Варианты диагностики и лечения инфекций мочеполовой системы

The study of protozoal invasions of the genitourinary system, which occur in combination with lesions of the urinary tract in women of childbearing age and their male sexual partners, is a promising area of ​​modern medicine.

The development of this direction can contribute to a significant increase in the level of diagnostic examination of patients with infections, predominantly sexually transmitted, and improve the effectiveness of their treatment.

Find out in the article on estet-portal.com what modern approaches to the diagnosis and treatment of infections of the genitourinary system.

Major pathogens of the genitourinary system

Among the protozoan invasions of the genitourinary system, the main role is played by lesions of Trichomonas.

According to modern concepts, a person can be a carrier of three types of Trichomonas:

  • Trichomonas tenax;
  • Pentatrichomonas hominis;
  • Trichomonas vaginalis.

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In the oral cavity, in carious teeth, as well as in the presence of periodontal disease, lives Trichomonas tenax. Pentatrichomonas hominis − commensal of the large intestine. Trichomonas, capable of living in the urogenital tract, until recently was considered exclusively Trichomonas vaginalis.

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Despite intensive study, in modern conditions there are certain difficulties in the diagnosis of urogenital trichomoniasis and its treatment.

 

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Atypical forms of Trichomonas vaginalis are the most problematic during laboratory diagnosis.

They have a wide variability in their shape, size, presence of flagella and nuclei. In addition, they have a certain external resemblance to other representatives of the simplestthem.

Change in understanding of the microflora of the genitourinary system

Over the past few decades, the living conditions of modern man have changed significantly. At the same time, as you know, the ideas about the pathogenicity of some microorganisms that can live in the human genitourinary system, for example, mycoplasmas and gardnerel, have changed.

It has been suggested that some protozoa may also have undergone certain changes and acquired the ability to colonize the human genitourinary system.

 

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When studying the relevant literature data, it was assumed that the highest probability of acquiring the above qualities among the protozoa exists in Trichomonas tenax and Pentatrichomonas hominis.

Even in the thirties of the last century, they tried to consider intestinal and oral Trichomonas as pathogens for the genitourinary system together with Trichomonas vaginalis. In this century, most researchers detected Trichomonas tenax or Pentatrichomonas hominis only in isolated cases, and mainly in women.

Therefore, they were inclined to regard their results as either contamination of the material of the test, or as a variant of transient microflora after oral or anal sex, which took place shortly before taking the biological material to conduct an appropriate study.

However, there is also a position on the possibility of colonization of the human genitourinary system by Trichomonas tenax and Pentatrichomonas hominis.

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As for Giardia, in the last decade in the foreign scientific literature there have been reports of lesion of the genitourinary system by Giardia lamblia. Identification of Giardia lamblia in the genitourinary system of patients with sexually transmitted infections (STIs), is about 6%.

The syndrome of damage to the genitourinary tract is characterized by the development of  urethritis. Difficulties in urination, disorders of sexual functions, and infertility are possible. Due to severe itching, patients scratch the perineum, external genitalia, rashes may appear on these areas ia.

Treatment of infections of the genitourinary system

Treatment of infections of the human genitourinary system caused by Trichomonas vaginalis is a complex process. This is due to the frequent chronization of the corresponding inflammations, as well as significant resistance of the pathogen to specific treatment.

Data on the treatment of trichomoniasis of the genitourinary system, which is caused by Trichomonas tenax or Pentatrichomonas hominis, is difficult to find in the literature that can be studied. This is quite understandable, since it was believed that these microorganisms are not able to exist in the human urogenital tract.

So, in modern medicine, in addition to the problem of treating infections of the human genitourinary system caused by Trichomonas vaginalis, a completely new problem has appeared associated with the lack of scientifically based approaches to the treatment of inflammation of the human genitourinary system caused by Trichomonas tenax or Pentatrichomonas hominis.

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For the specific treatment of trichomoniasis, antibacterial drugs are used, in which the causative agent of this disease is sensitive. These are, first of all, preparations of the nitroimidazoles and nitrofurans.

In addition, one of the decisive factors in the treatment of chronic Trichomonas invasion is & nbsp; the duration of therapy . It is believed that in case of chronicity, especially in the presence of resistance to therapy, it is advisable to carry it out up to 10-20 days, using various drugs.

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