Frequently asked Questions
Ureaplasma is a unicellular microorganism that is an intracellular microbe and that contributes to the emergence of a disease like ureaplasmosis. There are 14 varieties of such a microorganism, of which the causative agent of the disease is U. Urealyticum.
This disease can be infected during sexual intercourse with a partner who is its carrier or patient. Also, this disease can be infected intrauterinely, at the time when the infection is transmitted from mother to child through the amniotic fluid, or during birth. The incubation period of the disease lasts from two to four weeks. In this case, the initial stage of the disease is often asymptomatic, although at this time the carrier of the causative agent of the disease can infect its sexual partner, even without knowing it. This is the complexity of the disease, which can have quite significant consequences for the human body.
First of all, these are inflammatory processes that the ureaplasma is capable of causing in every area of the urogenital system. However, without proper treatment, the disease is able to go into the chronic stage and cause the occurrence of prostatitis, colpitis, endometritis, cystitis, pyelonephritis, vesiculitis, inflammation of the uterus, the appearance of adhesions in the fallopian tubes. An increasing number of doctors agree that such a type of male infertility as asthenospermia, in which there is a decline in sperm motility, is also caused by this particular microorganism. In the course of research, it was revealed that ureaplasma is capable of parasitizing on sperm and such contact contributes to a decrease in viability and mobility of the latter. Also, this pathogen is directly related to such a disease as arthritis, contributing to the inflammation of the joints.
So, the treatment of ureaplasmosis can be carried out only after all the necessary diagnostic actions have been performed. The main components of this treatment is certainly antibacterial therapy.
On the other hand, any antibacterial treatment can have only two results – or a medicine. "will destroy" of all existing pathogens, and you will get rid of this disease, or some pathogens will nevertheless survive, grow stronger and gain resistance to this antibiotic. To cure the disease after one incorrectly implemented antibiotic therapy becomes a couple of times more difficult, after several it is especially difficult. With such caution should be chosen and the dosage of the drug, as well as the scheme of its use.
Also, therapeutic measures, depending on the localization of the process and the characteristics of the course of the disease can be immunocorrective treatment, massage of the prostate gland, physiotherapy and so on. Depending on the specifics of ureaplasmosis, the course of treatment can last from two weeks to several months, but usually the whole therapy takes no more than two or three weeks.
An equally important stage in the treatment of this disease is the identification of the degree of cure of the patient. Two weeks after the completion of antibacterial treatment, and for women, before the onset of the next menstruation, the first follow-up analysis is performed. In the case when his result is negative, in a month (for women before the next menstruation) another similar control analysis is performed. If his result is negative, after 1 month a test with provocation is carried out. The negative outcome of this test suggests that in the complex treatment of ureaplasma, after all, the victory was left to man. If ureaplasmas are detected at least in one of these tests, a second course of therapy should be performed.
Urogenital ureaplasmosis has no specific signs, based on which it is possible to make a diagnosis. Often the disease does not manifest itself, or passes unnoticed by humans. A similar course of the disease is inherent in 40% of cases. But when the situation is stressful for the body, mycoplasmas are activated and signs appear, which are common mainly for all urinary infections.
In men, the symptoms of the disease are manifested in mild clear urethral secretions in the morning, pulling pain in the groin area, moderate pain and tingling during urination.
With the defeat of this disease of the prostate gland symptoms of prostatitis appear. With the defeat of the epididymis, an incomprehensible pulling pain is likely to appear in the groin area, perineum, in the scrotum, after which the appendage may increase in size and the skin of the scrotum redden. In addition, urogenital ureaplasmosis in men can contribute to the appearance of significant changes in sperm, which contributes to the development of male infertility.
Among the symptoms of ureaplasmosis in women are the following symptoms: abundant or scanty transparent vaginal discharge, burning and itching when urinating, lower abdominal pain (with inflammation of the uterus and appendages), pain during sexual intercourse.
Especially dangerous can be infection with this disease during pregnancy, as this disease causes spontaneous abortion, premature birth. In addition, ureaplasmosis can contribute to premature discharge of amniotic fluid, fever during childbirth and for some time after birth in mothers, the appearance of pneumonia or meningitis in children.
Ureaplasmosis – one of the most common and so-called "commercial" diagnoses in urology and gynecology, which unscrupulous doctors often use. This diagnosis can be made to almost half of men and 80 percent of women.
But is ureaplasmosis dangerous? Do I need to treat it? And where does it come from, in principle? Let’s try to deal with all these questions.
What kind of beast is ureaplasma?
Ureaplasma in 1954 was first discovered by an American doctor Shepard in the discharge of a patient with non-gonococcal urethritis. Further studies have shown that most sexually active people are carriers of ureaplasma. In this case, it is not necessary that they will have any external signs of infection. Ureaplasma can be in the human body for years and even decades and does not manifest itself.
Ureaplasma is a tiny bacterium that in the microbiological hierarchy occupies an intermediate position between viruses and unicellular microorganisms. Due to the multi-layered outer membrane that surrounds the bacterium on all sides, it is very difficult to detect under a microscope.
A total of five varieties of ureaplasma are known, but only two of it are dangerous for humans – ureaplasma urealyticum (ureaplasma urealyticum) and parvum ureaplasma (ureaplasma). It is they who have a special weakness for epithelial cells located in the urinary tract. In the rest of the body, ureaplasmas are almost never detected.
By the way, closest "relative" ureaplasma is mycoplasma. Due to the huge similarity in structure and preferences, both microorganisms are often colonized in the genital tract at the same time and then doctors talk about mixed infections, i.e. diseases causing a mixed microflora.
Where does ureaplasma come from?
Normally, a huge number of microorganisms live in the urogenital tract of a person, and all of them to some extent 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 then they become dangerous for human health.
Similarly, the situation with ureaplasma. Many people live with it for a long time and do not even realize that they are carriers of this bacterium. It is found most often by chance when the patient turns to a doctor for some very different reason, and sometimes simply out of curiosity. For a full examination, the doctor sends smears to the laboratory. And this is where the fun begins. The analysis reveals ureaplasma, and the patient is urgently treated. And even the fact that a person has no complaints does not stop some doctors from taking active steps to "exile" microbe from the human body.
The main argument in favor of emergency treatment is that in the absence of his man or woman will (possibly!) Suffer from infertility, and the probability of giving birth or conceiving a child will be zero. And begins a long struggle with ureaplasma. Carriers undergo multiple courses of drug treatment, which leads to the appearance of many side effects. They, in turn, are often blamed on the manifestation of other hidden infections, etc. It can be 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 the microorganism can cause diseases, 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 conditionally-dangerous cohabitant, and no more. Taking care of one’s health, orderly sex life, proper nutrition and physical activity are the keys to well-being in the genitourinary area.
After years of discussion at the scientific level, it was decided that only those people who have symptoms and complaints from the urogenital tract need to be treated, 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 identified any other pathogens, then the primary cause of the disease is considered ureaplasma, and sometimes mycoplasma. In this situation, really need targeted treatment of ureaplasma. 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 preterm birth. To date, this issue remains controversial, because no expert has been able to reliably confirm the guilt of ureaplasma in these pathologies. Of course, if you need to identify ureaplasma in the urinary tract, then it is quite easy 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 the ureaplasm.
Some researchers are still trying to prove the ureaplasma disease, using as an argument 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 here you can make quite a logical conclusion – the cause of inflammation of the pelvic organs is another, more aggressive flora.
How can you get ureaplasma?
Ureaplasma is very unstable in the environment and dies out very quickly outside the human body. Therefore, it is almost impossible to get infected in public places, such as saunas, baths, swimming pools, public restrooms.
For infection requires close contact with the carrier of ureaplasmosis. The most likely infection during sexual intercourse, which one – oral, genital or anal, does not matter. However, it is known that several other ureaplasmas live in the oral cavity and rectum, which are dangerous to humans significantly in rarer cases.
Detection of ureaplasma in one of the sexual partners is not a fact of betrayal, because a person could get infected many years ago, and sometimes during the prenatal period, or during childbirth from his own mother. By the way, another conclusion follows from here – the infection can be detected even in infants.
Some people believe that ureaplasma refers to "bad" sexually transmitted infections. This is fundamentally wrong, in itself Ureaplasma does not cause venereal diseases, but can accompany them quite often. It is proved that the combination of ureaplasma with trichomonas, gonococcus, chlamydia really represents a serious danger to the genitourinary system. In these cases, inflammation develops, which almost always has external manifestations and requires immediate treatment.
What is ureaplasmosis treated?
Antibiotics against ureaplasma
All microorganisms in varying degrees "fear" antibiotics, and ureaplasma in this case is no exception. Unfortunately, not every antibacterial agent is able to suppress the activity of bacteria, since ureaplasma is not a cell wall. Penicillin-type 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 a microbial cell. Such drugs are tetracyclines, macrolides, fluoroquinolones, aminoglycosides, Levomycetin.
The best indicators in relation to ureaplasma infection in Doxycycline, Clarithromycin, and in the case 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 they are sensitive to ureaplasma, which is determined during microbiological research.
Indications for treatment
Drugs that affect ureaplasma
Some doctors believe that the growth of ureaplasma can be suppressed with a single dose of Azithromycin in the amount of 1 g. Indeed, in the instructions for the drug and in the medical recommendations for the treatment of sexually transmitted infections, Azithromycin effectively affects urethritis non-gonococcal and chlamydial nature in men and chlamydial cervicitis in women. However, numerous studies have shown that after Azithromycin, taken in this dosage, the destruction of ureaplasma does not occur at all. But taking this same drug for 7-14 days almost guaranteed to get rid of the infection.
Doxycycline and its analogs – Vibramitsin, Medomycin, Abadoks, Biocyclind, Unidox Solutab – are among the recommended remedies for the treatment of ureaplasma infection. These drugs are convenient because 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 double the amount of medication.
The most good results from taking doxycycline were obtained in the treatment of infertility on the background of ureaplasmosis. After the treatment course, 40-50% of cases were followed by a long-awaited pregnancy, which proceeded without complications and ended successfully in childbirth.
Despite this high efficacy of the drug, some strains of ureaplasma remain insensitive to Doxycycline and its analogues. In addition, these drugs can not be used in the treatment of pregnant women and children under 8 years of age. Also worth noting are quite frequent side effects, primarily from the digestive organs and skin.
In this regard, the doctor may use other drugs, for example, from the group of macrolides, linkosamines or streptogramins. Clarithromycin (Clabax, Klacid) and Josamycin (Vilprafen) recommended themselves best of all.
Clarithromycin does not adversely affect the gastrointestinal tract, and therefore can be taken independently of the meal. 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 probability of re-activating the infection decreases sharply. Clarithromycin is prescribed 1 tablet twice a day, the course of treatment is 7-14 days. In pregnancy and children under 12 years old, the drug is contraindicated, in which case it is replaced with josamycin.
Josamycin belongs to the group of macrolides and is able to suppress the synthesis of proteins in ureaplasm. 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 ureaplasm, preventing its reproduction, and when a certain concentration in the cells is reached, it begins to have a bactericidal effect, i.e. leads to the final death of the infection.
Josamycin almost does not cause side effects and can be prescribed even to pregnant women and children under 12 years old, including nursing. In this case, only the form of the drug is changed, not a tabletting 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 three times.
In cases where the development of ureaplasma inflammation in the urogenital tract occurred against a background of reduced immunity, antibacterial agents are combined with immunomodulatory drugs (Immunomax). Thus, there is an increase in body resistance and more rapid destruction of infection. Immunomax is prescribed according to the scheme at the same time as taking antibiotics. A single dose of the drug – 200 U, it is administered intramuscularly in the 1-3rd and 8-10th days of antibacterial treatment – only 6 injections per course. Reception of the tableted immunomodulatory agents – Echinacea-Ratiopharm and Immunoplus is also possible. They have a similar effect, but they are taken daily, 1 tablet for the entire course of antibacterial treatment. At the end of such a combined treatment in almost 90% of cases, the ureaplasma is irretrievably gone.
Naturally, if, in addition to ureaplasma, another pathology of the urogenital tract was found, then additional treatment may be needed to eliminate associated diseases.
When to treat ureaplasma – video
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 stresses, and hypothermia, the likelihood of activation of the ureaplasma increases with the development of symptoms characteristic of inflammation of the vagina or urethra.
Even with the detection of ureaplasma, treatment is required only for those people who show signs of inflammation of the urogenital tract to married couples who are planning to become pregnant to women undergoing treatment for infertility.
In other cases, it is senseless and sometimes ineffective to fight ureaplasma, since even after recovery from infection, persistent immunity does not develop to it, and a person can repeatedly become infected again during his life.