tetracycline/

Self-medication can lead to undesirable consequences! The dose, amount and term of application is determined solely by the doctor!

Usually, the effectiveness of treatment is about 85-90%. The duration of the course is approximately 2 weeks. The term of treatment is also fair for most antibiotics in the treatment of men from ureaplasma.

Supplement the main therapy using:

1. Local treatment (application of suppositories, etc.)
2. Physiotherapeutic procedures
3. Prevention of gastrointestinal disorders
4. Immunomodulation as needed
5. Treatment of comorbid chronic diseases
6. Use of enzymes to prevent adhesions

Like all microorganisms, ureaplasma can acquire drug resistance. The most often ineffective during the treatment of ureaplasmosis are such drugs:

1. Ciprofloxacin
2. Ofloxacin
3. Erythromycin

It is important to choose a drug for the treatment of ureplasma, since the use of many antibiotics at the same time is not always appropriate. It is necessary to avoid polypharmacy - the inappropriate prescription of drugs that are not needed for treatment.

Treatment should be administered with caution:
1. Pregnant women (assigned before pregnancy planning)
2. Women with a history of stillbirth, abortion, miscarriage
3. Women diagnosed with infertility
4. Debilitated patients with severe systemic infections

It should be remembered that in women, ureaplasmosis can be caused by two types of ureaplasma:
Ureplasma urealiticum
Ureaplasma parvum.

Parvum is a more pathogenic microorganism than urealiticum. Therefore, in its treatment, the doctor's tactics provide for a longer course of antibiotic therapy. An important part of the treatment regimen for ureaplasma in women is the timely prevention of complications. Complications from infection with ureaplasma parvum often lead to infertility!

It should be noted that before planning pregnancy, laboratory diagnostics should be carried out to detect ureaplasmosis, since if the disease is detected already during pregnancy, then many of the drugs cannot be used.

Antibiotics cause many malformations in the fetus, complicates the course of pregnancy!

Ureaplasma in women should be treated with joint treatment with a sexual partner. This is necessary for the following reasons:
1. Increases effectiveness from therapy
2. Prevents the possibility of re-infection.
3. Reduces the resistance of ureaplasmas to different types of antibiotics (one drug is used for both partners)

Among the bacteria that are the causative agents of sexually transmitted diseases, one of the most common gynecologists named ureaplasma. It belongs to the group of conditionally pathogenic microorganisms present in the natural microflora of the genitals, and the degree of its danger has not yet been determined. Is it necessary to start treatment if it was found in a woman, and how does she manifest herself?

What is ureaplasma

A genus of bacteria belonging to the family Mycoplasmataceae and the order of mycoplasmas (single-celled microorganisms that are the simplest of self-reproducing) - such a definition in official medicine is given to ureaplasma. A little over half a century ago (in 1954), the bacterium Ureaplasma urealyticum was isolated from a patient suffering from non-gonococcal urethritis (inflammation of the urethra). Some characteristics of this microorganism:

The disease that this microorganism causes is called "ureaplasmosis" (one of the varieties of mycoplasmosis). It was diagnosed in some women suffering from infertility and chronic problems of the urogenital area, but ureaplasmosis was not included in the current International Classification of Diseases (ICD-10). Manifestation pathological activity ureaplasma can lead to damage to the cervix, prostate, urethra (urethra), and may be accompanied by the following diseases:

• adnexitis (inflammatory process in the appendages);
• colpitis;
• cervicitis;
• cervical erosion;
• endometritis;
• pyelonephritis;
• vaginitis;
• gonorrhea;
• chlamydia.

The mechanism of the development of the disease

The pathogenesis of ureaplasmosis is based on adhesive-invasive properties (the ability to overcome the membrane barrier and attach or adhere to the surface) and enzyme-forming. Thanks to them, the bacterium that got into the urinary organs:

1. It clings to the cylindrical epithelium located on the mucous membrane (attached to its cells).
2. It merges with the cell membrane and due to this it gets the opportunity to penetrate into the cytoplasm: the internal liquid environment of the cell.
3. It begins the process of reproduction and production of an enzyme that has the ability to break down immunoglobulin A.

Against the background of what is happening (a decrease in the number of immunoglobulins of a specific group), the body's defenses are reduced, the immune response to the activity of infectious agents is weakening. If the activity of ureaplasma, which has received a pathogenic status, is low, the disease is asymptomatic, the inflammatory process is sluggish, destructive changes are minimal. With a high activity of the bacterium (against the background of concomitant factors), the symptoms of ureaplasmosis appear, because:

• increased tissue permeability;
• increased vascular response;
• epithelial cells begin to break down.

Is it necessary to treat ureaplasma

The hostility of a microorganism for a healthy person (when ureaplasma in women is opportunistic) in modern medicine continues to be discussed. Doctors detect the bacterium in 60% of adults who do not have pathological processes in the body, and in 30% of newborns, but it can be in a harmless state for years. If the microflora of the vagina and urinary tract is normal, this is a sufficient protective barrier to prevent inflammation. If symptoms of ureaplasmosis appear, it is necessary to take care of the issue of treatment.

Causes of manifestation

Like most other bacteria that are opportunistic in nature, ureaplasma is present among the natural microflora of the genital organs and urinary tract in 70% of women. Doctors diagnose it in every 3rd newborn and even in schoolgirls who are not sexually active (more than 20% of teenage girls), but it makes itself felt only in rare cases. The development of ureaplasmosis begins only against the background of the appearance of certain factors that turn a conditionally pathogenic microorganism into an infectious agent:

• Disorders of the hormonal balance are the primary cause of the development of ureaplasmosis in pregnant women entering the menopause who are taking hormone-based drugs. Not less than important point are diseases of the endocrine system, especially those associated with the functioning of the ovaries.
• Reduced immunity - both against the background of taking immunosuppressants (drugs that suppress the body's defenses: prescribed in the treatment of oncology), and against the background of infectious viral or bacterial diseases: influenza, SARS, etc.
• Vaginal dysbacteriosis - a violation of the natural microflora of the vagina, gynecologists associate mainly with hormonal imbalance, sexually transmitted infections, violation of the rules of intimate hygiene. This situation provokes the activity of all conditionally pathogenic microorganisms, therefore, candidiasis (thrush) may appear with ureaplasmosis.
• Invasive interventions - the danger is not only abortion (mainly the curettage procedure), but also the treatment and diagnostic manipulations of the gynecologist: ureteroscopy, hysteroscopy, cystoscopy, surgical intervention for cervical erosion.
• Frequent change of sexual partners - unprotected sex and the constant appearance of random sexual partners leads to the introduction of infectious agents into the vagina, which provokes the activation of ureaplasma and other opportunistic microorganisms against the background of general changes microflora.

Transmission routes

Ureaplasma in women is much more common than in men (they have a tendency to self-heal), so they are considered the main carriers of the infection. Sexual transmission leads among all transmission routes - among all infected, about 80% are people who have sexual contacts, especially without a permanent partner. The transmission of the causative agent of ureaplasmosis is possible both with unprotected vaginal intercourse and with oral intercourse. Bacteria are present:

• in women - in the secret of the cervical canal, vagina;
• in men - in the secret of the prostate, urethra, sperm.

Some doctors suggest the possibility of infection through household contact: through the patient's personal hygiene items, but the theory has not yet received proper confirmation. It is almost impossible to get infected in the bath, pool and other common areas. In addition, there are several other ways that are relevant for childhood infection:

• During childbirth, when passing through the birth canal - this is how small children become infected (30% of newborn girls get ureaplasmosis), even if the mother does not experience symptoms of ureaplasmosis.
• Through the amniotic fluid (intrauterine through the placenta) - bacteria will be found in the oral cavity, nasopharynx, conjunctiva. Infection mainly occurs in the 1st trimester of pregnancy, when the disease worsens in the mother.

Types of ureaplasma in women

There are several ways to classify this disease: according to the severity of manifestations, it is often divided into asymptomatic carriage and an active inflammatory process (typical of other forms). According to the duration, ureaplasmosis happens:

• Early - subdivided into sluggish (erased symptoms, can be observed in the incubation period - 2-4 weeks), acute (pronounced manifestations, may be accompanied by severe intoxication; lasts 1-2 months, damage mainly to the urinary system), subacute (transitional stage to chronic ).
• Chronic - appears 2 months later, after the development of any of the previous forms. The organs of the reproductive system may be affected. Mostly looks similar to carriage, but is periodically accompanied by relapses, manifesting themselves as an acute form. Stress factors are often the catalyst.

Carrying

The most common option is when ureaplasma in women is present in the body, but does not manifest itself at all. Carriage in the absence of risk factors may never make itself felt, as in the latent (hidden) course of the disease, but the bacterium is transmitted to the sexual partner. As soon as immunity decreases, a stressful situation occurs, the hormonal background is shaken, a woman may experience erased symptoms (rare mucous discharge, vaginal itching), but the general condition will remain normal, and the described manifestations will quickly disappear on their own.

Acute ureaplasmosis

If sexually transmitted infection occurs, after incubation period the acute stage of the infection will manifest itself, which, according to the clinical picture, is similar to the manifestations of other sexually transmitted diseases. May be tormented by frequent urge to urinate (the process is uncomfortable), pain in the lower abdomen, discomfort during sexual contact, a slight rise in temperature. Symptoms persist for no longer than 2 months.

Chronic

Symptoms at this stage may be absent, but if the bacterium is not active during the carriage, then during the chronic course of the disease, its pathological vital activity is hidden. The transition from acute to chronic takes 1.5-2 months. Periodically, a woman may experience relapses, or develop complications on the organs of the urinary system, as a result of which there will be:

• mucous discharge mixed with bloody;
• pain in the lower abdomen, radiating to the lower back;
• symptoms of cystitis (urinary disorders with inflammation of the bladder).

Symptoms and signs of the disease

How the activated ureaplasma in women will manifest itself depends on several points: the general condition of the body, the presence of additional diseases (especially sexually transmitted diseases - diseases that provoke chlamydia, gonococcus, and other bacteria), and even the infection path. So in women who got the disease during oral sex, there will be signs of tonsillitis, pharyngitis. Mostly the symptoms are:

• vaginal discharge (from weak clear to cloudy yellowish and even bloody);
• discomfort or pain during urination and increased urge to urinate;
• cutting pains in the lower abdomen (if endometritis, adnexitis are attached);
• vaginal pain during intercourse;
• weakness, increased fatigue;
• subfebrile temperature.

The main symptoms of ureaplasma in women are similar to those that appear during other inflammatory diseases of the genitourinary system, which complicates the process of self-diagnosis at home. If the transmission of a pathogenic microorganism occurred during intercourse, the symptoms will begin to appear after 2-4 weeks (incubation period), but often (more than 70% of cases) even the disease that has begun in a woman does not make itself felt.

What is dangerous ureaplasmosis in women

The mere presence of an opportunistic bacterium in the body is not a cause for concern, but microorganisms that have settled on the walls of the vagina, uterus, and bladder can be activated at any time when one of the factors described above appears. The result will be the development of the disease, which, in the absence of timely and proper treatment develop into a chronic form. Relapses will begin against the background of:

• colds;
• hypothermia;
• third-party inflammatory processes;
• stressful situations;
• active alcohol consumption;
• heavy physical exertion;
• other reasons for the decrease in immunity.

The main consequence is a general deterioration in the condition of a woman, against which the body temperature may rise, but ureaplasmosis becomes dangerous not because of this. Against the background of a chronic inflammatory process caused by ureaplasmas, concomitant diseases and pathologies develop in the body (mainly in the reproductive system and urinary system):

• inflammation in the kidneys (pyelonephritis);
• pain during intercourse;
• inflammation in the bladder (cystitis);
• the formation of adhesions in the fallopian tubes;
• inflammatory processes in the joints;
• narrowing of the urethra (urethra);
• inflammatory process on the walls of the uterus (endometritis), in the appendages or in other parts of it;
• the appearance of stones in the kidneys or bladder;
• inflammation of the vagina (colpitis);
• violation of the menstrual cycle;
• infertility (due to a permanent inflammatory process, it is equally possible in women and men - the latter get an infection during intercourse from a sick woman).

Ureaplasma infection during pregnancy

A woman who plans to have a baby is advised by gynecologists to be sure to undergo an examination for the presence of ureplasma, since during pregnancy the risk of its activation is especially high. Even a small amount of these bacteria, which are in a conditionally pathogenic state, can lead to the development of ureaplasmosis - due to hormonal fluctuations, a natural decrease in immunity. There are several reasons for examination and treatment before pregnancy:

• In the 1st trimester, it is forbidden to use antibiotics (they are the only strong medicine against ureaplasma), since such therapy will negatively affect the development of the fetus. As a result, the active development of the disease will begin, which is especially dangerous for the baby directly in the first weeks - from the 2nd trimester he is less vulnerable.
• Severe inflammation associated with autoimmune processes in the endometrium can cause primary placental and secondary placental insufficiency: conditions in which morphological and functional disorders occur in the placenta. The result is problems in the development of the fetus (with an increased risk of anomalies), up to the appearance of diseases in the perinatal period.
• The most terrible consequence of ureaplasmosis in a woman carrying a child at any time is not only premature birth, but also abortion due to miscarriage.

Diagnosis and identification of the pathogen

Doctors say that the diagnosis is not made on the basis of the presence of ureaplasma in the body - the more important point is the number of these microorganisms and the mass character of their spread throughout the organs of the genitourinary system. The symptoms that the patient complains about are necessarily taken into account, but the basis is laboratory and instrumental diagnostic methods. A comprehensive check, especially in the presence of concomitant diseases, includes:

• Bakposev on ureaplasma (cultural study) - sowing biomaterial (for women, a smear and vaginal discharge are used) on a nutrient medium, as a result of which bacterial colonies can be isolated and their resistance to specific antibiotics can be determined.
• PCR diagnostics (polymerase chain reaction) - helps to track the DNA molecules of the infection present in the body. It is carried out through taking a smear. Such an analysis is highly accurate; after the end of treatment, after 3 weeks, it can be re-appointed to check the quality of the therapeutic measures taken.
• Serological examination - is considered the most significant for women suffering from infertility, or having diseases that are on the list of potential complications of ureaplasmosis. It is an ELISA (enzymatic immunoassay) and RIF (immunofluorescence reaction) tests. They are aimed at identifying antigens to the cellular composition of the walls of a given bacterium; a smear is taken for their implementation.

The scheme of treatment of ureaplasma in women

According to official medical statistics, when diagnosing ureaplasma in women, it is found along with mycoplasma and chlamydia, so several types of antibiotics are included in the treatment regimen. Specific therapeutic methods should be selected by the doctor, but an approximate course is as follows:

1. Impact on the pathogen - this is done by antibiotics, selected for a specific microorganism through bakposev.
2. Elimination of concomitant diseases of the genitourinary system (groups of drugs and procedures depend on the specific problem).
3. Local infection control with suppositories that have antiseptic or antibacterial properties.
4. Restoration of the bacterial microflora of the intestine and vagina after antibiotic treatment (probiotics are used, mainly on lactobacilli).
5. Strengthening immunity with the help of immunostimulants / immunomodulators, vitamin and mineral complexes.
6. Repeated tests after 2-3 weeks to check the effectiveness of treatment.

In addition, a diet that is relevant for all stages of treatment is necessarily added here: fatty foods, salty, spicy foods are excluded. A woman is recommended to limit sexual contacts, if necessary, to sanitize the vagina. In some situations, doctors advise undergoing a course of physiotherapy, which eliminates unpleasant symptoms and improves the penetration of drugs locally.

Etiotropic antibiotic therapy

Drugs that help stop the reproduction of a pathogenic microorganism and kill it are selected during a diagnostic examination, which helps to establish the sensitivity of ureaplasma to specific antibacterial substances. Self-administration of such drugs is unacceptable! Treatment lasts 1-2 weeks. The following groups of antibiotics can affect ureaplasmosis:

• Macrolides (Josamycin, Midecamycin, Clarithromycin, Azithromycin) are relatively safe, can be used in pregnant women from the 2nd trimester, and have a minimal number of side effects.
• Tetracycline series (Unidox, Doxycycline) - prohibited for pregnant women. Ureaplasmas are insensitive to tetracycline in 10% of cases, therefore it is referred to as reserve substances.
• Fluoroquinolones (Ofloxacin, Ciprofloxacin, Ciprolet) are not recommended during pregnancy, pathologies of cerebral vessels. Additionally, the fluoroquinolone series increases the sensitivity of the skin to UV rays, so sunbathing during treatment is prohibited.
• Aminoglycosides (Neomycin, Spectinomycin) - rarely prescribed, but they work at all phases of bacterial development, they are effective even in severe forms of the disease.
• Lincosamines (Dalacin, Clindamycin) - are effective against mycoplasma, are related to macrolides in principle of action, activate the mechanisms of nonspecific protection of the microorganism.
• Probiotics - some of them (Bifidumbacterin, Linex) have activity against pathogens, but the main purpose of their appointment is the normalization of microflora. The pluses include the safety of use in pregnant women.

Candles from ureaplasma in women

Doctors advise to act on pathogenic microorganisms from all sides, so the local use of antiseptic and bacterial agents, presented in suppository format, is not superfluous. They can have a vaginal or rectal appointment and, in addition to influencing the pathogen, have a symptomatic effect: they eliminate pain, itching, burning, and minimize inflammation. Mainly appointed:

• Genferon - are an antibacterial and antiviral agent, have an analgesic effect, stimulate local immunity. Composition combined (interferon, taurine, benzocaine), works systemically. Suppositories are applied vaginally 2 times / day, the course of treatment is 10 days (chronic forms of the disease - 1-3 months, but use every other day).
• Hexicon - are prescribed for a weekly course, allowed during pregnancy. Used 1 time / day, vaginally. They work on chlorhexidine, so they only have an antiseptic effect. They do not have a systemic effect, they are not used alone.

Immunotherapy

Drugs that increase the body's defenses have almost no effect on pathogenic microorganisms, but without them, firstly, even after a complete cure, a new infection is possible. Secondly, they help speed up the healing process, as they set up the body to fight on its own. For this purpose use:

• Immunostimulants - give a “push” to immunity, help to more actively develop protective cellular links. They can be stimulators of nonspecific resistance of the body (Methyluracil), humoral immune responses (Myelopid), cellular immunity (Timoptin, Timalin). They can be of plant and synthetic origin. The safest for pregnant women include Lysozyme, which has an additional antibacterial quality.
• Immunomodulators (Wobenzym, Cycloferon) - are of high importance in autoimmune diseases, correct the defense system. The function of immunomodulators is performed by probiotics, cytostatics, anti-Rhesus immunoglobulins, hormonal agents, and even some antibiotics (cyclosporine, rapamycin).

Taking vitamins and probiotics

Both during etiotropic treatment and after, it is required to restore the microflora of the vagina (with prolonged use of antibiotics - and intestines) and drink a course of restorative vitamin-mineral complexes. Probiotics are applied internally and externally, which will help to completely suppress the pathological activity of bacteria. Doctors advise using the following drugs:

• To eliminate intestinal dysbacteriosis - Linex, Bacteriobalance, Bifikol: contain lactobacilli and bifidobacteria.
• Local vaginal probiotics - Vagisan, Gynoflor, Vagilak, Bifidumbacterin.
• Vitamin-mineral complexes - Alphabet, Solutab, Biovitrum, Complivit (it is advisable to select with a doctor, based on the deficiency of specific elements).

Sanitation of the vagina

Treatment of ureaplasma in women necessarily involves antiseptic treatment of the vaginal mucosa (sanation), which is carried out using any local means that have this property. The technique makes sense both during treatment and for the prevention of re-infection. For rehabilitation use:

• ointments;
• vaginal tablets;
• suppositories;
• solutions.

If the procedure is carried out in a clinic, a vacuum method or ultrasound can be used. At home, sanitation is carried out after washing the genitals, the course of treatment lasts 2 weeks. Every day, a woman injects 10 ml of chlorhexidine into the vagina, lying on her back and slightly raising her pelvis. After the procedure, you can not wash yourself, you should refrain from urinating for 2.5 hours.

Physiotherapy procedures

The most useful of all physical therapy options (prescribed for sexually transmitted diseases), doctors call electrophoresis: it helps to deliver drugs faster and more reliably locally. It is especially valuable in a chronic inflammatory process. Additionally, the following may be recommended:

• Magnetotherapy - can also involve the introduction of drugs, is the effect on the genitals of a magnetic field.
• Laser irradiation - exposure to the urethra with a special laser to relieve pain, stop inflammation, stimulate local immunity.
• Exposure to dry heat - has an analgesic effect, enhances lymph flow, especially useful when cystitis is attached. With exacerbation, this technique is not used.

Prevention and prognosis

With timely and correctly carried out etiotropic treatment, it is possible to completely destroy the pathogen, but re-infection of the woman is not excluded. Due to the nature of the transmission of infection, a reliable way to protect against it (mainly from an increase in the number of bacteria in the vagina and changes in its microflora) is the use of a condom during intercourse, including oral. Additionally, it is desirable to avoid frequent changes of sexual partners and:

• after casual intercourse, use local antiseptics (Chlorhexidine, Miramistin);
• monitor immunity (periodically take courses of immunostimulants);
• observe the rules of personal hygiene;
• undergo a preventive examination by a gynecologist annually;
• timely treat diseases of the genitourinary system.

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Ureaplasmosis is a bacterial disease that affects the organs of the urinary and reproductive systems. The pathogen is transmitted in more than 90% of cases through unprotected sexual contact. Transplacental infection or infection of the child during passage through the birth canal is also possible.

The disease is caused by ureaplasmas. These are opportunistic microorganisms from the class of mycobacteria, they lack their own DNA and cell wall. Conditional pathogenicity means its usual presence in the body, but under certain conditions, the bacterium begins to actively multiply, then ureaplasmosis develops. The normal functioning and reproduction of ureaplasma is possible only in the presence of urea, therefore, mycobacteria live in the main organs of the urinary system. It is necessary to treat ureaplasmosis only when there are clinical and labo

Attention! Ureaplasmas are so primitively arranged that they are often considered as a transitional stage between bacteria and viruses.

Ureaplasmosis can cause whole line various unpleasant symptoms and can lead to the development of secondary pathologies of the genitourinary system. That is why it is necessary to detect this disease in a timely manner and carry out the correct treatment.

Pathology can have both pronounced symptoms and proceed hidden. With a latent form of ureaplasmosis, women are not worried about any signs of the development of pathogens in the body. In rare cases, there are more abundant than usual discharge from the genital tract.

When the immune system is suppressed due to previous diseases or during pregnancy, a woman begins to show characteristic symptoms of pathology:

1. Burning and itching in the vagina and urethra. Unpleasant sensations intensify during and after urination.
2. Urine color change. With the development of an inflammatory process in the urinary tract, the urine becomes darker, it contains mucus or curdled sediment.
3. Pain in the lower abdomen. A similar symptom indicates the appearance of a secondary infection in the organs of the reproductive system.
4. Pain during intercourse.
5. Hyperemia and swelling of the mucous membrane of the external opening of the urethra, mucous membrane of the vagina and cervix, infiltration of the walls of the urethra, mucopurulent discharge from the urethra and in the lateral, posterior fornix of the vagina, from the cervical canal.

Attention! According to modern research, a relationship is found between ureaplasmosis and disruption of the reproductive system, miscarriages and infertility in women.

Therapy for ureaplasmosis in women

With ureaplasmosis, conservative, that is, medical, treatment is carried out. Its goal is the complete elimination of the inflammatory process in the body of a woman. In the chronic form of the disease, therapy is aimed at the maximum possible reduction in the number of mycobacteria and the prevention of relapse.

Attention! The treatment regimen is selected by a specialist individually for each patient, depending on the nature of the disease and the degree of its manifestations.

Therapy of ureaplasmosis includes several mandatory conditions:

1. Taking a course of antibacterial drugs aimed at the destruction of mycobacteria.
2. The use of funds to normalize the functioning of the immune system and the microflora of the reproductive system and the gastrointestinal tract.
3. During the course of treatment, you should refrain from sexual intercourse.
4. Therapy of ureaplasmosis should be carried out by the patient herself and all her sexual partners.
5. The patient must stop drinking alcohol and smoking.
6. A woman should follow a diet that excludes fatty, salty and spicy foods.

Attention! If any doctor's recommendations are not followed, the treatment may be ineffective, which is why ureaplasmosis will take a chronic course. This form of the disease is very difficult to treat.

Antibacterial drugs for ureaplasmosis

The use of antibacterial drugs is a mandatory measure for the activation of mycobacteria. Before starting therapy, it is necessary to take tests to make sure that the pathogen is sensitive to these drugs.

Since ureaplasmas are considered an intermediate link between bacteria and viruses, they are difficult to treat with antibiotics. To destroy the microorganism, it is necessary to undergo a sufficiently long therapeutic course, which is at least 10 days. Depending on the severity of the pathological process, the doctor prescribes the drug to the patient in tablets or in the form of intramuscular injections. Intravenous injections are indicated only for patients with a generalized form of pathology that occurs in women with extremely low immunity.

Attention! The scheme of therapy and dosage of drugs is determined by a specialist after the necessary diagnostic measures have been taken.

In the treatment of ureaplasmosis, the following types of antibacterial drugs are used:

Auxiliary drugs for ureaplasmosis

In most cases, ureaplasmosis develops in women whose immunity is extremely weakened. To normalize the functioning of the immune system, patients are prescribed a number of different drugs.

During therapy with antibacterial agents, it is necessary to take multivitamin complexes. They help strengthen the body and stop a number of side effects that affect the patient due to taking antimicrobials:

• hair loss;
• fragility of nails;
• acne, skin rash;
• nausea and dyspeptic symptoms: abdominal pain, flatulence, diarrhea.

Antibacterial therapy leads to the almost complete destruction of the microflora in the genital tract of a woman and her gastrointestinal tract. Under such conditions, a favorable environment is created in the patient's body for the development of various fungal diseases. To prevent such complications, as part of complex therapy, Nystatin, Fluconazole etc.

To normalize the immune system, it is necessary to use immunomodulators. These are synthetic drugs that are used to increase the body's resistance to various infections. In most cases, such therapy is needed in the treatment of chronic ureaplasmosis or the addition of a secondary infection. The most commonly used for this pathology Cycloferon, Taktivin or Timalin. Often, the use of such drugs allows to achieve a long-term remission of the disease.

To normalize the microflora, a woman is recommended to take medications containing bifido- and lactobacilli. They allow you to populate the genital tract and gastrointestinal tract of the patient with beneficial microorganisms after the use of antibiotics. Most often used in ureaplasmosis Bifidumbacterin, Laktonorm, Lactobacterin etc.

Video - Treatment of ureaplasmosis

Therapy of ureaplasmosis during pregnancy

During gestation, a woman's immune system is weakened. In addition, during pregnancy, the microflora of the genital tract changes, which increases the risk of penetration into the body of the pathogen or exacerbation of a chronic process.

Attention! During pregnancy, it is necessary to visit a doctor in a timely manner and regularly take tests for the presence of sexually transmitted infections.

If the disease is detected in early stages development, then in more than 90% of cases, therapy is successful and does not lead to complications. Treatment begins only from the fourth month of gestation, since during this period the chorionic membranes are already formed in the fetus, which protect it from the effects of antibacterial drugs. If the therapy is early dates gestation, then there is a high probability of developing congenital pathologies of the embryo or miscarriage. Used in the treatment of pregnant women Josamycin.

Prevention of ureaplasmosis in women

In order to prevent the development of an infectious process in a woman's body, a number of preventive measures must be observed:

1. News healthy lifestyle life, eat well and eat right, play sports.
2. Use barrier contraception during intercourse.
3. Regularly take a smear for the presence of infections of the genitourinary system.
4. Carefully follow the rules of personal hygiene, do not share towels, razors, etc. with anyone.
5. Monitor the state of your immune system, treat infectious diseases, and prevent exacerbations of chronic pathologies.

Ureaplasmosis is a pathological condition of the genitourinary system caused by the development of mycobacterium ureaplasma. In order to prevent the development of various complications in a woman's body, it is necessary to diagnose this disorder in a timely manner and carry out complex therapeutic measures. study the link.

Video - How to treat ureaplasma in women quickly and safely

Ureaplasma or otherwise ureaplasmosis is an infectious pathology of the genitourinary system with mild symptoms, more typical for women. Consider the main methods of its treatment with drugs, causes and complications and consequences if the disease is not treated.

The occurrence of ureaplasma is the most common inflammatory pathology affecting the urinary and reproductive systems of women. One of the features of the disease is the prolonged secrecy of symptoms, while the pathological process is gaining momentum.

The causative agent that causes ureaplasma is small bacteria Ureaplasma urealyticum transmitted through sexual contact. Such microorganisms do not have cell walls, which is why they do not have the ability to break down urea. Ureaplasmosis affects the urethra (urethra) and cervix, ureaplasmosis in men most often leads to damage to the prostate gland and prostatitis. To treat the disease, antibacterial drugs prescribed by a specialist are used.

Causes of ureaplasma

Factors causing the occurrence of ureaplasmosis are mainly conditions reduced immunity. After penetration into the female body, usually after sexual contact, the infection encounters an immune barrier in its path. If the immune system is weakened, then the microorganism does not die and begins to develop. In addition to sexual, ureaplasma is transmitted during childbirth, when the baby becomes infected from the mother.

ABOUT domestic way Infection among physicians opinions were divided. Some believe that the household and airborne route transmits ureaplasmosis, while others exclude such a route of infection. In most cases, a minimum amount of ureaplasma is present in the body of many women. There are no symptoms and no treatment is required. This continues until the disease is under the control of the defense system. At such moments, the population of microorganisms increases dramatically, which leads to the activation of the inflammatory process.

Types of ureaplasma

In order to determine exactly what treatment a woman needs and what drugs to use, it is important to establish the existence of comorbidities, such as endometritis, urethritis and others, as well as the type of ureaplasma. The disease happens:

• Early, within this classification there is an additional division into sluggish, subacute and acute forms of ureaplasmosis. This type of disease is characterized by severe symptoms.
• Chronic when no symptoms are observed. Ureaplasma in women quickly passes into the chronic stage, usually this occurs 60-80 days after the infection has been received and developed inside the body.

Ureaplasmosis has an incubation period of 20-35 days, after which the disease becomes chronic with periodic relapses, or progresses to an acute form. Physiologically, the body in women is more adapted for the survival of such bacteria, so they are the main carriers.

Symptoms and first signs

Ureaplasma is characterized by the first signs by which a woman can detect it:

• Presence of burning sensation in painful urination
• Presence of unnatural vaginal discharge
• Scanty bloody discharge after sex
• Pain in the lower abdomen
• Painful intercourse
• Never coming conception

The first signs are quite are common, they are also characteristic of other diseases of the female genitourinary system, therefore, if they are detected, it is necessary to contact a gynecologist for examination, diagnosis and treatment.

If ureaplasmosis is confirmed and the infection continues to develop in the body, then more pronounced symptoms occur. However, their appearance does not occur immediately, usually not earlier than 2-4 weeks from the moment of infection. Often, even after the incubation period, the ureaplasma does not noticeably manifest itself, continuing to develop. This will result in chronic form.

We list the main symptoms of ureaplasma in women:

1. Vaginal discharge, are characterized by a transparent color and no odor. With the activation of the inflammatory reaction, the shade changes not yellowish with a characteristic odor
2. Pain at the bottom of the abdomen. By nature, they resemble pain, they appear due to the occurrence of inflammation in the uterine cavity and appendages.
3. Frequent urge to urinate. characteristic symptom for many urinary disorders. The feeling of pain during the emptying process, localized in the urethra, should alert.
4. Feeling of discomfort and pain during intercourse and some period later.

A serious problem is the course of ureaplasmosis without symptoms. The disease must be treated, but the woman does not even know about its existence. Therefore, all the fair sex should carefully monitor their feelings and respond to them in time.

Pregnancy with ureaplasma

Pregnancy planning is a serious process, examination for ureaplasmosis is an important stage:

• The existence of even a small amount of the pathogen in the genitourinary system in women will lead to an increase in their population during pregnancy, since gestation is inevitably associated with a weakening of female immunity.
• Ureaplasma is treated with strong drugs, such as antibiotics. This has a serious effect on the fetus, so it is best to avoid unnecessary therapy during pregnancy and take it before conception.

Treatment of ureaplasma in women

Below we will understand how and what should be treated for ureaplasmosis. To begin with, we must mention the special sparing diet, excluding spicy, salty, fatty, alcoholic drinks . Another important principle in treatment is abstinence from sexual relations. It is important for a woman's sexual partners to conduct a diagnosis, since the pathogen must have entered their body.

Usually, a woman is diagnosed with a chronic form, her treatment follows the patterns characteristic of other diseases of the reproductive system. The emphasis in therapy falls on the intake of immunostimulating and strong drugs against microflora - antibiotics.

The most characteristic agents are tetracycline antibiotics, macrolides, fluoroquinolones in tablet form. Medicines are prescribed only by a doctor, the intake is carried out in a course lasting 1-1.5 weeks.

Usually therapy begins with drugs against chlamydia, gonorrhea and other sexually transmitted infections. Treatment is Midecamycin or Josamicin, which are well tolerated and minimal side effects. The active substances, localized in the cell membranes, affect the infectious microenvironment. It is recommended to complete the course of therapy with drugs that normalize the intestinal microflora, for example, Befidumbacterin, Bificol, etc.

The greatest efficiency is achieved with parallel local treatment. For it apply rectal and vaginal suppositories:

• Candles Genferon achieve antiviral effects, as well as the activation of the immune forces of the woman's body. The usual course lasts 10 days, two candles each. In situations of chronic course, longer therapy is carried out.
• Hexicon vaginal suppositories contain an antiseptic that actively destroys ureaplasma, but does not affect the vaginal flora. To effectively suppress bacteria, one suppository should be used for seven days.

If ureaplasmol is not treated, then it is fraught with various complications. A woman often has no symptoms, but the disease gradually leads to:

1. infertility
2. Cystitis (inflammation in the bladder)
3. Pyelonephritis, if ureaplasma moves up the urinary tract
4. Vaginosis, in which the bacterial flora of the vagina is disturbed
5. Violations of the timing of menstruation
6. Inflammatory reaction in the ovaries