The author - Sozinova AV practicing obstetrician-gynecologist. Experience in the specialty for more than 12 years.
Trichomoniasis (trichomoniasis) - is an infectious disease of the genitourinary system, which is caused by Trichomonas vaginalis.
Some authors refer to trichomoniasis a venereal disease, although the disease is not included in the list of sexually transmitted diseases.
The prevalence of trichomoniasis is wide enough, it infects about 170 million people each year (data are taken into account only surveyed people). According to WHO statistics, trichomoniasis affects up to 10% of the population in developed countries and in developing up to 40%.
Kinds
The following classification of trichomoniasis adopted in Russia:
- Fresh trichomoniasis: acute, subacute and torpid (malosimptomno) form;
- chronic trichomoniasis (disease duration 2 months or more or not installed);
- trihomonadonositelstvo (absence of symptoms in detecting Trichomonas vagina or semen).
Causes
The causative agent of urogenital trichomoniasis is Trichomonas vaginalis, which belongs to the protozoa. In humans still live oral and intestinal Trichomonas, but causes only vaginal trichomoniasis. Trichomonas is not stable in the environment and a drying die quickly, but it is possible to maintain their activity in a moist field (linens, washcloths, towels).
Trichomoniasis is transmitted through sexual contact, although it is possible and vnepolovoe infection: a vertical path of transmission during childbirth, during the passage of the fetus through an infected birth canal. Household transmission path Trichomonas vaginalis is currently being questioned. Many authors argue that possible infection through towels, swimsuits and more.
It is known that trichomoniasis is often combined with other infections, sexually transmitted diseases (gonorrhea, mycoplasmosis, chlamydia), Due to the ability of the simplest to phagocytosis (ingestion of pathogens other infections). Also established the role of Trichomonas in the spread of HIV infection.
Factors contributing to the development of urogenital trichomoniasis:
- endocrine system disorders;
- metabolic disorders;
- vitamin deficiencies;
- bacterial contamination of the vagina, accompanied by a change of its acidity;
- menstruation and poslemenstrualny period.
symptoms of trichomoniasis
Manifestations in women
The acute form
In acute and subacute forms of trichomoniasis women complain of heavy, foamy whites with an unpleasant odor, itching and burning in the vulva. Beli may be yellowish or greenish color.
With the spread of the urethra there are signs urethritis (Pain and burning during urination).
May cause aching pain in the abdomen (with the defeat of the uterus and appendages). It is also characterized by pain during intercourse.
In marked itching noted sleep disturbances.
During gynecological speculum examination reveals an abundance of foamy, leucorrhoea puruloid which cover vaginal wall and accumulate in the posterior fornix, as well as redness and swelling of the mucous membrane of the vagina and cervix (cervicitis). A characteristic symptom of cervicitis colposcopy is a so-called "strawberry cervix" - multiple petechial hemorrhages on the mucous membrane of the vaginal portion of the cervix.
The symptoms of the chronic form
Chronic trichomoniasis is characterized by a prolonged duration and recurrence of the disease.
Relapse contribute to violations of personal hygiene, reduced ovarian endocrine function, chronic diseases.
In chronic trichomoniasis patients complain of whites, sometimes itchy. Signs of inflammation are expressed little.
Trichomoniasis in men
In men, trichomoniasis is the phenomenon of a minor or absent (trihomonadonositelstvo).
All the symptoms of the disease are associated with urethritis (itching and pain during urination and sexual intercourse, pain urethra, copious discharge from the urethra and urinary frequency).
Diagnostics
Recognition of trichomoniasis promotes history (urethritis her husband, duration of disease, recurrence, etc.) and physical examination data.
From laboratory diagnostic methods used:
- microscopic examination of native smears from the vagina, urethra and cervix (is valid only for a quick svezhevzyatyh microscopy smears);
- microscopic examination of stained smears for Gram;
- culture method (seeding of mucus and urethral content on nutrient media, but requires from 4 to 7 days);
- PCR (polymerase chain reaction) - extraction of DNA from Trichomonas vaginal or urethral discharge (very expensive analysis).
Differential diagnosis of trichomoniasis performed with diseases such as bacterial vaginosis, nonspecific colpites, chemical and allergic vaginitis.
treatment of trichomoniasis
Treatment of trichomoniasis in women carries a gynecologist and venereal diseases, venereal diseases in men and urologist. The duration of treatment is 7-14 days.
The therapy of the disease is carried preparations of 5-nitroimidazole (metronidazole, Trichopolum, terzhinan, flags, and other tinizadol).
The dose and duration of treatment selects the physician depending on the duration of disease, severity of symptoms and comorbidity.
Metronidazole protivotrihomonadnye and other drugs are prescribed in the local state, and for oral ingestion. Local treatment in the form of creams, ointments and suppositories are administered into the vagina or the urethra lubricate them in men (Clione-D terzhinan, Betadine).
Treatment of trichomoniasis in pregnant preparations imidazole group is assigned only to the second trimester (cross the placenta). Possible treatment with other antitrihomonadnyh means (trihomonotsid, trihotsid suppositories), but they are less effective.
Following primary therapy performed restoring intestinal flora and vaginal eubiotics (laktobakterin, bifidumbakterin).
It is important to remember that in the period of treatment is completely excluded alcohol intake and sexual life.
Control of cure is carried out after 10 days of drugs such as metronidazole, and then for three months after menstruation (preferably with provocation).
Complications and prognosis
Complications of trichomoniasis in women:
- adnexitis and endometritis;
- cystitis and pyelonephritis;
- infertility;
- fetal death;
- miscarriage and abortions;
- low birth weight.
Complications in men:
- prostatitis, vesiculitis, Orchitis;
- infertility;
- cystitis pyelonephritis.
The prognosis for timely and quality treatment of trichomoniasis favorable.
