Urogenital Trichomoniasis In Men: Causative Agent, Diagnosis And Treatment

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Urogenital Trichomoniasis In Men: Causative Agent, Diagnosis And Treatment
Urogenital Trichomoniasis In Men: Causative Agent, Diagnosis And Treatment

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Video: What is trichomoniasis? | Infectious diseases | NCLEX-RN | Khan Academy 2023, February
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  • Features of the development of inflammation, the causative agent of urogenital trichomoniasis
  • How does infection occur
  • Where Trichomonas lives in the body
  • Diagnostics
  • Symptoms of Trichomonas lesion
  • Danger to pregnant women
  • The clinical picture of trichomoniasis in men
  • Trichomoniasis treatment
  • You can defeat parasites!

Among diseases of the human genitourinary system, a special group is made up of pathologies in which microbes enter the body through sexual contact.

Such a problem includes urogenital trichomoniasis, an inflammatory disease is often accompanied by the identification of causative agents of other types of genital infections. The signs of pathology, as well as the tactics of treating women and men, have some differences.

What to do in such a situation? To get started, we recommend reading this article. This article details the methods of dealing with parasites. We also recommend contacting a specialist. Read the article >>>

Features of the development of inflammation, the causative agent of urogenital trichomoniasis

The causative agent of trichomoniasis as a sexually transmitted infection (STI) is the simplest microorganism - Trichomonas vaginalis. The problem of trichomoniasis is in first place in terms of the frequency of diagnosis, and 40-50% of people suffering from mixed urogenital pathologies become carriers.

Trichomonas in women: symptoms, causes and methods of treatment
Trichomonas in women: symptoms, causes and methods of treatment
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Trichomonas

Due to the minimum of clinical manifestations, Trichomonas is often detected only during routine examinations. Moreover, when diagnosing one type of ailment, one can expect the identification of pathogens of other types of genital infections.

The predominance of symptoms of a sluggish form of urogenital trichomoniasis, the latent carriage of the parasite leads to the development of a prolonged inflammatory process, which is not seasonal.

How does infection occur

A single-celled microorganism has a pear-shaped shape and dimensions of 8-24 mm, thanks to the flagella and a unique membrane, it is able to actively move and parasitize on the relief of the epithelial layer.

Once in the urethra and cervical canal, Trichomonas colonize the mucous membrane, are found in the connective tissues, which leads to inflammation of the gonads.

The following routes of infection with urogenital trichomoniasis have been established:

  • Sexual contact of any kind (genital, oral, anal), infection is possible even if the hymen is preserved.
  • Infection through household items contaminated with Trichomonas (towels, shower handles, toilet lid, etc.).
  • Transmission of the pathogen to the fetus from an infected mother during labor (infected tissue of the birth canal).

Observing the usual rules of hygiene, it is impossible to get infected in public places, since Trichomonas vaginalis dies outside the body of an infected person.

How does infection occur
How does infection occur
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The active process of reproduction of the causative agent of urogenital trichomoniasis poisons the carrier of the infection with toxins, reducing his immune defense.

The ability of the vaginal Trichomonas to absorb other microorganisms turns into epithelial dysplasia, the development of extensive inflammation with hemorrhages and damage to smooth muscles.

Basically, infection with trichomoniasis occurs through sexual contact! Use condoms to protect you from unwanted diseases!

Classification of pathology by type of manifestation:

  1. The fresh form of the disease can proceed acutely, develop in a low-symptom or subacute type, if 1-2 months have passed since the onset of infection.
  2. Chronic urogenital pathology develops 2 months after infection, proceeds with scant symptoms, but with exacerbations.
  3. In the absence of symptoms, but traces of the parasite in the discharge (vagina) or smears (urethra), trichomoniasis is classified as a latent type (carriage).

Treatment of symptoms of urogenital pathology is prescribed depending on the form of its development, as well as the characteristics of its manifestation. An important condition for the effectiveness of the treatment process is the simultaneous therapy of all sexual partners.

Where Trichomonas lives in the body

From the urethra, the causative agent of the disease can penetrate into the epididymis, the prostate gland. Some researchers reported in the results of their observations about the detection of Trichomonas in the blood and human organs.

They noted that microorganisms can be interstitial parasites. However, this idea has not received universal confirmation and requires rechecking.

The clinical picture of trichomoniasis lesions is nonspecific. The manifestations of urethritis are the same for different types of pathogen (gonococci, chlamydia, trichomonads).

Diagnostics

As a rule, the primary diagnosis of urogenital trichomoniasis occurs during examination by a gynecologist.

The specialist notes:

  • swelling and redness of the vagina and vulva;
  • severe swelling in the cervical region;
  • dysplasia of epithelial cells.

In order to finally confirm the diagnosis, the doctor prescribes microscopic or microbiological diagnostic methods. Biological material for analysis is taken from the posterior fornix, the walls of the vagina or the urethral canal.

Diagnostics
Diagnostics
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During treatment, special drugs are used that have a detrimental effect on urogenital Trichomonas.

In addition, the specialist prescribes antibiotics, antifungal, antiviral and immunostimulating drugs, vitamin complexes, suppositories and gels, as well as physiotherapy.

After recovering from this disease, each person should understand that re-infection with this infection can recur again, since the body is not able to develop immunity to it.

As a preventive measure, experts strongly recommend using a condom during intercourse, carefully selecting a candidate for a partner's place and not having casual relationships.

If this happened, then immediately after sexual contact, you need to use a special antiseptic that will help avoid infection with the parasite.

Symptoms of Trichomonas lesion

Female trichomoniasis is often more pronounced than male trichomoniasis.

This feature of the development of infection is associated with the fact that men are often only carriers of this disease.

Trichomoniasis in women can cause any of the following symptoms:

  • Abnormal vaginal discharge, which can be profuse, slight or frothy, and most importantly, the discharge will have a yellow-green color;
  • conditionally pathogenic flora, including gardnerella, begins to dominate in the vagina, which leads to the appearance or intensification of a fishy smell;
  • soreness, inflammation, swelling and itching around the vagina, sometimes the discomfort extends to the inner thighs;
  • pain or discomfort when urinating;
  • dyspareunia - pain during intercourse;
  • pain in the lower abdomen.

Genitourinary trichomoniasis in men is less severe, but can still cause any of the following symptoms:

  1. Pain during urination or ejaculation.
  2. Frequent urination.
  3. Discharge from the glans penis in the form of white mucus.
  4. Soreness, swelling and redness around the glans penis or along the contour of the foreskin.

For men, trichomoniasis is terrible because the infection spreads ascending to the prostate and testicles, causing prostatitis and epididymitis.

Danger to pregnant women

The onset of a disease during this period may be a sign of primary infection or exacerbation of an already existing chronic form. Most often, inflammation is widespread: the urethra, bladder, vagina, rectum are affected.

Changes in the body of a pregnant woman are aimed at preserving the developing fetus. When Trichomonas penetrates, the immune system triggers a phagocytic response.

Defense mechanisms begin to work from the moment of conception and become more perfect as the unborn child grows.

The likelihood of infection depends on the length of pregnancy In the early stages, cervical mucus thickens, which creates an obstacle to the entry of pathogenic microorganisms. In the later stages, infection of the fetus is prevented by the amniotic membranes. Infection in the first weeks of pregnancy contributes to endometrial inflammation and spontaneous abortion.

Danger to pregnant women
Danger to pregnant women
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The clinical picture of trichomoniasis in men

Genitourinary trichomoniasis in men develops like gonorrheal urethritis, but with weak signs of trichomonas invasion. Having occupied the surface of the internal mucous membranes, the pathogen actively moves along the urethra.

After a while, the parasite can be found in the tissues of the prostate gland, as well as in the bladder, it populates the epididymis, vesicles of the seminal glands.

Trichomonas colonizes the genitourinary organs, causing malfunctions in reproductive capacity, manifesting itself with acute symptoms of a fresh form:

  • With moderate foamy discharge, they intensify after light pressure on the glans.
  • In addition to problems with urination, itching appears, a red border around the outer part of the urethra.
  • Symptoms of inflammation affect the head of the penis (balanoposthitis), and discomfort also accompanies intercourse.

In a small number of patients (10-12%), there may be an acute progression of the disease with abundant discharge with pus against the background of cuts during urination. Most of the sick men, STIs are not worried about the characteristic signs.

Therapy of urogenital ailment begins when its complications are found - prostatitis, vesiculitis, epididymitis (30-50% of patients) with appropriate symptoms.

Trichomoniasis treatment

The only class of drugs recommended for the treatment of urogenital trichomoniasis is 5-nitroimidazoles, to which most strains of T. vaginalis are susceptible.

In randomized controlled trials, it has been shown that the recommended regimens of metronidazole administration allow achieving clinical recovery and eradication of the pathogen in 90% –95% of patients, and tinidazole administration - in 86–100% of patients.

To avoid the development of severe adverse reactions (disulfiram-like reaction), patients should be warned about the need to avoid alcohol and alcohol-containing products both during therapy with metronidazole and tinidazole and within 24 hours after its termination.

The doctor should recommend that the patient refrain from sexual intercourse or use barrier methods of contraception until cure is established during the period of treatment and dispensary observation.

Indications for inpatient treatment:

Recommended treatment regimens:

  • metronidazole 500 mg
  • ornidazole 500 mg
  • tinidazole 500 mg
Metronidazole
Metronidazole
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Metronidazole

Alternative treatment regimens:

  • metronidazole 2.0 g
  • ornidazole 1.5 g
  • tinidazole 2.0 g

Treatment of complicated and recurrent trichomoniasis:

  • metronidazole 500 mg
  • ornidazole 500 mg
  • tinidazole 2.0 g
Tinidazole
Tinidazole
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Tinidazole

In the treatment of complicated forms of trichomoniasis, the simultaneous use of local and systemic drugs is possible:

  • metronidazole vaginal tablet 500 mg
  • metronidazole, gel 0.75% 5 g intravaginally

Treatment of pregnant women with urogenital trichomoniasis is carried out no earlier than the second trimester of pregnancy according to the scheme:

  • metronidazole 2.0 g
  • metronidazole 10 mg per kg of body weight
  • ornidazole 25 mg per kg of body weight

Requirements for treatment results:

  • eradication of T. vaginalis;
  • absence of complaints and manifestations of the disease.

The cure is established by the method of microscopy of the native preparation, or by the culture method, not earlier than 14 days after treatment. A PCR study is carried out no earlier than 1 month after therapy. If the causative agent of trichomoniasis has not been identified, then there is no need for further observation.

Tactics in the absence of treatment effect:

  • exclusion of re-infection;
  • the appointment of another drug and according to a different scheme.

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