Genital or genital herpes refers to viral diseases. This disease is one of the most common among sexually transmitted infections. Almost 99% of the world’s population is believed to be infected with the herpes simplex virus. This disease occurs equally in both women and men.
Depending on the clinical manifestations of genital herpes can be:
- primary infection, that is, signs of herpes appeared for the first time;
- recurrent infection, that is, the clinical picture of the disease is repeated more than once;
- asymptomatic, that is, a person does not suffer from herpes, but is a virus carrier.
Genital herpes by the characteristics of the symptoms is divided into typical and atypical.
The disease usually goes through 3 stages:
- Stage 1 – external genital organs are affected;
- Stage 2 – affected vagina, cervix, urethra in men and women;
- Stage 3 – the internal organs are involved in the pathological process: in women, the uterus, appendages, bladder, in men, the prostate gland and bladder.
The causative agent of the disease is herpes simplex virus (HSV), which is divided into type 1 HSV and type 2 HSV. As a rule, genital herpes causes a 2nd type of virus.
The disease is transmitted only sexually, household path is excluded. The spread of infection is promoted by all types of sexual contacts, both traditional sexual, anogenital and oral-genital. Therefore, infection with oral-genital contacts with a carrier partner of HSV type 1 is possible, especially if there are clinical manifestations of herpes in the lips and mouth cavity.
Predisposing factors for infection with the herpes simplex virus include:
- promiscuous sex life;
- homosexual contact;
- rejection of condoms;
- reduced immunity;
- the use of intrauterine devices;
- artificial abortion with curettage of the uterus;
- constant stress;
- infection with other infections, both sexually and common;
- climate change.
The period from infection with HSV to the onset of clinical signs can last from 3 to 26 days. Symptoms of genital herpes in men and women are generally similar.
As a rule, the external genital organs are involved in the pathological process: in men, the bubbles are located on the head of the penis, on the foreskin, along the entire length of the penis, in the groin and scrotum; in women, vesicles are localized on the pubis, labia, in the area of the buttocks and thighs. During homosexual contacts in men, the buttocks and the anus are affected.
First, vesicles are formed against the background of reddish and edematous skin and mucous membrane at the site of infection. Their appearance is preceded by itching and burning. The size of the bubbles reaches 2-3 mm, sometimes they form a spot, the area of which takes 0.5-2.5 cm. At this stage of the disease, vesicles do not last long, after 3 days they burst, and ulcers appear in their place. Sometimes they are covered with a bloom of yellow and then a crust. These wounds heal within 2, maximum 4 weeks, without scarring.
Patients of both sexes may experience symptoms such as:
- heaviness in the abdomen;
- an increase in the inguinal lymph nodes;
- temperature rise;
If the urethra and the bladder are involved in the process, then signs of dysuria and the appearance of blood in the urine are expressed.
For atypical forms of genital herpes, the erased or abortive (short) course of the disease is characteristic. This affects not only the external genitalia, but also internal: the uterus, appendages, prostate, seminal vesicles. Most often, patients complain of persistent itching and burning, women have leucorrhoea, which is not amenable to treatment. At the same time, vesicles and edema may be absent on the genitals, only red (hyperemic) spots are visible.
Especially dangerous is infection with genital herpes or relapse of the disease in the first and last trimesters of pregnancy. Infection can cause spontaneous miscarriage , missed abortion, premature birth or the birth of a child with developmental abnormalities. In addition, when passing through the birth canal of a woman with obvious clinical signs of infection, infection with the virus and the baby is possible, which can lead to his death.
Therefore, pregnant women with an atypical form of infection during the last 6 months are examined (mucus from the cervical canal) for the presence of HSV antigen. If it is found, a planned cesarean section is performed.
First and foremost, differential diagnosis aims to distinguish between genital herpes and primary syphilis. Also, the disease should be distinguished from pemphigus, recurrent thrush, lichen planus and staphylococcal impetigo.
The diagnosis is established on the basis of anamnesis, characteristic complaints and clinical signs. In addition, additional laboratory research methods are used to detect HSV or its antibodies in the blood.
To identify the HSV DNA, material is collected from several sites: the cervix, urethra, etc. The analysis also includes a discharge of the prostate, urine, and so on. It is then sown on biological media to detect the virus, or the presence of the HSV antigen is determined using a polymerase chain reaction. Laboratory tests of blood are used to detect antibodies of class M and G: analysis of fluorescent antibodies and immunoperoxidase method.
The treatment of genital herpes is engaged in a dermatovenerologist.
In order to eliminate the virus (remove it from the blood), alleviate the clinical manifestations and reduce the frequency of relapses, antiviral drugs are used in tablets and injections (systemic therapy), as well as in ointments, creams and gels.
- The most commonly prescribed antiviral is zovirax (acyclovir). It is prescribed including during pregnancy.
No less effective are:
- foscarnet (pyrophosphate analogue);
The duration of treatment depends on the form of the disease and clinical manifestations and is usually 1 – 1.5 months. Six months later, a second course.
In addition, the first stage of therapy includes the appointment of immunomodulatory drugs:
- interferon and its analogs: viferon, genferon;
- interferon inducers, for example: lavomax, cycloferon, antiherpetic immunoglobulin, taktivin and others.
In the second stage of the disease, antiviral drugs are applied topically against the background of the administration of vitamins B1 and B6, autohemotherapy and the use of fortifying agents (tinctures of ginseng, eleutherococcus, echinacea).
The third stage of treatment is to conduct vaccine herpetic vaccine. And after the recurrence of the disease should take at least 2 months.
The most dangerous genital herpes during pregnancy, possible complications were considered by us above.
Genital herpes is also likely to:
- secondary infection of ulcers with the development of creeping phlegmon;
- acute urinary retention;
- synechiae in the region of the genital lips (their fusion of varying degrees);
- infertility in both men and women (with affection of the internal genital organs);
- sexual problems are not excluded.
It is impossible to get rid of genital herpes, treatment is aimed at reducing the frequency of relapses and preventing complications, so the prognosis for the disease is relatively favorable.