Trichomoniasis (trichomoniasis) is an infectious disease of the urogenital system, which is caused by trichomonas vaginalis.
Some authors attribute trichomoniasis to venereal diseases, although the disease is not included in the list of sexually transmitted diseases.
The prevalence of trichomoniasis is quite wide, annually about 170 million people are infected with it (only data from the people examined are taken into account). According to WHO statistics, trichomoniasis affects up to 10% of the population in developed countries, and in developing countries up to 40%.
In World , the following classification of trichomoniasis is adopted:
- fresh trichomoniasis: acute, subacute and torpid (low symptom) forms;
- chronic trichomoniasis (disease duration 2 months or more or not installed);
- trichomonadal carriage (absence of symptoms when trichomonads are detected in the vagina or in sperm).
The causative agent of urogenital trichomoniasis is trichomonas vaginalis, which belongs to the simplest single-celled organisms. In the human body live still mouth and intestinal Trichomonas, but trichomoniasis causes only vaginal. Trichomonas are not stable in the external environment and die quickly when they are dried, but it is possible to maintain their activity in a wet sphere (linen, washcloths, towels).
Trichomoniasis is transmitted through sexual intercourse, although non-sexual infection is also not excluded: a vertical transmission route of the pathogen during childbirth, when the fetus passes through an infected birth canal. Domestic route of transmission of Trichomonas vaginalis is currently subject to doubt. Many authors argue that infection through towels, swimsuits, etc. is possible.
It is known that trichomoniasis is often combined with other sexually transmitted infections ( gonorrhea , mycoplasmosis , chlamydia ), which is explained by the ability of protozoa to phagocytosis (ingestion of pathogens of other infections). Also established the role of Trichomonas in the spread of HIV infection.
Factors contributing to the development of urogenital trichomoniasis:
- endocrine disorders;
- metabolic disorders;
- bacterial contamination of the vagina, accompanied by a change in its acidity;
- menstruation and postmenstrual period.
Manifestations in women
In acute and subacute forms of trichomoniasis, women complain of copious, frothy leucorrhoea with an unpleasant odor, itching and burning sensation in the region of the external genital organs. Bleach can be yellowish or greenish.
When extending the process to the urethra, there are signs of urethritis (pain and burning during urination).
Perhaps the appearance of aching pain in the lower abdomen (with the defeat of the uterus and appendages). Also characterized by pain during intercourse.
In severe itching, sleep disturbance is noted.
During gynecological speculum examination reveals an abundance of foamy, leucorrhoea puruloid that covers the vaginal wall and accumulate in the posterior fornix, and redness and edema of the mucosa of the vagina and cervix ( cervicitis ). A characteristic colposcopic symptom of cervicitis is the so-called “strawberry cerviks” – multiple point hemorrhages on the mucous membrane of the vaginal part of the cervix.
Symptoms of the chronic form
Chronic trichomoniasis is characterized by the duration and recurrence of the disease.
The occurrence of relapses contribute to violations of personal hygiene, reduced endocrine function of the ovaries, chronic diseases.
In chronic trichomoniasis, patients complain of leucorrhoea, sometimes itching. Signs of the inflammatory process are little pronounced.
Trichomoniasis in men
In men, the effects of trichomoniasis are insignificant or absent (trichomoniasis).
All symptoms of the disease are associated with urethritis (pain and itching during urination and sexual intercourse, pain in the urethra, heavy discharge from the urethra, and frequent urination).
Recognition of trichomoniasis contributes to history (urethritis in her husband, the duration of the disease, relapses, etc.) and data from an objective examination.
From laboratory diagnostic methods used:
- microscopic examination of native smears from the vagina, urethra and cervix (reliable only with rapid microscopy of fresh smears);
- microscopic examination of stained Gram smears;
- culture method (seeding mucus and urethra contents on nutrient media, but requires 4 to 7 days);
- PCR (polymerase chain reaction) – isolation of Trichomonas DNA from a detachable urethra or vagina (very expensive analysis).
Differential diagnosis of trichomoniasis is carried out with such diseases as: bacterial vaginosis, nonspecific colpitis, chemical and allergic colpitis.
The treatment of trichomoniasis in women is carried out by a gynecologist and venereologist, in men a venereologist and urologist. The duration of treatment is 7-14 days.
Therapy of the disease is carried out with drugs of the 5-nitroimidazole group (metronidazole, trichopol, tergynan, flagel, tinizadol, and others).
The doctor determines the dose and duration of treatment depending on the duration of the disease, the severity of the symptoms and the accompanying pathology.
Metronidazole and other protivotrihomonadny drugs are prescribed both in the local form, and for oral administration. Topical treatment in the form of creams, ointments and suppositories that are inserted into the vagina or they lubricate the urethra in men (Klion-D, terginan, betadine).
Treatment of trichomoniasis in pregnant women with an imidazole group is prescribed only from the second trimester (penetrate through the placenta). Treatment with other antitrihomonadny means (trichomonocide, trichocide in candles) is possible, but they are less effective.
After the main therapy, the intestinal microflora and vagina are restored by eubiotics (lactobacterin, bifidumbacterin).
It is important to remember that during the treatment period alcohol intake and sex life are completely excluded.
The control of cure is carried out after 10 days of taking drugs of the type metronidazole, and then within three months after menstruation (preferably with provocation).
Complications of trichomoniasis in women:
- adnexitis and endometritis ;
- cystitis and pyelonephritis;
- fetal fetal death;
- premature labor and miscarriages ;
- low birth weight.
Complications in men:
- prostatitis, vesiculitis, orchitis;
- cystitis and pyelonephritis .
The prognosis for timely and quality treatment of trichomoniasis is favorable.