Mycoplasma in men - symptoms and treatment, causes and tests. Manifestation and treatment of mycoplasmosis in men Discharge with mycoplasma in men

Mycoplasma is a gram-negative non-nuclear unicellular microorganism that occupies an intermediate position between fungi, bacteria and viruses and can cause an inflammatory disease of various organs in humans.

The causative agents of the disease in humans can be several types of mycoplasma - Mycoplasma hominis, Mycoplasma genitalium, Mycoplasma pneumonia, Ureaplasma urealiticum.

The disease caused by mycoplasma is called mycoplasmosis, or.

Causes of mycoplasmosis

Mycoplasma is commonly referred to as opportunistic microorganisms; it can be isolated from the mucous membranes of the external genitalia and urethra of healthy men. However, under favorable conditions, a mycoplasma colony can begin to grow uncontrollably and cause both lower urinary tract and vulvar disease and ascending infection. The inflammatory process is caused by an autoimmune reaction.

Ways of transmission of mycoplasma:

• sexual;
• airborne;
• vertical (infection of the fetus through the placenta);
• in contact with the soft tissues of the birth canal.

Predisposition to the disease occurs with damage to the tissues of the urinary tract and genital organs, as well as in patients with dysfunction of the immune system. Risk factors:

• autoimmune diseases, a tendency to allergic diseases;
• endocrine diseases;
• long-term use of immunosuppressants;
• treatment with cytotoxic drugs;
• hypothermia;
• extragenital acute and chronic infections;
• local inflammatory processes caused by another disease;
• urological manipulations;
• genital trauma.

The main symptoms of mycoplasma in men

The acute form of the disease can last up to two months, after which, if there is no cure, the disease becomes chronic with undulating relapses and attenuation.

Mycoplasma infection most often occurs almost asymptomatically or with erased symptoms. There are no specific (pathognomic) symptoms of mycoplasmosis in men; the same symptoms are characteristic of the disease as for other infections that affect the genitourinary system:

• from the urethra;
• and ejaculation;
• drawing pains in the groin;
• enlargement of regional lymph nodes;
• rashes in the glans penis and prepuce associated with an autoimmune reaction.

The clinical picture of mycoplasmosis in women is similar. You can learn about the symptoms and methods of treatment in women from the article

Complications of mycoplasma in men

Complications can arise not only from the genitourinary organs: since mycoplasmas are isolated from the tissues of distant organs, it is believed that they can be transported in the body by the hematogenous (through the bloodstream) route.

Mycoplasmas synthesize exotoxins, which, in case of a massive infectious lesion, can have an effect on the cardiovascular and nervous systems, make the blood-brain barrier permeable.

Even with an asymptomatic course, urogenital mycoplasmosis can cause a number of complications:

The diagnosis is made on the basis of clinical signs and verified by laboratory tests.

Laboratory diagnostics is carried out by direct (identification of the pathogen by DNA or grown culture) and indirect (identification by immune response) methods. Direct methods include bacteriological and molecular biological methods, indirect methods include immunological methods. Direct methods are more accurate. PCR is considered the most sensitive method.

Before taking material from the urethra, it is necessary to cancel local forms of drugs (for bacteriological examination - and internal ones) for three days, do not urinate for two hours.

Blood for immunological studies is taken on an empty stomach.

Bacteriological research

The culture is sown on a nutrient medium, after a few days the drug is studied under a microscope. This is a direct method, which is one of the most accurate and allows you to determine the sensitivity of a microorganism to drugs (in vitro).

Molecular biological method

PCR (polymerase chain reaction) is a direct method that allows not only to detect the presence or absence of a microorganism by its genetic material - DNA, but also to determine the genus.

Material: scraping from the urethra, biological fluids - urine, ejaculate, prostate secretion.

Immunological method

Enzyme-linked immunosorbent assay (ELISA) is an indirect method that allows you to identify a microorganism by the presence of antibodies to its antigens in the blood. This method is less accurate than bacteriological and molecular biological, but it can be useful in cases where biological fluids are examined by direct methods: if there are no particles of epithelium with mycoplasma in the latter, the result may be false negative.

ELISA also allows you to assess the dynamics of the disease and the response to the drug. For this, the method of "paired sera" is used. The study is based on the measurement of antibody titers to a specific antigen at intervals of 10-14 days.

Material: venous blood.

Differential Diagnosis

Mycoplasma can be found in tissues in case of other urinary tract infections, so mycoplasma infection should be differentiated from the following diseases:

• gonorrhea;

Treatment of mycoplasma in men

For the treatment of acute forms of mycoplasmosis, antibiotic therapy is prescribed.

Treatment of chronic forms is complex:

• immunocorrection;
• systemic antibiotic therapy;
• local treatment.

For the correct prescription of antibiotics, a sensitivity test is performed. Macrolides and fluoroquinolones are prescribed for empirical treatment.

Immunocorrective therapy is prescribed after a laboratory assessment of the state of the immune status.

For local treatment, anti-inflammatory, antibacterial drugs and enzymes are prescribed.

After treatment with antibacterial drugs, probiotics are prescribed.

Mycoplasmosis in men is a bacterial disease that affects the respiratory tract and genitals. This ailment can also occur in women, but in the male population it causes more serious reactions.

The causative agent of mycoplasmosis is a small bacterium called mycoplasma. It is invisible to the human eye, while actively multiplying and easily transmitted. Therefore, infection and the development of the disease occur quickly and mycoplasmosis in men often reaches serious stages that must be treated.

Types of bacteria

What is mycoplasma? This is a bacterium that cannot be seen even under a microscope. Mycoplasma is represented on Earth in more than 10 species. For a person, in particular for a man, 3 of them are dangerous - these are pathogens, urealiticum and hominis. Depending on the species, the bacterium infects a person in two ways:

The first 2 types of mycoplasma are sexual, and more likely to cause problems in the respiratory tract. The bacterium is dangerous for any type of ailment.

Severity of the disease

Patients may underestimate mycoplasmosis and delay its diagnosis and treatment. However, the disease poses a serious danger to men. As with other sexually transmitted diseases, genital dysfunction can occur. Mycoplasmosis can lead to serious complications:

• damage to the penis and genital organs, leading to infertility or non-viability of spermatozoa;
• prostatitis;
• kidney damage up to necrosis, the initial stage of infection is pyelonephritis;
• arthritis.

Mycoplasma easily spreads throughout the body, using blood or lymph for this. With prolonged absence of treatment, it rises from the affected genitals upward and affects the kidneys. Also, the microorganism goes down, covering the area of ​​\u200b\u200bthe knee joints and leading to arthritis. In the case of respiratory mycoplasmosis, the disease leads to frequent bronchial pathologies. Against its background, there is chronic bronchitis and cough.

Reasons for the development of the disease

Sexual mycoplasmosis is transmitted through sexual contact with an infected partner. There is no proper protection (condoms). As a result of such contact, mycoplasma infection develops within 3-35 days from the moment of intercourse. The incubation period depends on the level of immunity of the infected person.

There is a high risk of contracting a respiratory infection in places with a large crowd of people. If a person lives next to an infected person or accidentally crosses paths with him in public places, then you can become infected through contact and household contact. It implies that the bacterium remains on a plate or a doorknob, and then a person puts it into his mouth when he yawns or eats.

The contact route of infection is also taken into account. When kissing with an infected individual who suffers from a respiratory type of illness, the chance of getting infected is quite high. There is a risk of transmission of the disease with a simple touch.

You can get infected from a person who is unaware of the presence of the disease. In both women and men, immunity can hide the problem. But the bacterium remains in the body and can be transmitted to the partners of the infected person, which poses a great danger to others.

Factors provoking the development of the disease

With good immunity, mycoplasmosis in the patient's body does not manifest itself. It can be extinguished by immunity for a long time, as a result of which there will be no external and internal signs of the disease. However, there are factors that lead to the development of mycoplasmosis.

The main causes of the first stage of the disease are a decrease in immunity and the problems that caused it:

• a serious injury that provoked a state of shock and other complications;
• taking antibiotics;
• autoimmune diseases;
• third-party problems (systematic diseases that cause a weakening of the body, additional ailments of the genitourinary system);
• age of the patient (over 40-50 years).

Increase the chance of rapid development of the disease promiscuity. Because of them, a man acquires a “bouquet” of venereal and genitourinary diseases, which hit the immune system hard and allow mycoplasmosis to manifest itself. The consequences of mixing several STDs at once are infertility and erectile dysfunction.

Symptoms of mycoplasmosis

How does mycoplasma appear in men? The defeat of the genital organs in the representatives of the stronger sex does not have specific symptoms. Due to the lack of specific symptoms, the disease is difficult to diagnose. It is often confused with similar pathologies related to the venereal area and the genitourinary system. It will be possible to fully distinguish mycoplasmosis from other ailments only with the help of analysis.

A good doctor will be able to identify the problem based on small symptoms. Symptoms of the disease vary depending on its stage. Early on, you may notice the following:

• when urinating, transparent threads are released from the urethra;
• in advanced cases, the threads can acquire a white or yellowish tint - these are purulent discharges that occur against the background of an inflammatory process in the penis;
• constant desire to empty the bladder;
• pain in the groin area and during urination;
• burning skin on the penis.

With prolonged lack of treatment, a person develops the second stage of mycoplasmosis. It is expressed in the form of more serious problems, including:

• constant general intoxication, which is characterized by headache, nausea, vomiting, dizziness, feeling of weakness and fatigue;
• slight enlargement of the testicles;
• constant pain in the groin area is a sign that the lesion has gone higher and affected the internal organs.

The secondary symptoms of mycoplasmosis are already more pronounced and make it possible to determine that a person has a genitourinary disease. But the symptoms of the first stage, the patient often may not notice, which allows the bacteria to develop and affect the body more strongly.

Diagnosis of the disease

Diagnosis of the disease is complicated by its simple symptoms, similar to all common signs of STDs. To fully identify the disease, it is necessary to do tests. However, before taking smears or blood, the stage of primary examination is mandatory.

To undergo an examination, you need to make an appointment with a venereologist or urologist. The patient is examined in places of the most frequent spread of bacteria (genitals). The doctor necessarily collects complaints from a person, is interested in the frequency of sexual contacts and whether they were protected. Other additional information may be required, at the request of a specialist.

As a result, an assumption is made whether a person is susceptible to mycoplasmosis or another ailment. If a decision is made in favor of the first, then 1 of 4 tests is assigned:

• semen analysis;
• Analysis of urine;
• blood analysis;
• a swab taken from the urethra or other affected organ.

For analysis, a PCR method is used. During such a test, with a probability of 90%, various types of bacteria are detected. The PCR method is based on finding the DNA of a bacterium, which makes it possible to distinguish it from other microorganisms.

Another way to determine the disease is a serological blood test. In its course, the highlighting of proteins that are associated with mycoplasma is done. These are antibodies produced to fight infection.

Bacteriological culture is also used. This method requires 4 to 7 days. During the test, some important types of bacteria that seriously affect the picture of the disease may not be found. This is due to the fact that some varieties of mycoplasma develop more slowly than others.

Therapy Methods

To combat mycoplasmosis, the infected are offered. Their course is prescribed depending on the individual characteristics of the organism:

• age;
• the level of immunity;
• tolerance to antibiotics;
• the presence of comorbidities.

Antibiotics are taken, depending on the severity of the pathology, from 5 to 7 days. The course can be extended, but only by prescription. You should not self-medicate.

If a person has associated problems with the genitourinary system, additional medications are prescribed for treatment. If secondary diseases are not found, a narrowly targeted antibiotic is selected.

When taking medications, it is important not to forget about auxiliary drugs:

• boosting immunity;
• antifungal;
• restoring the intestinal microflora after taking antibiotics.

These medicines speed up the treatment and make it softer and more effective. In order for the patient not to receive complications, it is necessary to coordinate the intake of auxiliary medications with the attending physician.

During therapy, you need to follow certain measures aimed at maintaining health when taking antibiotics. It is strictly forbidden to consume alcohol and junk food. These factors seriously affect the intestinal mucosa and its microflora, weakened by medication.

During therapy, it is recommended to strengthen the immune system. Walking in the fresh air will help, but you should not start hardening. Sudden changes in temperature for a non-hardened organism will lead to respiratory diseases and an increase in the duration of treatment.

Prevention of mycoplasmosis

To protect yourself from mycoplasma, the patient must first limit the range of sexual intercourse. It is necessary either to narrow the circle of partners to proven and definitely not infected, or to constantly use protection during sexual contact.

It is necessary to improve personal hygiene measures. Antiseptics that kill bacteria work well. If there was contact with the toilet handle in a public place, you should use a special gel. And with unprotected sexual contact, it is recommended to use an antiseptic for the treatment of the genitals. The most effective method is to pour the solution into the urogenital canal within an hour of communication.

On an ongoing basis, you can take drugs that strengthen the immune system, and vitamin supplements. A strong organism is able to overcome the bacterium itself, although after that it will be necessary to eliminate it with a little additional therapy.

Mycoplasmosis is a disease that should not be underestimated. With prolonged development, the bacterium affects the internal organs of the patient, leading to serious complications. It is impossible to completely protect yourself from the disease, but you can increase the number of preventive examinations at the doctor for the year and improve personal hygiene.

When it comes to mycoplasmosis in men, there is usually a urogenital infection, the causative agent of which is two groups of microorganisms: Mycoplasma hominis and genitalia. To date, urogenital mycoplasmosis prevails over the classic sexually transmitted diseases - syphilis and gonorrhea.

Sexually active men of reproductive age account for the largest number of those suffering from this sexually transmitted infectious disease.

Mycoplasma

Mycoplasmas are very interesting microorganisms. These are the smallest cellular microorganisms that are classified as bacteria, but they are very different from other representatives of their domain. They do not have the usual for these microorganisms rigid, cell-limiting wall. And this partly makes them related to viruses.

But unlike viruses, mycoplasmas are able to grow on a cell-free medium. They also differ in sensitivity to antibacterial agents, and the need to include certain substances (sterols, cholesterol) in their metabolic processes. In a microbial cell, both RNA and DNA helices are present.

More than 200 species of bacteria belong to this family. 16 of them cause a bacterial infection in humans (urogenital, respiratory, generalized).

The reasons

The only cause of the disease is the penetration of pathogenic microorganisms into the body of a healthy person and the uncontrolled growth of their colonies. Mycoplasmas are able to live on the mucous membranes of the genital organs without causing disease. This condition is considered a carrier state. Asymptomatic carriage in men is less common than in women, but it is still possible.

Mycoplasmosis develops in men under the influence of adverse factors:

• Infection with other types of bacteria (pathogenic or opportunistic), or viruses.
• Chronic or severe stress.
• Overwork.
• Hypothermia.
• Internal and infectious diseases that weaken the immune system.
• Immunodeficiency.
• Frequent change of sexual partners (with unprotected sex).
• Excessive addiction to alcohol, smoking, drug addiction.

The disease can proceed chronically, with alternating periods of exacerbation (when immunity is weakened) and visible healing (when the body's defenses are restored).

Transmission route

According to medical data, there are many ways for mycoplasmas to enter the body of a healthy person. The main ones are:

• Sexual.
• Contact, contact-household.
• Intrauterine (vertical).
• During childbirth.

The main route of penetration of pathogenic microorganisms is considered sexual (with unprotected sex). Infection occurs both during genital and oral-genital or anal contact.

The contact-household way of transmission of infection to men is extremely rare. It becomes possible when using a towel of a sick person, his bed linen (together with him).

The fetus can be infected in utero, ascending, or infected from a sick mother, passing through the birth canal.

Symptoms of the disease do not appear immediately after unprotected contact with a sick person. Perhaps a latent or subclinical course. In this case, there will be no bright symptoms, and the disease remains undiagnosed for a long time.

In the classic version, incubation is from 5 to 60 days. The average incubation period is a couple of weeks. Then the symptoms of the disease appear.

Symptoms

Since carriage and an asymptomatic course are possible, a man can find out that he is sick in a few years, when third-party factors cause a persistent weakening of immunity. Bacteria will multiply and cause discomfort. It is expressed in:

• Painful mictions (the act of urination).
• Burning sensation when emptying the bladder.
• The appearance of mucous (glassy) discharge from the urethral canal.
• The appearance of pain in the inguinal zone, in the testicles, scrotum, perineum. The pains are not sharp, but unpleasant, pulling.
• The lips of the urethra may become inflamed, swollen and stick together after a long pause between micturitions (usually in the morning).

The symptoms of mycoplasmosis are not specific and may wax and wane periodically, causing apparent recovery. And the man does not seek help from a specialist and does not find out the cause of a temporary ailment, motivating the lack of action by the fact that he no longer has symptoms. At the same time, he serves as a source of infection for his partners. If the partner becomes pregnant, such an infection can affect the intrauterine development of the fetus.

If a symptom such as burning in the urethra and mucous discharge appears, it is better to get tested for STIs.

Effects

Mycoplasmas are opportunistic bacteria that can be present in a small amount in the body of a healthy person (carrier). This means that the man received these bacteria from a sick person, but his immune system is able to cope with them, suppressing the growth of colonies.

Before the weakening of the body's defenses and the appearance of persistent symptoms, Western medicine, and after it the domestic one, ceased to insist on the treatment of this disease. The treatment of Mycoplasma genitalium is considered mandatory, but the rest of the urogenital mycoplasmas are subject to treatment only before conception or in case of discomfort. For the most part, this approach is justified by the fact that it is not possible to completely destroy bacteria that have entered the body of a healthy person with the help of antibiotics. It is possible to suppress their uncontrolled growth, leading to a balance, that is, a state where mycoplasmas can cause only minimal damage.

In addition, the transferred infection does not form specific immunity, and young men who have an active sex life are easily exposed to a new infection. Because of this approach of specialists, mycoplasmosis in men began to be considered a “non-serious disease” that could not lead to significant complications. In fact this is not true. The reproduction of mycoplasmas is not limited to seeding the urethra (urethritis), they can cause:

1. Orchitis. The disease manifests itself in the form of pain in the testicle and groin, back pain may appear. The testicle swells, increases in size, the skin of the scrotum becomes hyperemic and smooth. Pain is aggravated by walking. There may be general symptoms: dyspepsia, nausea, headache, fever. An inflamed testicle may abscess, atrophy, and infertility may develop.


2. Vesiculitis (the so-called inflammation of the seminal vesicle). Manifested by pain in the suprapubic area with irradiation to the lower back. The pain may be aggravated by ejaculation and defecation. In an acute course, body temperature may rise, sometimes an admixture of blood in the semen will appear. The inflammatory process eventually ends with suppuration of the seminal vesicle, inflammation of the epididymis and infertility.
3. Colliculitis (this is an inflammatory process affecting the seminal tubercle). Accompanied by discomfort in the anus, pain in the groin and perineum, increased spontaneous erection and weakening adequate. Urine is expelled during micturition in a thin, intermittent stream.
4. Prostatitis. This inflammatory process in the prostate is characterized by pain in the lower abdomen and lower back, pain during urination, cutting and burning, pain during defecation. In an acute course, fever and hemispermia (the appearance of blood in the semen) is possible. Prostatitis can lead to sepsis, cystitis, and inflammation of the kidneys (pyelonephritis).
5. infertility.
6. Decreased potency.
7. Cystitis. This disease is characterized by soreness of mictions, imperative (irresistible, obligatory) urge to urinate, pain and cramps during intercourse. With the penetration of a pathogenic microorganism into the interstitial tissue of the kidneys, pyelonephritis develops. It can be manifested by lumbar pain, dysuria, nausea, vomiting, fever.
8. Pyelonephritis.

Mycoplasmosis is a serious disease, the treatment of which should not be postponed. In the presence of a permanent sexual partner, the treatment of the disease is also carried out for a couple.

Diagnostics

In the laboratory, the patient is offered a culture method or PCR to confirm the diagnosis. Most often, PCR is used, although it is not approved as a standard.

For a more reliable study, the study of samples is carried out by the following methods:

• Cultural.
• Cytoimmunofluorescent.
• indicator culture.

The standard is the study of samples by cultural and indicator methods. A blood test for the presence of antibodies to mycoplasma is not considered a reliable diagnostic method. It is preferable to study a smear from the urethra.

Treatment

The symptoms and treatment (therapy strategy) of male mycoplasma, that is, the disease that affected the stronger sex, is slightly different from the symptoms and treatment of this disease in women. It should be comprehensive, take into account the specific type of pathogenic microflora.

Treatment may be limited to the use of antibacterial agents and the doctor's recommendations to lead a healthy lifestyle, regulate their sexual contacts and get rid of bad habits. And you may need a more serious approach with the use of medicines from different pharmaceutical groups:

1. vitamins.
2. Immunostimulants.
3. Spasmolytics.
4. Probiotics and prebiotics.

This disease can be treated with antibiotics of different groups:

• Tetracyclines (Doxycycline, Doxan, Tetracycline).
• Macrolides (Erythromycin, Vilprafen, Roxithromycin).
• Aminoglycosides (Gentamicin).
• Lincosamines (Klitndamycin).
• Fluoroquinolones (Levofloxacin, Ciprofloxacin).

Before prescribing an antibiotic, it is advisable to check the sensitivity of a particular strain of mycoplasma to it.

Treatment should be prescribed by a doctor, focusing on the course of the disease. Depending on the chosen remedy, the course of treatment can be from 3 to 5 days or from 7 to 14 days. In some cases, treatment will last up to a month.

Also, treatment is carried out using:

1. Installations (lavages) of the urethra and bladder.
2. Physiotherapy procedures.
3. Treatment of developed complications and concomitant infections.

An important aspect of speedy healing is a well-chosen diet. Experts advise to temporarily exclude from your menu not only alcoholic beverages, but also sweets, if a man is used to regularly lean on cakes, smoked meats, spicy dishes and spices. From dishes fried to a golden brown, pickles and marinades, it is also temporarily worth abstaining. But adding lactic acid products enriched with lacto- and bifidobacteria to the diet will not hurt.

Prevention

Unfortunately, effective prevention of STIs in unprotected promiscuous sex has not yet been invented. Therefore, preventive measures can be aimed at:

• Strengthening your own body and giving up bad habits.
• Legibility in sex (it is better to have a permanent partner) and protected sex.

If a man has other STDs, inflammatory processes of the genitourinary system, chronic diseases of the internal organs, they must be treated in a timely manner. These measures will significantly reduce the possibility of mycoplasmas entering the body of a healthy person and the possibility of their reproduction, if they still got into the urogenital tract. You can control the health of your genitals and avoid infertility if you regularly (at least once a year) are tested for major sexually transmitted infections.

Mycoplasma in men is the causative agent that leads to the development of an infectious disease called mycoplasmosis. The genitourinary system is affected. Often, the pathology develops asymptomatically, is detected during a clinical examination. It is possible to damage other organs of the body, which is accompanied by unpleasant sensations in the rectum, on the skin, in the groin.

The development of the pathological process in the genitourinary system of a man is promoted by mycoplasma bacteria of the hominis type and genitalium. They affect the urethra, prostate, head of the penis, can provoke the destruction of the seminal vesicles and tubercles.

Infection process

There are several ways of introducing mycoplasma infection. Pathological microorganisms enter the body through:

• the use of other people's contaminated attributes of personal hygiene;
• unprotected intercourse of any type (anal, genital, oral);
• upon contact with a carrier of pathology by airborne droplets.

Unfavorable conditions that provoke the development of the disease include a weakening of the immune system, severe and regular hypothermia. The progression of mycoplasma in men occurs due to bad habits in the form of drug addiction, alcohol intake in large quantities, and smoking. Practice shows that the described disease often acts as a concomitant complication in the development of sexually transmitted diseases. In the case of chlamydia or gonorrhea, it is asymptomatic.

Symptoms of the disease

If the case is neglected, complications in the kidneys and bladder appear. The main symptoms are:

• pain in the groin area;
• clear discharge that appears after a night's sleep;
• severe burning when urinating.

When infected, the prostate is affected. In this case, the following states are added:

• in the anus, pressing pains are felt;
• the presence of erectile dysfunction;
• discomfort in the lower abdomen, in the perineum;
• frequent nighttime urination;
• urine becomes cloudy, may contain purulent impurities.

If left untreated, the epididymis becomes inflamed, which is called epididymitis. The following signs make themselves felt:

• reddening of the skin in the genital area;
• a pulling pain is felt in the scrotum;
• testicles increase in size.

Without qualified medical assistance, a person develops chronic mycoplasmosis. It is accompanied by an increase in the size of the lymph nodes, impaired renal function, and inflammation in the joints.

The appearance of infertility

Most men with impaired reproductive dysfunction are diagnosed with mycoplasma infection. The inflammatory process that accompanies it leads to disruption of spermatogenesis. The bacterium hominis leads to the defeat of the seminiferous tubules, namely the death of their tissues. As a result, fertilization does not occur.

If latent inflammation continues in the body for several years, scars form in the appendages of the ovary and in the prostate. They disrupt the movement of sperm, causing infertility.

Consequences of the disease

In the presence of obvious symptoms indicating infection with mycoplasma, complex therapy should be carried out . Otherwise, serious complications appear:

1. The bladder does not work properly, the kidneys function defectively, pyelonephritis develops in a chronic form.
2. Mycoplasmas with intensive development contribute to the appearance of ureaplasmosis. With this disease, the mucous membrane in the urethra is damaged. Of the signs, there is itching, burning, especially aggravated during intercourse and emptying the bladder. Ejaculation entails severe pain and cramps.
3. The described infection contributes to the development of orchitis, an inflammation of the testicles. In the scrotum, pulling spasms are constantly felt.
4. Another danger of mycoplasma infection is the development of prostatitis. Inflammation occurs that affects the prostate gland. A man complains of inguinal pain, aggravated by pressure. Prostatitis leads to a decrease in potency, a deterioration in the quality of life.

It is impossible to determine mycoplasmosis by external examination and history taking. The patient must pass tests, as a result of which the presence or absence of pathogens is determined. The electron microscope is not suitable for recognizing bacteria that are small in size. Accordingly, cytological examination is not carried out. Of the effective methods, PCR, ELISA, bakposev are noted. All of them have advantages and disadvantages, but together they help to establish an accurate diagnosis.

This method is called cultural, it is carried out if it is necessary to identify Mycoplasma hominis. The sampling of material from the urethra is carried out after 3 hours after urination. Immediately, bakposev is located in a special and nutrient medium for it. With an indicator less than 10 4, it can be argued that a man is not contagious with a bacterium and does not need treatment. If this limit is exceeded, antibiotic therapy is carried out. In the course of a laboratory study, the sensitivity of bacteria to drugs that are subsequently introduced into therapy is immediately determined. The disadvantages of the procedure are noted:

1. Culture does not detect the presence of mycoplasma genitalium, which often affects the male genitourinary system.
2. In the case of taking antibiotics at the time of the test, a negative result may be obtained.
3. The control result of bakposev in the course of treatment is determined no earlier than 10 days after the start of medication.

Enzyme immunoassay (ELISA)

The presence of antibodies against mycoplasma is determined in the body, for which blood is taken from the patient. But there is a significant drawback. The described bacteria settle inside the cells, so the body's response to the study will be weak. Diagnosis in this way is not as accurate as possible. It can be repeated after 6 months of treatment. The number of antibodies during this time is significantly reduced.

Using PCR, any type of mycoplasma is detected, the method is considered the most effective. Any material from a man is used to detect infection. It can be blood, urine, semen or prostate secretions, scrapings taken from the foreskin, urethra. Among the shortcomings, the following points are noted:

1. The examination is able to detect genetic material, but the number of bacteria and their sensitivity to specific drugs is not determined.
2. The high cost of the procedure, so it is not carried out in every laboratory.
3. The effectiveness of treatment is determined during the control PCR, which is prescribed no earlier than 1 month after taking the drugs.

Treatment of mycoplasmosis

If mycoplasmosis is detected, treatment is carried out exclusively with the use of antibacterial drugs - without them it is impossible to get rid of microorganisms. In some cases, the attending physician may prescribe a whole range of drugs, among which, in addition to antibiotics, there are probiotics, vitamins, and immunostimulating drugs.

Mycoplasmosis is necessarily treated with the help of medications selected according to the scheme by the doctor. The following drugs are commonly used:

1. Tetracyclines are most commonly used in the treatment of mycoplasmosis. The patient is prescribed Doxycycline, which shows more effective action and increased safety compared to Tetracycline. Drugs of this group are able to suppress protein biosynthesis inside bacteria.
2. The use of antibiotics belonging to different pharmacological groups. Drugs with high bacteriostatic efficacy that can affect protein synthesis are also applicable.
3. Preparations related to macrolides eliminate symptoms and cope with pathogenic organisms. From this group, therapy often includes the drug Vilprafen (Josamycin), which quickly accumulates in the body and remains in high concentration for a long time. The drug provides an immunomodulatory effect, enhancing the effect of treatment. It is an excellent tool for eliminating the disease, as well as concomitant mixed infections.
4. Fluoroquinolones are unique, their feature is a high antimicrobial effect. In the process of treatment, inhibition of enzymes that ensure the development of bacteria occurs.

Often the treatment of mycoplasmosis is carried out with the help of Ofloxacin, Levofloxacin. They are effective, but also too toxic, so therapy based on them is prescribed for a short period. Additionally, a doctor may prescribe topical agents based on antibiotics, an example would be Oflokain, Tetracycline ointment.

The patient should notify the doctor about the presence of allergic reactions. . It is not uncommon for antibiotics to provide a side effect:

1. Enterocolitis, nausea followed by vomiting, anorexia, dysbacteriosis, indigestion.
2. Dizziness, followed by severe headaches, in rare cases, confusion.
3. Redness and itching of the skin, rashes, difficult breathing, in exceptional cases Quincke's edema.

During treatment with tetracycline drugs, prolonged exposure to the sun, a visit to the solarium is unacceptable. Such medicines increase the susceptibility of ultraviolet radiation. If side effects make themselves felt, therapy is stopped, which is notified to the attending physician.

Useful folk remedies

Upon completion of the consultation with a specialist in the form of additional procedures, it is allowed to use simple and affordable home recipes. They will not help cure the infection, but will effectively relieve its unpleasant symptoms. Washing for men and douching for women with the help of infusions and decoctions of chamomile, calendula, cornflowers, St. John's wort, meadowsweet will be useful. This provides a powerful anti-inflammatory, antiseptic and healing effect.

Increasing therapeutic efficacy

The treatment will be successful, and the infection will be defeated if certain rules are followed. Among them are the following points:

1. It is unacceptable to independently reduce the therapeutic course, skipping medications, which will negate all the efforts made. Do not hope for a complete cure only with the help of folk remedies. It is noted that a vaccine against mycoplasmosis has not yet been developed.
2. It is forbidden to combine therapy with the intake of alcoholic beverages. Recommended a healthy lifestyle, diet food based on vegetables, fruits, cereals in the range, fermented milk products.
3. Sexual life during the entire period of treatment is acceptable. But doctors strongly recommend using barrier protective equipment during this period. This prevents re-infection, infection of the partner.

Preventive measures

You can prevent infection by following simple tips . They are simple, but will help protect yourself from a dangerous disease, for which you need:

• regularly take tests for the detection of mycoplasma;
• lead a decent sex life;
• be examined by a urologist every six months;
• strengthen immunity;
• use contraceptives;
• avoid constant emotional upheavals, stress;
• eat a balanced diet, enrich the body with essential trace elements and vitamins;
• eliminate bad habits from life.

Treatment of mycoplasmal infection is a complex and lengthy process. Successful recovery depends on the timely detection of pathology and seeking specialist help.

Mycoplasmosis is one of the most common sexually transmitted infections of bacterial origin.

Treatment of ureaplasma and mycoplasma in men with drugs involves the appointment of antibiotics, as well as drugs that increase the effectiveness of antibiotic therapy.

When is mycoplasma treatment needed in men?

All over the world, disputes about the advisability of treating mycoplasma in men do not subside.

There are two diametrically opposed points of view.

The first is that all patients who have isolated mycoplasma DNA should be treated.

The second is that no one needs to be treated, since mycoplasmas are harmless bacteria that live peacefully in the urethra and do not cause symptoms in most patients.

All other opinions are in the middle.

There is no doubt that mycoplasma is pathogenic, capable of causing inflammation of the urogenital tract and causing complications.

On the other hand, symptoms do not appear in all men who have the DNA of this bacterium.

As a result, whether a man needs treatment or not, doctors make their own decisions, guided by many criteria.

The main ones are:

1. Does the man have signs of urethritis or laboratory symptoms indicating inflammation of the urogenital tract.

2. Whether there are signs of a prostatitis.

3. Do you plan to change your partner in the near future?

4. Whether pregnancy is planned, or the patient's family has already implemented all their reproductive plans.

5. What is the concentration of mycoplasma in the smear.

6. What kind of mycoplasma is it: hominis or genitalium.

7. Are there signs of inflammation of the testicles or prostate gland.

8. Is the titer of antibodies to mycoplasma in the blood high, does it increase in dynamics or decrease.

9. Are there concomitant sexually transmitted infections.

10. Are there any risk factors that increase the risk of exacerbation of mycoplasmosis or its complications (immunodeficiency, upcoming surgery on the genitals, taking immunosuppressants).

Currently, most venereologists believe that if mycoplasma genitalium is detected, the disease should be treated immediately and without further questions.

It does not matter if there are signs of inflammation, risk factors for complications, and at what concentration microorganisms are contained.

They are more pathogenic than Mycoplasma hominis.

If there is no genital urethritis today with the carriage of mycoplasma, then tomorrow it will definitely appear.

At the same time, the attitude towards Mycoplasma hominis is not so unambiguous.

Treatment may not be given if the man:

• no active signs of inflammation
• does not suffer from concomitant STDs
• does not plan to change partners in the near future
• not planning to have a baby
• does not have risk factors that increase the likelihood of complications of mycoplasmosis

Thus, if the likelihood of infecting other people is low, and if the risk of developing inflammation and complications is low, the disease can be left untreated.

But such people usually do not go to doctors.

The most common reasons for referral are:

• symptoms of inflammation of the urogenital tract
• wife's pregnancy planning
• preventive examination due to a stormy and varied sexual life
• search for causes of infertility
• upcoming surgeries or invasive procedures

No one comes to the doctor without any reason, just to be examined for mycoplasmosis out of curiosity.

Therefore, in practice, most situations when this bacterium is found in the urogenital tract require the appointment of therapy.

Features of the use of antibiotics

The main group of drugs for the treatment of mycoplasma are antibiotics.

The problem of mycoplasmosis therapy is that these bacteria are resistant to many drugs.

Therefore, it is optimal to carry out treatment not empirically, but after performing a bacteriological study.

Material from the urethra is sown on a nutrient medium.

After colonies of mycoplasmas grow, a study is carried out for sensitivity to antibiotics.

As a result, the doctor finds out to which drugs the bacterium is sensitive and to which it is resistant.

But only for the treatment of Mycoplasma hominis in men, drugs that are highly likely to work can be selected in this way.

The problem of the effectiveness of the treatment of infections caused by mycoplasma genitalium remains not fully resolved.

Because sowing on this bacterium is not carried out.

It grows on nutrient media poorly and for a long time.

As a result, the treatment of mycoplasma in men with antibiotics has to be prescribed empirically.

That is, choose those of them to which the bacterium is most often sensitive.

But nevertheless strains of mycoplasmas come across different.

Therefore, this treatment does not always work.

Solutions to the problem:

• simultaneous use of antiseptics that allow the destruction of mycoplasmas in the urethra
• the use of enzymes that improve the penetration of antibiotics into tissues
• use of two antibiotics at the same time

Regimen for empiric treatment of mycoplasmosis

There are many regimens for the treatment of mycoplasma with antibiotics in men.

The following groups of drugs are mainly used:

• macrolides
• fluoroquinolones
• tetracyclines

Studies indicate that the most effective drugs against mycoplasma genitalium are macrolides.

For therapy, erythromycin, azithromycin, josamycin can be used.

Fluoroquinolones have a good effect, but only new generations.

Sparfloxacin or levofloxacin are used.

However, tetracyclines are less effective.

A study by Horner P. J. showed that treatment with doxycycline was unsuccessful in 50% of patients.

They revealed the DNA of mycoplasma genitalium after treatment.

And the symptoms of urethritis returned 2-3 weeks after the therapy.

At the same time, there are other studies demonstrating the opposite results.

While azithromycin was ineffective in 18% of patients.

The difference was in the dosages used.

In the first case, doxycycline was used on the first day at 200 mg, then for another 5 days at 100 mg per day.

The second study used a 7-day 100 mg regimen.

In two out of three patients, fluoroquinolones are effective.

At the same time, studies show that even if the mycoplasma genitalium is found in the urethra, in almost all patients this does not lead to the return of symptoms of urethritis.

In Russia, three main treatment regimens for mycoplasmosis are used:

• doxycycline 100 mg, once a day, a course of 3 days
• josamycin - a course of the same duration, 500 mg per day
• azithromycin - on the first day 0.5 grams, then another 2 days, 250 mg each.

It is believed that macrolides are more effective than tetracyclines.

But this opinion is based largely on the experience of doctors.

It has not yet been confirmed by large studies.

Confirmation of the cure of mycoplasmosis

After the abolition of antibacterial drugs, the patient is examined again.

For this:

• examine, evaluate symptoms
• take a swab from the urethra for microscopic examination
• perform PCR 2-4 weeks after discontinuation of drugs

In most cases, after a course of therapy, the symptoms go away.

But this does not indicate recovery, since small amounts of bacteria could remain in the urogenital tract.

To check the etiological cure, the doctor takes a scraping from the urethra and sends it for molecular biological diagnostics.

If, according to the results of the study, a negative result is obtained, and the person has no complaints, objective symptoms, further monitoring is not required.

But there are situations when the DNA of a bacterium is found in a urethral smear.

Then a second course of therapy is carried out.

Causes of failure in the treatment of mycoplasmosis

Treatment of mycoplasma genitalium in men is not always successful.

It happens that after a course of antibiotic therapy, the bacterium is detected in the urogenital tract again.

This rarely happens in our clinic.

There are several reasons for this:

1. We use antibiotics that can accumulate inside cells.

Once inside the cells, they become immune to some antibiotics.

2. We apply adequate schemes and doses.

We prioritize therapies that have been shown to be the most effective in studies.

3. We use additional drugs and procedures.

We use antiseptics for washing the urethra, physiotherapy, prostate massage.

We prescribe immunomodulators and enzyme preparations.

These measures help enhance the effect of antibiotics.

As a result, the likelihood of success is much higher.

However, there are times when treatment fails.

Main reasons:

1. The man did not fully comply with the doctor's prescription.

2. The bacterium was insensitive to the antibacterial drug.

3. The patient was re-infected with mycoplasma from an untreated partner.

In addition, there are cases when the DNA of mycoplasma is not detected, but the symptoms of urethritis return.

With a high probability, this indicates the underexamination of the patient.

Signs of inflammation can be provoked by the accompanying pathogenic flora.

To exclude such situations, during the initial visit of the patient, we examine him immediately for all common sexually transmitted infections.

What to do in case of unsuccessful treatment of mycoplasmosis?

If the course of treatment was unsuccessful, it is worth finding out why this happened.

Very often, therapy does not work because the patient does not fully comply with medical recommendations.

A feature of the treatment of mycoplasmosis is the need to use mainly bacteriostatic drugs.

They are used for a long time.

Some drugs are taken 1 or 2 times a day.

In addition, the patient is treated on an outpatient basis.

Already in the first days, if successful, he gets rid of all the symptoms.

All this leads to insufficiently high compliance (the patient's willingness to comply with the doctor's recommendations).

The most common mistakes patients make are:

• forget to take another pill from time to time
• want to save money and buy a cheap analogue of the prescribed antibiotic
• reduce doses in the event of side effects or in an effort to prevent their occurrence
• stop therapy prematurely because they notice the disappearance of symptoms

Undertreatment is one of the most common causes of failure.

Many patients, if they are prescribed antibiotics for 5-7 days, do not drink the course to the end.

After a few days of admission, clinical recovery often occurs.

But it is not synonymous with microbiological recovery.

If there are very few bacteria left in the urogenital tract, they no longer cause symptoms.

But they are still able to reproduce, if not completely destroyed.

Therefore, after premature discontinuation of antibiotics, the disease usually recurs.

Mycoplasma in men often becomes insensitive to the drug used.

This complicates further treatment of the disease.

If the patient perfectly complied with medical prescriptions, but was not cured, this is most likely due to the primary resistance of mycoplasma to the antibiotic used.

No drug works 100% of the time.

Therefore, the empirical appointment of treatment is always somewhat risky.

If the first course did not bring results, a second course is required.

The doctor either prescribes a drug of another pharmacological group, or conducts a bacteriological culture.

Re-treatment of mycoplasmosis after bacterial culture

More effective is the treatment that is carried out after performing a cultural study.

The frequency of unsuccessful outcomes of therapy in this case is reduced by three times.

But the method is not applicable in case of infection with mycoplasma genitalium.

It does not grow well on nutrient media.

Therefore, in clinical practice, culture is not used to diagnose this infection.

But Mycoplasma hominis can be cultured.

After that, an assessment of the sensitivity of this bacterium to various antibiotics is carried out.

According to the results of the study, the doctor receives an antibioticogram.

It lists antibiotics that can be used to treat Mycoplasma hominis in men.

Near each drug there is information about the sensitivity of the bacteria to it.

It can be denoted by the letters:

• S– high sensitivity;
• I– low sensitivity;
• R- resistance.

In other cases, the minimum inhibitory concentration of the antibacterial substance is determined in mg / l.

After receiving an antibiogram, the doctor can treat with the drug to which the bacteria definitely do not have resistance.

Therefore, the next course of therapy is highly likely to be successful.

Treatment of a partner with mycoplasmosis in a man

One of the reasons for the re-detection of mycoplasma in a man after treatment is re-infection.

Most often, the source of infection is the same person.

This is the constant partner of the patient.

To rule out such situations, both partners should be examined and, if necessary, treated at the same time.

This ensures that there is no recurrence in case of successful therapy.

Where to go for the diagnosis and treatment of mycoplasmosis?

For the diagnosis of mycoplasmosis and its treatment, you can contact our clinic.

We have dermatovenereologists who have been successfully treating this infectious disease for a long time.

Our services:

• testing for mycoplasmosis
• topical diagnosis: we will check which organs are involved in the inflammatory process, as this affects the choice of therapeutic tactics
• screening for associated sexually transmitted infections
• determination of the concentration of mycoplasma DNA in the foci of inflammation
• assessment of the amount of antibodies in the blood
• choice of antibiotic therapy
• the use of other methods of treatment, including non-drug
• restoration of sexual and reproductive function after antibiotic treatment
• confirmation of cure by laboratory methods

In our clinic, effective treatment of mycoplasmosis is carried out, even if it has become chronic and has spread to the internal genital organs.

For the diagnosis and treatment of mycoplasmosis contact the author of this article - a venereologist in Moscow with many years of experience.