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Timing of progression from Chlamydia trachomatisinfection to pelvic inflammatory disease: a mathematical modelling study | BMC Infectious Diseases

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  • Chlamydia

    How common is chlamydia?

    Very. In the United States, chlamydia is the most common bacterial sexually transmitted infection (STI). In 2018, nearly 1.8 million cases of chlamydia were reported to the Centers for Disease Control and Prevention (CDC). However, it is estimated that almost 3 million cases actually occur each year.

    Chlamydia is most common in younger people. It is estimated that 1 in 20 sexually active young women aged 14-24 years has chlamydia.

    How does someone get chlamydia?

    Chlamydia is passed through oral, anal, or vaginal sex. Chlamydia can be passed from one person to another even if the penis or tongue does not go all the way into the vagina or anus. Eye infections can occur when discharge caries the disease into the eye during sex or hand-to-eye contact.

    Chlamydia can also be passed from mother to newborn as the baby passes through the infected birth canal. This can result in eye infections, pneumonia or other complications.

    What are the symptoms of chlamydia?

    It is important to understand that focusing on signs and symptoms is not very useful in determining if someone is infected with chlamydia. First, the symptoms of chlamydia are similar to the symptoms of gonorrhea, and the two infections are often confused. Also, approximately, most women and about half of men do not experience symptoms. So, most people who are infected will not be able to tell from symptoms.

    If a person does have symptoms, they usually develop within one to three weeks after exposure to chlamydia. How long a person remains infectious (able to transmit the bacteria to others) is difficult to determine since so many people are asymptomatic. A person must be considered infectious from the time they become infected until treatment is completed.

    If a person does have symptoms, they may include:

    • Proctitis (inflamed rectum), urethritis (inflamed urethra) and conjunctivitis (inflamed eyelid)
    • Soreness and redness in the throat or mouth (for chlamydia infection of the throat
    • vaginal discharge
    • pain or burning sensation during urination
    • pus (thick yellow-white fluid) or watery or milky discharge from the penis
    • pain or swelling of the testicle

    If the infection spreads to the fallopian tubes, symptoms may include:

    • lower abdominal and lower back pain
    • pain during intercourse
    • bleeding between menstrual periods
    • nausea or fever

    Who should get tested for chlamydia?

    Because chlamydia is very common and often has no symptoms, anyone who is sexually active should think about being tested. Because chlamydia is very common among young women, The Centers for Disease Control and Prevention (CDC) recommend sexually active women age 25 or younger get tested once per year. Chlamydia testing is also recommended for women with new or multiple sexual partners and pregnant women.

    Anyone who is sexually active should talk with a healthcare provider about whether they need testing for chlamydia or other STIs. Don’t be afraid to speak openly about your sex life, as you can get the best care by having an honest discussion with your healthcare provider.

    How do you get tested?

    There are several different reliable tests for chlamydia. Newer tests, called NAATs (short for nucleic acid amplification tests), are very accurate and easy to take. Your healthcare provider can explain what testing options are available (urine or swab tests, for example). If you don’t have a regular healthcare provider, you can search here for a clinic near you.

    People infected with chlamydia are often also infected with gonorrhea, so patients with chlamydia are often treated for gonorrhea at the same time, since the cost of treatment is generally less than the cost of testing.

    If you live in Alaska, Maryland, or Washington, D.C., you can have a free at-home chlamydia test. Visit iwantthekit.org for more information.

    What is the treatment for chlamydia?

    There are antibiotic treatments that are effective in treating chlamydia. A healthcare provider will decide which antibiotic is prescribed, taking into consideration the particular needs of the patient.

    Whatever treatment is prescribed, there are some important points about any treatment:

    • The patient must take all medications as directed.
    • All partners should be examined and treated.
    • The infected person should not have sex until they and any partner or partners have been treated and cured.
    • People who show symptoms after treatment should be tested again.
    • Women should be retested three to four months after treatment because of a high rate of reinfection.
    • Because the symptoms of chlamydia are similar to the symptom of gonorrhea, and because a person can be infected with both, doctors will sometimes go ahead and treat people with chlamydia for both infections (chlamydia and gonorrhea). Remember, partners should be examined for infection and treated as well to avoid reinfection.

    What does chlamydia infection mean for my health?

    Chlamydia can be treated and cured easily, but that doesn’t mean that chlamydia infection isn’t potentially dangerous. If chlamydia isn’t diagnosed and left untreated, it can cause serious complications.

    Untreated chlamydia infections in women may lead to:

    • Pelvic inflammatory disease (PID), a serious infection of the reproductive organs (uterus, fallopian tubes and ovaries). Left untreated, PID can cause infertility (and inability to become pregnant or maintain a pregnancy), chronic pelvic pain, or ectopic (tubal) pregnancy.
    • Cystitis (inflammation of the urinary bladder)
    • A condition called mucopurulent cervicitis, characterized by a yellow discharge from the cervix

    Untreated chlamydia in men may lead to:

    • Prostatitis (inflammation of the prostate gland)
    • Scarring of the urethra
    • Infertility
    • Epididymitis (inflammation of the epididymis, which is the elongated, cord-like structure that runs along the back of each testes)

    Chlamydia and pregnancy | Pregnancy Birth and Baby

    Chlamydia is a bacterial sexually transmitted infection (STI) that affects both men and women. Chlamydia can also cause a number of issues during pregnancy.

    Most people with chlamydia are unaware that they have the infection. Left untreated, chlamydia can cause serious complications including infertility and chronic pain. Chlamydia is fairly easy to treat if you know you have it — one course of antibiotics is usually enough.

    Causes of chlamydia

    Chlamydia is caused by an infection with the bacterium Chlamydia trachomatis. It is spread by unprotected (unsafe) vaginal or anal sex with an infected person.

    Chlamydia is the most commonly reported STI in Australia.

    What are the symptoms of chlamydia?

    Most men and women with chlamydia have no signs or symptoms, which makes it very easy to spread. Some people have the infection for many months or years without knowing it.

    Women who get symptoms may have:

    • vaginal discharge
    • bleeding between periods or after sex
    • burning or pain when urinating
    • abdominal or pelvic pain
    • pain during sex

    Men who get symptoms may have some clear discharge from the penis or pain during urination.

    In rare cases, people with chlamydia have sore joints (arthritis) or inflammation of the eye (uveitis).

    Diagnosing chlamydia

    Chlamydia is easily diagnosed. Your doctor may take a sample from the vagina, cervix, anus or penis, and may ask for a urine test. These are sent to a laboratory for testing.

    If you think you or your partner have chlamydia, see your doctor or sexual health clinic so you can both be tested. It is important that any sexual partners of people with chlamydia are tested, even if they don’t have symptoms.

    Treating chlamydia

    Treatment for chlamydia is a course of antibiotics. It is important to avoid sex until the full course of treatment is finished, and for at least a week following. You should have another test 3 months after you are treated.

    If you have chlamydia, all of your sexual partners should be informed, tested and treated, as they may be infected and can infect you, and others, again after treatment.

    If your partner has had a positive test for chlamydia, you should be treated even if you have had a negative test result. As chlamydia infection increases the possibility of contracting other infections, it is important to be tested for other STIs such as gonorrhoea, hepatitis, HIV and syphilis. Using latex condoms and a water-based lubricant is the most effective way to prevent STIs. People who have chlamydia for long periods without treatment risk becoming infertile or developing arthritis. Women can get pelvic inflammatory disease, and men can get epididymitis (a painful infection near the testicle).

    Chlamydia complications

    If chlamydia isn’t treated properly, it can cause serious complications. People who have chlamydia for long periods without treatment risk becoming infertile or developing arthritis.

    For women, chlamydia can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease. Pelvic inflammatory disease can lead to ectopic pregnancies, chronic pelvic pain and infertility.

    In men, chlamydia can cause epididymitis (a painful infection near the testicle) or spread to the prostate gland, and the tubes that carry sperm, which may result in chronic pain and/or fertility problems.

    Both men and women can develop arthritis, eye inflammation and inflammation of the rectum.

    Chlamydia and pregnancy

    Because of this, doctors recommend that pregnant women under the age of 30 should be screened for chlamydia.

    Pregnant women who are infected with chlamydia have an increased risk of their waters breaking prematurely, causing the baby to be born early.

    If a woman has chlamydia when giving birth, the baby might become infected during delivery. These babies can develop an eye infection (conjunctivitis) or pneumonia, and might need antibiotics. Chlamydia has also been associated with low birthweight.

    The antibiotics used to treat chlamydia are safe in pregnancy and are used in pregnant women for many other types of infections.

    Pelvic Inflammatory Disease (PID): Symptoms, Treatments & Causes

    Overview

    Female reproductive tract.

    What is pelvic inflammatory disease (PID)?

    Pelvic inflammatory disease, or PID, occurs when female reproductive organs become infected. The reproductive system is the part of the body involved in getting pregnant and having a baby.

    Reproductive organs affected by PID include the uterus, ovaries and fallopian tubes. When you have PID, you may feel stomach pain in your lower abdomen (belly). You may also have unusual discharge (leaking) from your vagina.

    How do you get PID?

    Most people typically get PID through unprotected sex, however 15% of these infections are not sexually transmitted. Sex may let bacteria enter the reproductive system, where they can infect the organs.

    How does pelvic inflammatory disease affect me?

    PID can damage parts of your reproductive system, including the uterus, ovaries and fallopian tubes. PID can be painful and make it difficult to become pregnant in the future. PID can also lead to a pocket of infection in the pelvis called a tubovarian abscess (TOA) which, if untreated can make people very sick.

    Who’s at risk for PID?

    You face a higher risk for pelvic inflammatory disease if you:

    • Have a sexually transmitted infection (STIs), especially gonorrhea or chlamydia.
    • Have many sexual partners or have a partner who has had multiple partners.
    • Have had PID in the past.
    • Are sexually active and younger than 25.

    How common is pelvic inflammatory disease?

    Each year, more than 1 million women in the U.S. get PID. And more than 100,000 women become infertile because of it, meaning they can’t have a baby. Many cases of ectopic pregnancies are also the result of PID. An ectopic pregnancy is when the baby starts to develop outside the uterus, most commonly in the fallopian tube. An untreated ectopic pregnancy needs immediate medical attention.

    Cases of PID have dropped in recent years. The reason may be that more women get regular testing for chlamydia and gonorrhea, the main infections that lead to PID.

    Symptoms and Causes

    What causes pelvic inflammatory disease (PID)?

    Bacteria entering the reproductive tract often cause pelvic inflammatory disease. These bacteria are passed from the vagina, through the cervix, into the uterus, fallopian tubes and ovaries, and into the pelvis.

    Normally, when bacteria enter the vagina, the cervix keeps them from spreading deeper to other reproductive organs. But sometimes, the cervix becomes infected from an STI like gonorrhea and chlamydia. When that happens, it’s less able to keep bacteria out.

    Untreated gonorrhea and chlamydia cause about 90% of PID cases. Other causes include:

    • Abortion.
    • Childbirth.
    • Pelvic procedures.
    • Insertion of an intrauterine device (IUD), either copper or hormonal. The risk is highest in the few weeks after insertion. Many times this type of infection is preventable with STI testing around the time of IUD placement.

    Does douching cause pelvic inflammatory disease (PID)?

    Most studies report only a very weak association between douching and PID. What can be said is that douching can lead to bacterial vaginosis infections, but there is only a potential association between douching and PID.

    What are the symptoms of PID?

    You may not realize you have PID. Symptoms might be mild or unnoticeable. But symptoms of PID can also start suddenly and quickly. They can include:

    Diagnosis and Tests

    How is pelvic inflammatory disease diagnosed?

    If you feel symptoms of PID, see your healthcare provider right away. The sooner you get care, the greater your chances of successful treatment.

    Usually, your healthcare provider can diagnose PID through:

    • Medical history, including asking about your general health, sexual activity and symptoms.
    • Pelvic exam to examine your reproductive organs and look for signs of infection.
    • Vaginal culture to take a sample of any bacteria.

    What other tests might I need to diagnose PID?

    Your provider may also order:

    In some cases, your provider may recommend:

    • Endometrial biopsy to remove and test a small tissue sample from the endometrium, the lining of the uterus.
    • Laparoscopy, a surgery using small incisions and a lighted instrument to look closely at reproductive organs.
    • Culdocentesis, with a needle inserted behind the vagina to remove fluid for examination. This procedure is much more rare then it used to be, but is sometimes helpful.

    Management and Treatment

    How is pelvic inflammatory disease (PID) treated?

    Your provider will prescribe antibiotics that you take by mouth. Make sure to take all your medicine, even if you start feeling better. Often, your symptoms improve before the infection goes away. Your provider may recommend you return a few days after starting the medicine. They can check that treatment is working.

    Some people take antibiotics and still have symptoms. If that happens, you may need to go to the hospital to receive medicine through an IV. You may also need IV medication if you:

    • Are pregnant.
    • Have a severe infection and feel very sick.
    • Have an abscess (collection of pus) in your fallopian tube or ovary.

    Will I need surgery for pelvic inflammatory disease?

    Surgery is rare for PID but can help in some cases. If you still have symptoms or an abscess after taking antibiotics, talk to your healthcare provider about surgery.

    Does my partner(s) need treatment for pelvic inflammatory disease?

    If you have pelvic inflammatory disease, tell your sexual partner(s). They should also get treated, for their sake and yours. Otherwise, you may get PID again when you resume sex.

    Prevention

    Can I prevent pelvic inflammatory disease?

    Sometimes, PID is not due to a sexually transmitted infection. It can come from normal vaginal bacteria traveling to your reproductive organs. Avoiding douching may lower the risk.

    Most of the time, though, PID happens because of unprotected sex. Take steps to practice safe sex. Protect yourself from sexually transmitted infections (STIs) that can cause PID:

    • Limit sexual partners: Your risk increases if you have multiple partners.
    • Choose barrier methods of birth control: These types of birth control include condoms and diaphragms. Combine a barrier method with spermicide, even if you take birth control pills.
    • Seek treatment if you notice symptoms: If you notice signs of PID or other STIs, get treatment right away. Symptoms include unusual vaginal discharge, pelvic pain or bleeding between periods.
    • Get regular checkups: Have regular gynecological exams and screenings. Often, providers can identify and treat cervical infections before they spread to reproductive organs.

    Do I need regular sexually transmitted infection tests?

    If you’re sexually active, talk to your healthcare provider about yearly testing for sexually transmitted infections. Providers often recommend testing for chlamydia to help keep you safe. It’s also helpful to get tested before having sex with a new partner.

    Outlook / Prognosis

    Can pelvic inflammatory disease be cured?

    If you get prompt diagnosis and treatment for an infection, antibiotics can cure PID. But treatment can’t reverse any damage that already happened to your reproductive organs. Don’t wait to get treated. See your provider right away so you can get the help you need to stay healthy.

    Are there complications of PID?

    If you get PID several times, you can develop scarring on the fallopian tubes. The scarring can lead to several problems, including:

    If I had pelvic inflammatory disease, will I have trouble getting pregnant?

    PID can affect fertility. Of the women who had PID, studies found that 1 in 8 had difficulty getting pregnant. People who had repeat infections had a harder time getting pregnant.

    How does PID affect fertility?

    An egg needs to travel from your ovary, down the fallopian tube and into the uterus (womb). Then the sperm can fertilize it. But bacteria from PID can cause scarring on your fallopian tubes. The scar tissue makes it harder for the egg to get where it needs to go.

    Can I get pelvic inflammatory disease again?

    Yes, you can get re-infected. Getting PID once doesn’t protect you from getting it again.

    If I had PID, when can I resume having sex?

    You and your partner should wait a week after finishing your antibiotics before resuming sex. Doing so will help prevent re-infection.

    Living With

    How can I take care of myself if I have pelvic inflammatory disease?

    If you feel symptoms of PID, see your healthcare provider right away. And if you had unprotected sex, it’s a good idea to talk to your provider, even if you don’t feel symptoms. The sooner you get treated, the more likely it will be effective. Prompt treatment also reduces your risk of serious complications.

    Other tips for taking care of yourself:

    • Avoid douching to prevent pushing bacteria upward from your vagina into your uterus and fallopian tubes.
    • Return to your healthcare provider a few days after starting medication to make sure it’s working.
    • Take all your medicine as directed.
    • Use condoms or dental dams every time you have sex to protect yourself from infections.
    • Wait one week after you (and your partner) have finished medication to resume your sex life.

    When should I see my healthcare provider about PID?

    See your provider if you experience any symptoms of PID. Seek immediate medical care if you have:

    • Intense lower belly pain.
    • Severe vomiting.
    • High fever (higher than 101 F).
    • Fainting.

    What should I ask my healthcare provider?

    If you have PID, ask your provider:

    • What treatment will I need?
    • Do I need to get rechecked?
    • Will PID affect my ability to get pregnant?
    • What are possible complications of PID?
    • When can I resume having sex?
    • What can I do to prevent PID?

    A note from Cleveland Clinic

    Pelvic inflammatory disease (PID) is an infection of your reproductive organs. It’s usually caused by a sexually transmitted infection, such as gonorrhea or chlamydia. Avoid douching. Although the evidence is weak, douching may be tied to PID; it can definitely lead to bacterial vaginosis. If you notice symptoms of PID, such as pain in your lower abdomen, talk to your healthcare provider. The provider can diagnose PID and give you antibiotics to treat it. Early treatment is essential to avoiding complications of PID such as infertility. Your partner(s) should get treated as well. You can prevent PID by using a condom every time you have sex.

    Why it’s important to be tested for chlamydia during pregnancy

    What is chlamydia?

    Chlamydia is a curable bacterial infection that can be transmitted through genital, oral, or anal sex. It can also be passed from a woman to her baby during delivery.

    The Centers for Disease Control and Prevention (CDC) estimates that 1.8 million people in the United States get chlamydia each year, making it the most common sexually transmitted bacterial infection. The rate increased 3 percent between 2017 and 2018. The highest rates are found in sexually active women under 30 years old, particularly those who are 20 to 24 years old.

    How can chlamydia affect my pregnancy?

    Prompt treatment may reduce the risk of these problems, but women who have chlamydia during pregnancy tend to have higher rates of:

    • Infection of the amniotic sac and fluid
    • Preterm premature rupture of the membranes (PPROM)
    • Preterm birth

    Some studies have linked chlamydia to an increased risk of miscarriage, although other studies have found no connection.

    An untreated chlamydia infection also makes you more susceptible to HIV and some other sexually transmitted infections (STIs) if you’re exposed to them. It also raises your risk of a uterine infection after you have your baby.

    Can chlamydia affect my baby?

    Yes, if you have a chlamydia infection when you go into labor, there’s a chance that you’ll pass the bacteria to your baby. In fact, up to half of babies born vaginally to mothers with untreated chlamydia (and even some babies born by c-section) will contract the infection.

    Between 25 to 50 percent of these babies will develop an eye infection (conjunctivitis) a few days to a few weeks after birth. (The medicated drops or ointments put in your baby’s eyes soon after birth to prevent gonorrheal conjunctivitis don’t prevent chlamydial eye infections.) And 5 to 30 percent of babies who contract chlamydia during delivery develop pneumonia a few weeks to several months after birth.

    Although these infections can be very serious, babies who are treated promptly with antibiotics generally do well. Of course, it’s best to get treated before delivery to prevent your baby from becoming infected in the first place.

    What are the symptoms?

    It’s important to note that in the vast majority of chlamydia cases (up to 90 percent of women) there are no symptoms. If you do have symptoms, they’re likely to show up about one to three weeks after you’ve been exposed. These symptoms may include:

    • Burning or discomfort when you urinate
    • Inflammation of your cervix
    • Increased vaginal discharge or possibly spotting
    • Abdominal pain
    • Pain during sex
    • If you engage in anal intercourse, you may also have inflammation of your rectum, rectal pain, and discharge.
    • If you have oral sex with an infected partner, your throat can become infected and may feel sore.

    Up to 70 percent of men infected with chlamydia have no symptoms. The most common symptoms include discharge from the penis, burning or pain while urinating, tender or swollen testicles, and inflammation of the rectum. It’s important to let your caregiver know if either you or your partner has symptoms of chlamydia and make sure you both get tested and treated if necessary.

    Can chlamydia cause PID?

    Yes. Before and after pregnancy, chlamydia can travel up from your cervix to infect your uterus or fallopian tubes, causing pelvic inflammatory disease (PID). In fact, up to 15 percent of women who aren’t pregnant who have untreated chlamydia infections end up with PID. (It’s possible to get PID during pregnancy, but it rarely happens.)

    Symptoms of PID include:

    • Pain in your lower abdomen or back
    • Pain during sex
    • Vaginal bleeding
    • Fever
    • Nausea

    PID can result in permanent damage to your fallopian tubes and lead to chronic pelvic pain and infertility, as well as an increased risk of ectopic pregnancy if you do become pregnant.

    Will I be screened for chlamydia during my pregnancy?

    Most likely, yes. Because it’s so important to detect and treat chlamydia during pregnancy, because it’s a relatively common infection, and because the infection usually occurs without symptoms, the CDC recommends that all pregnant women be screened for chlamydia at their first prenatal visit.

    To test for chlamydia, your practitioner will send either a swab from your vagina or cervix or a urine specimen to the lab for analysis. If your chlamydia test is positive and you weren’t tested for other STIs at the same time, your caregiver will do so now.

    If you’re under 25 years old or otherwise at high risk for contracting chlamydia (you or your partner has a new sex partner or more than one sex partner), your practitioner might repeat the test during your third trimester, to make sure you’re not infected as you prepare for delivery. You’ll also be retested if you’ve contracted another STI during your pregnancy or if you or your partner develops symptoms of chlamydia.

    How is chlamydia treated during pregnancy?

    Chlamydia is treated with antibiotics that are safe to take during pregnancy. Your practitioner may prescribe an antibiotic that you take in a single dose or one that you take over the course of a week. (Be sure to take the medicine exactly as prescribed.) In most cases, one round of treatment will cure the infection.

    Your partner should be treated at the same time, and both of you should abstain from sex until a week after completing treatment so you don’t get reinfected.

    The CDC recommends that pregnant women be tested again three to four weeks after completing treatment to make sure the infection is gone.

    How can I avoid getting chlamydia during pregnancy?

    Have sex only with a long-term partner who has sex only with you. Otherwise, use latex condoms during intercourse, and a dental dam during oral sex, to reduce your risk of getting chlamydia and certain other STIs.

    Again, if it’s possible that you’ve been exposed to chlamydia (or any other STI) during pregnancy, or you develop any symptoms, tell your practitioner right away so that you can be tested and treated if necessary.

    The test for chlamydia is one of the many tests you’ll have during pregnancy. Here’s an overview of what tests you can expect in each trimester.

    Learn more:

    How does chlamydia affect your fertility?

    Did you know that Chlamydia is one of the most common sexually-transmitted infections (STIs) in the UK?

    And, yep, you guessed it: it can have an impact on your fertility, and in some cases can even make you infertile.

    So, it’s important to know what you’re dealing with, what symptoms to look out for – plus how to get checked, and then treated.

    Here’s everything you need to know about chlamydia, how chlamydia affects fertility, symptoms to look out for and treatment…

    What is chlamydia?

    Chlamydia is a bacteria-like organism, which is passed around during unprotected vaginal, oral or anal sex. (That’s sex without a condom – other forms of contraception only protect against pregnancy).

    In 2007, it was estimated that 10% of all sexually active young people in the UK were infected with chlamydia.

    11 years later, and it’s so widespread that the NHS still recommends that sexually active under 25s get checked every year, or every time they get a new sexual partner.

    What are the symptoms?

    Worryingly, there often aren’t any signs or symptoms to suggest that anything’s wrong. In fact, 70% of women and 50% of men don’t have any symptoms at all. For those that do, it might feel similar to an infection of the urethra or cervix.

    For women, the 30% who DO get symptoms might also experience, according to the NHS:

    • cystitis-like symptoms
    • a small increase in vaginal discharge
    • bleeding between periods or after sex
    • discomfort during sex may arise if the cervix becomes very inflamed.

    How does chlamydia affect fertility?

    If left untreated, the infection can lie dormant for several months before travelling through the cervix to infect the fallopian tubes, leading to Pelvic Inflammatory Disease (PID).

    PID can cause unpleasant and painful symptoms such as:

    • stomach or pelvis pain
    • ‘discomfort or pain during sex that’s felt deep inside the pelvis’
    • pain while having a wee
    • bleeding between periods or after sex
    • painful or heavy periods 
    • vaginal discharge that’s not normal for you – especially if yellow or green.

    In extreme cases, you might experience severe pain, a fever and nausea/vomiting.

    However, many women have a less acute inflammation that produces few if any symptoms.

    When PID isn’t taken care of, it can eventually lead to blockage or scarring of the fallopian tubes and subsequent infertility.

    The NHS website estimates that around 10% of women with PID will very sadly become infertile as a result. 

    Can chlamydia cause other problems?

    In addition to infertility in women, chlamydia can have a negative impact on male health, too. It can cause epididymo-orchitis (basically a short-but-still-long way of saying ‘inflammation of the testicles’).

    In some cases, it can also go on to cause reactive arthritis, which is caused by STIs and can affect multiple parts of your body.

    It usually lasts around 3 – 6 months (12 in some cases), after the STI has been caught and treated.

    Essentially, all we’re saying is that you don’t want this infection to run away from you. Best to catch it quick, and treat it quick.

    How to get checked for chlamydia

    To get checked for chlamydia is surprisingly easy – just arrange a test at your local sexual health/GUM clinic. Your GP may also be able to arrange a quick test.

    Infection in men is diagnosed from a urethral swab, and infection in women is diagnosed from a cervical swab and a urethral swab.

    Anything that doesn’t feel right, tell your doc – as it may help them determine if you’ve got any of the conditions it can cause.

    What’s the treatment for chlamydia?

    It’s really easy for docs to treat the chlamydia infection itself – just a course of antibiotics, which your GP or GUM clinic can prescribe.

    Any conditions that occur as a result can also be treated with antibiotics, in the early stages.

    The NHS says those who catch PID early will get prescribed a 14-day course, a mix of injections and tablets, to clear up the infection.

    Have your say (anonymously!)

    Would you be willing to talk about your own fertility experience after chlamydia? Perhaps you conceived just fine – or you’ve had PID and want to share your story?

    Please do get in touch (privately, anonymously, whatever you like) on Instagram, Facebook or via our forum, in the comments below.

    Images: Getty Images

    Read more:

    The STD You May Have and Not Even Know It

    Image Point Fr/Shutterstock

    No wonder chlamydia has been nicknamed the silent stalker: After analyzing the latest data, the Centers for Disease Control estimates that more than one in 100 U.S. adults currently have this sexually transmitted disease. That works out to 1.8 million cases—yet only 1.4 of those have been reported. In other words, 400,000 people may have it and be clueless about the risk it poses to themselves and their partners.

    MORE: Which STDs Are on the Rise?

    But it’s not necessarily their fault they’re in the dark. Most of the time, chlamydia has zero symptoms. “In men and women, it can trigger signs such as abnormal discharge and pain, especially during urination, but the most common symptom is actually none at all,” says Mary Jane Minkin, M.D., clinical professor of ob-gyn at Yale University.

    For men, it rarely develops into a more severe condition, yet having it means they can spread it to their partners. For women, the consequences are much more serious. If left untreated for months or years, the bacteria will move past primary infection locations such as the urethra, vagina, and cervix and into the uterus and fallopian tubes. There it leads to scar tissue that can quietly harm your fertility, all while you have no idea what’s going on, says Minkin. At that point, it can bring on a condition called Pelvic Inflammatory Disease (PID), which often causes intense pain and cramping. But by the time PID strikes, irreversible damage may have been done. “Chlamydia and PID are huge causes of infertility in women,” says Minkin. Untreated chlamydia infection can also make your system more receptive to HIV.

    MORE: Could You Give YOURSELF an STD?

    But here’s the good news: A simple test at your gyno’s office (either a cervical swab or a urine test) can diagnose chlamydia, and if you have it, a quick course of antibiotics will cure the infection. Ob-gyn guidelines call for all sexually active women under age 25 to be tested yearly, but if you’re over 25 and aren’t sure (and we mean really sure) of your partner’s status, consider getting tested, just to play it safe. Read this for more information on this scary STD.

    MORE: The Shocking Number of New STD Cases Each Year

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    90,000 Between us girls

    Timely treatment of chlamydia is a guarantee of your health and the health of your children
    “You need to be tested for chlamydia” – this recommendation is often given to women who see a doctor with unclear symptoms, especially in the genitourinary system, as well as those who have decided to have a child. Many have heard about chlamydia, or a trash infection, but not everyone knows what it is, what causes it.
    Insidious microorganisms
    Chlamydiae are microorganisms that live in humans and animals and cause various diseases such as urogenital chlamydia, as well as trachoma, pneumonia, respiratory diseases, arthritis, encephalomyocarditis, lymphogranulomatosis venereal disease.Chlamydiae are interesting in that they have the properties of both bacteria and viruses. These are very small microorganisms with the basic characteristics of bacteria, but they can also exist inside cells, which combines them with viruses. And yet, just like viruses, chlamydiae at some stages of development do not respond to antibiotics.
    Chlamydia live in epithelial cells, therefore they affect the mucous membranes, which are lined with epithelial cells. These are, of course, pathogenic microorganisms, unlike, for example, ureaplasma.
    Four species are distinguished in the genus Chlamydia. But the most common and dangerous, found only in humans, is Chlamydia trachomatis, and the urogenital chlamydia that it causes is one of the most common infections. Infection with this infection occurs in most cases during sexual contact, therefore chlamydia is referred to as STDs – sexually transmitted diseases, or sexually transmitted diseases.
    Settling on the mucous membranes of the genitourinary tract: fallopian tubes, cervical canal, urethra – chlamydia trachomatis causes the development of inflammation in the genitourinary organs.If the infection is not identified and untreated, the process eventually becomes chronic, giving serious complications, including infertility.
    Chlamydia trachomatis affects both men and women, but for the latter, this infection is especially dangerous. The fact is that in women, chlamydia in the first stages proceeds without visible manifestations. Doctors believe that sixty to seventy percent of patients do not have any subjective symptoms of the disease. Therefore, they go to the doctor only when the inflammation becomes chronic, spreads to other organs and causes various diseases of the genitourinary sphere.
    Symptoms and treatment
    How does chlamydia infection occur in women? Most often, the cervical canal is initially affected and cervicitis develops. From there, the infection can spread to the inner lining of the uterus, leading to inflammation – endometritis. As a result, pregnancy and fetal development become impossible. From the affected uterus, chlamydia penetrates the genitals located above: the fallopian tubes and ovaries. Salpingitis, or inflammation of the fallopian tubes, often causes their obstruction and, as a result, infertility.
    Infection can also affect the urethra, leading to urethritis. The reproductive tract of a woman through the fallopian tubes is connected to the abdominal cavity, so chlamydia can also penetrate the mucous membranes of the abdominal organs, contributing to the development of inflammatory processes in them and the formation of adhesions.
    If a woman is pregnant, the infection can be transmitted to the baby when he passes through the birth canal. And this threatens him with diseases such as conjunctivitis pneumonia, vulvovaginitis, urethritis. Damage to other organs of the child is also possible.
    The peculiarity of chlamydia trachomatis is that after the transferred infection, immunity to it is not developed, therefore, chlamydia can be infected repeatedly.
    What else is dangerous about chlamydia trachomatis? Today, experts have established that this infection causes serious immunity disorders, and this, in turn, threatens the development of various complications, including diseases of the joints and internal organs. One of the serious complications of chlamydia is Reiter’s disease (or syndrome). This is a simultaneous damage to the joints, eyes and genitourinary organs.True, mostly young men are ill with it.
    To avoid these serious consequences of chlamydia, it is recommended to be examined for chlamydia for women at risk:
    • with inflammatory diseases of the genital organs, especially with cervical erosion and cervicitis;
    • suffering from infertility for two to three years;
    • women with complicated pregnancy (threat of termination, fever of an unclear nature, polyhydramnios), as well as those who had previous pregnancies with pathologies (miscarriage, missed pregnancy, premature birth, etc. )etc.).
    Well, in order to minimize the possibility of infection, it is advisable to streamline sexual intercourse (remember: chlamydia is sexually transmitted) and protect yourself during sex.
    Dear women, take care of your health!

    T.I. Popova, gynecologist, TGBUZ “GKB No. 3 of Tambov”

    Material published in the newspaper “Tambov Courier”

    Chlamydia – chlamydial infection – signs, symptoms, diagnosis and treatment of chlamydia

    Chlamydia – what is it:

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    If you have reason to believe that you have a sexually transmitted infection (STI) or that you have been exposed to a sexually transmitted infection such as chlamydia, stop having sex immediately until you are examined by a doctor …

    Chlamydia is

    • Chlamydia is the most common sexually transmitted infection.
    • This is an infection caused by a microorganism called Chlamydia trachomatis.
    • Chlamydia usually affects the reproductive and urinary systems.
    • It can also affect the throat, eyes and anus.
    • This can lead to serious problems, especially in women, if left untreated.

    How do I get chlamydia? How is chlamydia spread?

    1. Chlamydia is spread from an infected person to an uninfected person during sex.
      Sex is the insertion of the penis into the vagina, rectum, or mouth; and / or oral sex on the penis, vagina, or rectum.
    2. Chlamydia is transmitted through ejaculate (semen).
    3. Chlamydia can be passed from mother to child during childbirth.
    4. Infection is more common in people with multiple sex partners.
    5. People who have been diagnosed with chlamydia and have received antibiotic treatment may become infected again if they have sexual intercourse with persons infected with chlamydia.
    6. Chlamydia affects the reproductive system.
    7. Chlamydia can be treated with antibiotics.
    If I have chlamydia and am pregnant, can I infect my child?

    Yes, a baby can contract chlamydia during childbirth.

    • An infant infected with chlamydia may develop conjunctivitis (infection of the lining of the eyelids) and / or pneumonia.
    • Chlamydial infection in newborns can be treated with antibiotics.

    Visit your healthcare professional and get tested and treated for chlamydia during pregnancy.

    How common is chlamydia:

    • Chlamydia is a very common infectious disease, especially among young people.
    • The Centers for Disease Control and Prevention estimates there are 2-3 million new cases of chlamydia each year. Only about half of these infections are recorded.
    • Sexually active young people are at high risk of contracting chlamydia.
    • Men who have sex with men are also at risk of chlamydial infection, as chlamydia can be transmitted through oral and / or anal sex.

    If you have contracted chlamydia – what to do?

    If you do not start treatment, you may have serious reproductive health problems:

    • Women may develop pelvic inflammatory disease (PID). Pelvic inflammatory disease is a serious problem and can lead to severe pelvic or abdominal pain in women.Left untreated, pain can last for months or years.
    • A woman can become infertile due to the damage that chlamydia can cause to her reproductive system.
    • Chlamydial infection can also cause an ectopic (“tubal”) pregnancy when the fetus develops outside the uterus, which then ruptures or removes the ovarian tube, and chlamydia can cause premature labor.

    Men have other complications. The infection spreads to the urethral mucosa, pain when urinating or during intercourse, and fever.

    Untreated chlamydia increases a person’s risk of contracting the HIV virus that causes AIDS.

    Signs and symptoms of chlamydia:

    Symptoms of chlamydial infection may occur 5-30 days after infection, although most people do not notice any symptoms.

    A woman has this:

    • Vaginal pain or itching.
    • Pain or burning sensation when urinating.
    • Increased vaginal discharge.
    • Vaginal bleeding between periods.
    • Pain during sex.

    Women with chlamydia are at risk of developing serious complications, even if they are asymptomatic.

    90,002 Men: 90,022

    • Pain or itching of the penis.
    • Pain or burning sensation when urinating.
    • Discharge from the penis.
    • Painful or swollen testicles.
    • Pain during sex.

    Men and women:

    • Abdominal pain.
    • Rectal pain, discharge or blood in the stool (if you become infected during anal sex).
    How do I know if I have chlamydia?

    Up to 90% of women and 70% of men, the disease is asymptomatic. Chances are, you will not be able to tell if you have chlamydia until you have been examined by a doctor. That is why it is important to visit your doctor and get tested for chlamydia and . If you are a girl, see an experienced gynecologist. If you are a young man – see a urologist.

    Diagnostics and treatment of chlamydia

    How is chlamydial infection diagnosed?

    A number of laboratory tests are available to diagnose chlamydia.
    • A doctor may take a sample of biological material for testing from parts of the body that may be susceptible to infection (vagina, cervix, urethra, rectum, or throat) and send the sample to a laboratory for analysis.
    • Chlamydia, which is present in the bladder in women or in the urethra (urethra) in men, can also be diagnosed in the laboratory by examining a urine sample.
    • Vaginal swabs can also be tested for chlamydia with the new molecular tests.

    Biological samples for the diagnosis of chlamydia:

    How to diagnose chlamydia?
    • Women: The doctor takes a vaginal and / or rectal swab, urine.
    • Men: The doctor takes a swab from the urethra (penis) and / or rectal swab, prostate secretions, ejaculate (semen), or urine.
    • The collected samples of biological material are sent to the laboratory, where they are examined using highly sensitive molecular tests, which give the most accurate result.

    Can chlamydia be cured?

    Yes! Chlamydia is treatable.

    • With antibiotics prescribed by your doctor, chlamydia can be successfully treated in adolescents and adults.
    • It is important to take all medicines as prescribed to treat chlamydia, even if you feel better. ALL antibiotics must be taken as directed by your doctor for treatment to be effective. You cannot stop taking, reduce the dose or shorten the duration of antibiotics on your own.
    • If your symptoms continue even after treatment, you should return to your doctor for another test.

    Prevention: Can Chlamydia Be Prevented?

    Yes. Chlamydia infection can be avoided. Follow the guidelines below:

    • Refrain from sexual intercourse; or use a latex condom correctly, every time you have sex (vaginal, anal or oral) with each partner.
    • Limit the number of your sexual partners.The more sex partners you have, the greater your risk of bumping into someone who has this or other latent sexually transmitted infections.
    • If you are infected, your sexual partner (s) should be aware of it so they can be tested and treated if needed. This will prevent you from re-infection.
    • Doctors recommend testing for chlamydia once a year for all sexually active women 25 years of age or younger.
    • Annual testing is also recommended for women over 25 with a new sexual partner or with multiple partners.
    • All pregnant women should have a screening test for chlamydia.
    • Men who have sex with men should be screened for chlamydia every year. Men who have sex with men who have multiple partners should be tested more frequently.
    • Women and men with chlamydia must be retested approximately three months after infection is treated.
    • Always see your doctor if you have any signs or symptoms of latent sexually transmitted infections, or if you have changed partners or learned about the existence of another sex partner.
    • There is no vaccine available to prevent chlamydia.

    Treatment of chlamydia will prevent more serious consequences.

    If I have had chlamydia once, can I get it again?

    Yes. You can get chlamydia again.Chlamydia is not immune.

    90,000 Chlamydia questions: page 6

    Is it possible to get chlamydia in the household? What drugs are effective in the treatment of ureaplasmosis and mycoplasmosis? Can chlamydia be treated during pregnancy? Doctors of medical clinics “Art-Med” answer questions about diseases: chlamydia, ureaplasmosis and mycoplasmosis.

    Pregnancy, 22 weeks. 3 weeks ago, my husband and I finished taking vilprifen for chlamydia, they have not yet taken a second test.A very strong burning sensation after intercourse disturbs, as if iodine is being poured over a wound, while the husband does not feel anything like that. What is it – a reaction to sperm or to the sexual act itself, what to do in this case? After Vilprafen, I was recovering with the Atzilact candles. Is it possible to somehow restore the husband?

    Self-medication is not worth it. The structure of the genitals in you and your husband is completely different and the adaptation to changes in microflora during antibiotic treatment is also completely different. A strong burning sensation after intercourse, which you feel, may be caused by some other infection that is not treated with wilprafen.In addition, during treatment, it is common to abstain from sexual activity or use a condom. In your situation, it is advisable to contact a specialist to clarify the situation. You can get all the necessary consultations and examinations in our medical center.

    I am planning a pregnancy next month, at the beginning of January. I am 29 years old, this will be my first pregnancy. The gynecologist took a smear for DNA infection and it turned out that I had ureplasmas, mycoplasmas, gardnerella and thrush.I did not take any tests from my husband, but prescribed treatment for both. Me: Fromilid (tablets), 1 * 2 for 10 days. Cleon D (tablets), 1 * 2 10 days; Candles Neointestopan No. 14. After that, the drug Orungal 1 tab. within 4 days. Husband the same tablets and Clotrimazole Ointment 2-3 times. Wait 10 days and get tested again. After the treatment, is it necessary for both of them to be tested or again only for me? Is the treatment prescribed correctly? When can I take it if treatment helps get rid of infections? In addition, I take euffilin, my asthmatic effect is weak.During the day, everything is fine, in the morning I start to choke, if I don’t drink euffilin. I have been drinking for many years. I read that euffilin can cause many side effects in the fetus. Constipation, what remedies can I take during pregnancy? I usually take festal and senade, or guttalax. I also have an allergy to dust, I have been treated with various methods for a very long time: treatment with allergens, homeopathy, acupuncture – it helps for a while, but then it reappears in the form of nasal congestion and shortness of breath. I take fencarol and ketotifen.All instructions indicate that drugs are contraindicated during pregnancy …

    There are a lot of treatment schemes for genital infections, each doctor uses his own established schemes. After the course of treatment, it is imperative to take tests for all sexual partners, but not earlier than 14 days after the last intake of antibacterial drugs. Pregnancy can be planned as soon as the infection is cured, since all drugs used are quickly cleared from the body. As for euphyllin, it seems to be vital for you.Taking antihistamines is best discussed with a geneticist. Of the laxatives during pregnancy, including in the early stages, you can use Duphalac.

    A bitter itching started 2.5 months ago. An urgent analysis revealed nothing. I endured for another half a month, then it became easier. Then the itching was repeated just unbearable. The analysis showed thrush and increased white blood cells. I drank Flucostat 150, clotrimazole and genalgin suppositories in courses, doused with soda. Did not help. The doctor prescribed Flucostat for 50 7 days and geno-pevaril suppositories (3 pcs).Did not help. After menstruation, I drank a course of Itrazol (3 days). Did not help. I drank a course of metronidazole and Pimafucin suppositories (6 pcs), doused with hydroperite. Tomorrow I am going to have tests, but I feel again it didn’t help. The itching did not stop, although it became less. I passed the analysis of biotopes (lactobacilli, gardnerella, mycoplasma, ureaplasma ureatilikum, mobilinkus, bacteroids) and chlamydia. The analysis is negative except for lactobacilli. The doctor said it was good. I have erosion. I went to the immunologist. I pierced a whole course of vitamins B1, B6.Now I am giving Polyoxidonium injections. I try not to eat sweets. I do not live sex life during treatment. My young man howls already from abstinence. He drank Flucostat 150. It seems that we are doing everything right, but there is no sense. Tired already. I can not. A bunch of pills were swallowed. What to do?

    You need to do a bacterial culture of the vaginal contents with the determination of sensitivity to antibiotics, be examined for the presence of herpes simplex virus type 2, human papillomavirus infection, determine the blood sugar level, wear only cotton panties (not thongs).

    Recently, I was diagnosed with chlamydia, inflammation of the cervix and thrush. Now I am undergoing a course of treatment. My husband has no chlamydia, only mycoplasma and fungus. We use condoms to protect ourselves. The husband has not yet been treated. What is the likelihood that I will get infected again (naturally, we will continue to protect ourselves)?

    Considering that both chlamydia and mycoplasma live in the cells of the columnar epithelium, which are part of all mucous membranes of the human body, any direct contact with biological fluids can theoretically lead to infection.Body fluids are blood, urine, semen, saliva, tears, etc.

    Pregnancy – 30 weeks Several times I passed the same tests (determination of ureplasmosis, chlamydia, etc.). First time: 4-5 weeks, second: 10-12, third: 20 weeks. Why so many – they did not explain. The results are all negative, except for the last (found ureplasmosis). Prescribed treatment: macropen, pimafucin, klion-d. Should I undergo treatment and use these particular drugs? Or is it worth taking repeated tests, but in a different clinic?

    It would be more expedient to clarify the validity of the number of studies conducted by you with the doctor who prescribed them for you.There were probably good reasons for this. It should be noted that it is not the isolated microbe that should be treated, but the disease that it causes. Unfortunately, you did not indicate whether you have signs of an inflammatory process? By what method and in what quantity was ureaplasma detected. If there really is a disease, then treatment is necessary. For this purpose, you can also use the drugs you have named. However, it is important to consider the dosage of drugs and the method of their use.

    I am 31 weeks pregnant.Found ureplasma, thrush and yeast. Doctors differ on treatment. Some say that it is better to heal after childbirth, while others say that before them. Prescribed Betadine suppositories, then acylact suppositories, but the discharge continues. What medicine or suppositories can be used during pregnancy so as not to harm the baby and so that he does not get sick with anything while walking along the birth canal during childbirth? What is the likelihood that the baby will be born unhealthy? When a child is born, is he checked for all infections and illnesses in the hospital?

    For the infections you indicated, it is advisable to carry out treatment during pregnancy.There are enough effective drugs to treat them. Treatment is prescribed strictly individually after examining the patient and studying the test results. It should be emphasized that suppositories with betadine are not recommended for use in late pregnancy, as indicated in the annotation enclosed in the package of the drug. Unfortunately, not all clinics check the child for all the necessary infections and diseases. It is impossible to estimate the probable condition of the child at birth on the basis of the data provided by you.You can get all the necessary consultations and examinations at the ART-MED medical center.

    I was diagnosed with ureaplasmosis (+++). Prescribed Giadiron (10) rectally, wobenzym – 3 weeks, Unidox – 2 weeks (1 tab 2 times a day) for me and my husband, tinidozole – 3 days for both, mycosist – 1 tab. for both and betadine – 14. What does the three plus signs mean, strong infection or not? The doctor prescribed treatment for me and my husband, but he did not take tests, should he trust the prescribed treatment, if neither he nor I had other contacts for 3.5 years.In what sequence should the drugs be taken, is it possible to drink tinidozole and unidox at the same time and use betadine suppositories? On the site, I read that all sexual contacts are excluded, that infection can even be through kissing and masturbation. Can I use a condom?

    You have been diagnosed with ureaplasma infection in a sufficiently high titer. Considering that this disease is sexually transmitted, your husband also has this infection, so he does not need to be tested before treatment, but after the end of therapy, control smears must be taken, just like you.All your prescribed medications can be taken at the same time. During treatment, sexual intercourse is not recommended, after the end of the course of treatment, you can have sex in a condom until the results of control tests are obtained.

    I passed the tests, they found a thrush, I was treated. After that, I was tested and I was diagnosed with chlamydia. I have a constant partner and from him I definitely could not get infected. Where did I get chlamydia? When I was being treated for thrush, we did not have sex, and literally the day before I found out that I had chlamydia, we had sexual intercourse.Could I infect him, if so, how to treat him?

    Chlamydia is a sexually transmitted disease. If sexual partners have sex without a condom, then they have one flora, respectively, chlamydia will also be common. Searching for the source of the disease is an absolutely hopeless occupation, since in modern conditions most women and men have several sexual partners (not necessarily at the same time). If you did not lose your virginity with this man, and he did not part with innocence with you, then accept the existing disease as a fact.Both of you need to undergo a course of treatment under the supervision of a gynecologist (for you) and a urologist or andrologist (for him). You can also get advice and undergo treatment in the ART-MED clinic.

    Is there a cure for chlamydia and chronic gonnococcus?

    These diseases can be cured. For the appointment of individual treatment, it is necessary to pass a number of tests, including for the correct selection of antibiotics. It is important to know all comorbidities and assess the state of the patient’s immune system.Therefore, it is not possible to prescribe treatment without examination by a doctor.

    I have infertility, I did computer diagnostics – nonlinear analysis (NLS): adnexitis, left ovarian cyst, follicular cyst on the right ovary. Were found: PSEUDOMONAS AERUGINOZA and ureaplasma. Before that, my husband and I took all the tests for infections several times, none of this happened. Could these infections have been hiding in the body for years. How can these infections be cured?

    Many infections can indeed persist for a very long time in the body, causing sluggish inflammation, for example, in the genitals.This is especially true for ureaplasma. However, before prescribing treatment, I recommend taking a culture for this infection with the determination of the titer and sensitivity to antibiotics. Regarding the second infection, I want to ask: did you have oral sex before taking a smear? When carrying out any auxiliary research – ultrasound, any computer research and other descriptive diagnostic methods, the diagnosis is not made, this can only be done by a clinician. However, if you only take tests without visiting a doctor after that, this will not lead to anything good.

    When I was tested, I was diagnosed with papilloma virus 31.33 and ureplasma. The doctor did not explain anything, prescribed a bunch of everything (suppositories, antibiotics, epigen spray). I have several genital warts on the labia. What are the consequences if not treated?

    The ureaplasma infection found in you can cause indolent oligosymptomatic inflammatory processes, especially in the uterine appendages. If you do not complete the course of treatment in a timely manner, inflammation can lead to the formation of adhesions in the fallopian tubes and in the small pelvis, which, in turn, will lead to infertility.In pregnant women, ureaplasma infection causes intrauterine infection of the fetus. It is impossible to get rid of the human papillomavirus, it is a lifelong infection, you can only prevent the development of exacerbations. Let me remind you that carriers of this virus have a manifold increased risk of developing cervical cancer. Therefore, do not forget to visit the gynecologist 2 times a year, if necessary – more often, and follow the doctor’s recommendations. If you are in doubt about something and you have questions, come to the medical center “ART-MED”, our specialists will certainly help you.

    I am 27 weeks pregnant. At 18 weeks, the smear showed mycoplasma, an increased number of leukocytes 40-50. She treated her leukocytosis with Terzhinan, but after about a month everything resumed. The doctor in the consultation prescribed re-treatment and said that my husband apparently had an inflammatory process and he constantly infects me. He passed tests for mycoplasma, ureaplasma and chlamydia – nothing was found. We are confused, doctors cannot clearly explain anything. Does leukocytosis occur because of a weakened immune system during pregnancy, or do I get infected from my husband after treatment? Are leukocytosis and mycoplasmosis related or not? How can we now be treated and from what?

    Leukocytes are not pathogens, but blood cells that protect the body from infection.Where there is an infection, many white blood cells appear, this phenomenon is called leukocytosis. In your case, leukocytosis arose in response to the presence of mycoplasma. Mycoplasma recurrence may be due to the natural weakening of the immune system during pregnancy, and not to your husband. Perhaps, in addition to mycoplasma, there is another infection. The treatment should be repeated with the use of other drugs, having previously consulted a specialist.

    My daughter (14 years old) has a menstrual irregularity.The first menstruation began 9 months ago (at 13.5 years) in December, then were in January, May, August 1 (3 days, not plentiful) and the last from September 10 to 18. Those. break for 2-3 months. Develops normally. They did an ultrasound scan. Result: the uterus is usually located, 36x28x47 mm. Left ovary – 36x18x15 mm, follicles up to 5 mm on the periphery, the capsule is not thickened. Right ovary 51x17x16 mm, follicles 5 mm, over the entire stroma more than 10 in the field of view. M-echo 9 mm for phase II. Chlamydia was found in the blood (1:40). We completed 2 courses of treatment (Viferon-3, Rulid, Echinacea).The gynecologist prescribed a course of vitamin therapy (Vit. E, A, C, B1, folic acid). How dangerous is the disease and whether the course of treatment is prescribed correctly.

    Treatment of chlamydia is absolutely justified, since it is a very insidious disease that can lead to various complications, including infertility. There are many treatment regimens for this disease, including the one that you have been prescribed. Control tests for infections are taken 10 days, 3 weeks and 3 months after treatment.Vitamin therapy is the first step in correcting menstrual function, as well as the recovery stage after antibiotic therapy. Your daughter needs to watch how her periods continue. The described ultrasound picture allows us to note that there is alertness regarding the structure of the ovaries, one of the sizes is slightly increased. Repeat the examination after 6 months.

    90,000 Treatment of chlamydial urethritis in men – why azithromycin? | # 01/08

    In recent years, in the Russian Federation, the incidence of urogenital chlamydial infection has come out on top among all bacterial sexually transmitted infections (STIs), and is second only in frequency to trichomoniasis.The same picture is in the countries of North America and Europe, where urogenital chlamydia has been the most common bacterial STI for many years. Although the share of Clamidia trachomatis (C. trachomatis) as an etiological agent in the general structure of urethritis in men does not exceed 50%, it is this pathogen that remains the main cause of such urethritis.

    Classification of chlamydial infections . In the international classification of diseases X revision (ICD-X) adopted in most countries of the world, urogenital chlamydial infections are subdivided:

    one.For chlamydial infection of the lower sections (uncomplicated):

    2. Infection of the upper urinary tract (complicated):

    In addition, in ICD-X, chlamydial infection of the anorectal region, chlamydial pharyngitis, as well as chlamydial infection of other localizations are isolated.

    This classification is more convenient for statistical reports, where a clear classification of all diseases is required. In clinical practice, specialists often modify the ICD in order to better adapt it to their work.So, for the appointment of adequate therapy for chlamydial infections, it is important to understand which of the 3 forms of urogenital chlamydia the patient has:

    1. Chlamydial infection of the lower parts of the urogenital tract;

    2. Chlamydial infection of the upper parts of the urogenital tract;

    3. Persistent or recurrent urogenital chlamydia.

    Clinical manifestations of chlamydial infection .Most often in men, in practice, there is a chlamydial infection of the lower parts of the urogenital tract – urethritis.

    Urethritis caused by C. trachomatis usually presents with scant clinical symptoms, although it may be accompanied by signs of acute inflammation similar to gonorrhea. Often, infection of the lower parts of the urogenital tract in men with chlamydia can proceed without any clinical symptoms.

    The most common manifestations of chlamydial infection of the lower parts of the urogenital tract in men are the presence of mucopurulent or mucous, abundant discharge from the urethra, dysuria (itching, burning, pain when urinating), discomfort, itching, burning in the urethra.Clinical examination in such patients can reveal hyperemia and edema of the mucous membrane of the external opening of the urethra, infiltration of the walls of the urethra, increased leukocytosis in the material from the urethra.

    The successful cure of chlamydial infection largely depends on the choice of the correct tactics of therapy, since mistakes at the very initial stage of the disease, be it diagnostic errors or inadequate choice of antibiotics, can lead to the fact that it will not be possible to get rid of the infection, which threatens the patient with serious complications.

    The most severe complications of chlamydial infection include: epididymitis, pelvic inflammatory disease (PID), infertility in both sexes, Reiter’s disease, perihepatitis, pelvioperitonitis, fetal pathology and postpartum pathology in the mother, as well as some other conditions. Their development may be associated not only with chlamydia, but also with other pathogens, but chlamydia remains the most common cause of these complications.

    The main drug for the treatment of various forms of urogenital chlamydial infection has been azithromycin for more than 10 years.All major Russian and foreign guidelines – “Rational pharmacotherapy of skin diseases and sexually transmitted infections” (2005), “Dermatovenereology 2007” (clinical guidelines of the Russian Society of Dermatovenereology), CDC clinical guidelines (Centers for Disease Control) (2006), European Guidelines for the treatment of sexually transmitted infections (2001) – it is azithromycin that is considered the drug of choice for the treatment of urogenital chlamydia.

    Azithromycin was synthesized in 1983.at the research institute “Pliva” (Croatia). Then it was a completely new antibiotic created on the basis of erythromycin, and the resulting substance with a unique chemical structure and exceptional pharmacokinetic properties surpassed all the indicators of its predecessor. This drug became the first representative of a new group of antibiotics – azalides.

    The uniqueness of azithromycin is based on its exceptional pharmacokinetics. Azithromycin is stable in an acidic environment, due to which it is well absorbed after oral administration (Feise EF et al, 1990).Simultaneous intake with food reduces absorption by 50%, so the drug is taken 1 hour before or 2 hours after meals. The tablet form of the drug is devoid of this drawback, which can be taken regardless of food intake.

    After oral administration of 500 mg of azithromycin, the bioavailability of the drug is 37%, and the maximum plasma concentration (0.4 mg / l) is reached after 2-3 hours, then it gradually decreases by 24 hours, in subsequent periods the drug is not detected in the blood (Komarov R.V. et al, 2001). This is not enough to achieve a therapeutic effect in the treatment of infections accompanied by bacteremia. However, the lipophilicity of the azithromycin molecule provides, in addition to a high level of absorption in the intestine, also excellent penetration of the drug into the tissues. The rapid penetration of azithromycin from the blood into tissues is also ensured by a low level of binding of azithromycin to blood proteins, which makes it possible to achieve a rapid therapeutic effect in infections that damage cells and tissues (Foulds G et al, 1990).

    Antibiotic efficacy is usually assessed by comparing in vitro activity (this is a measure of the minimum suppressed concentration (MIC) and serum drug concentration. These comparisons can lead to misconceptions about the real effectiveness of the antibiotic. For its assessment, it is necessary to take into account the drug concentration in tissues and the site of inflammation.It is these indicators of azithromycin that ensure its superiority.In various tissues, the concentration of azithromycin is ten times higher than the concentration in the blood serum (Fig.one).

    Experiments and studies on animals have shown that the clinical and bacteriological effects of macrolide antibiotics directly depend on the time when their concentrations exceed the MIC90 values ​​of pathogens, and the condition for a positive effect is that the MIC concentrations exceed the concentration for at least 40% of the dosing interval. Considering that, according to R.V. Komarov. et al. (2001), 3 days after administration, the concentration of azithromycin in the secretion / tissue of the prostate gland was 16.8 times higher than the MIC values ​​and, taking this value of time as 40%, it is possible to predict the persistence of the effect of azithromycin for at least 7 days after a single dose.

    For antibacterial drugs, not only the level of accumulation in tissues is important, but also the ratio of tissue concentrations and MIC values ​​for infectious agents. Thus, the concentrations of azithromycin in the secretion and tissue of the prostate gland presented above (Fig. 1) exceeded the MIC 90 for chlamydia at all follow-up periods, up to 2 weeks (in the study by LeBell M. et al (1996)).

    The data obtained confirm the possibility of a single use of azithromycin in uncomplicated chlamydial infection, when a 7-day exposure to the microorganism is needed, overlapping 2 life cycles of chlamydia, as well as its appointment in short courses with long intervals between them in complicated and persistent chlamydia.

    The accumulation of the drug in macrophages and polymorphonuclear leukocytes and its transportation with them to the site of inflammation complement the targeted action of azithromycin in the focus of infection. It has been shown that the concentration of the drug at the site of inflammation significantly exceeds its concentration in healthy tissue (Pukander J, 1990).

    The ability of azithromycin to penetrate into cells provides an active effect on intracellular microorganisms, which include C.trachomatis . In diseases caused by intracellular pathogens, the effect of treatment and the rate of elimination of the pathogen from the body depend on the level of concentration of the antibiotic inside the cells (polymorphonuclear leukocytes, macrophages, epithelial cells). Among all antibiotics, macrolides are characterized by the greatest ability to concentrate inside the cell. In this case, azithromycin is especially attractive, since the ratio of antibiotic concentrations inside the cell and in the extracellular space is 40 or more for it.According to this indicator, azithromycin is superior not only to erythromycin, but also to other semi-synthetic macrolides (Fomina I.P. et al., 1996).

    In the experiment, it was found that azithromycin accumulates in leukocytes with subsequent slow release. The ratio of intra- / extracellular concentrations in polymorphonuclear leukocytes and macrophages in vitro after 2 h of incubation with an antibiotic is 79, exceeding the corresponding indicators for erythromycin by 4-5 times. Intracellular concentration of azithromycin is detected within 24 hours or more.It was also found that pretreatment of cells with azithromycin does not affect the gripping, digesting and killer functions of phagocytes (McDonald P. J. et al, 1991). Additional important properties of azithromycin, contributing to the rapid implementation of the therapeutic effect, even with short regimens of use, is the concentration of the antibiotic in fibroblasts, which turn into a kind of reservoir from which the drug is released in the focus of infection (Glodue R. P. et al, 1990).

    Another important feature of azithromycin is the long half-life of 68 hours, which leads to the fact that high levels of concentration at the site of infection, which persist for a long period of time (up to 10 days), provide a constant active effect on pathogenic microorganisms (Andriole V.T., 1990, Retsema J., et al, 1990). Reducing the time of taking an antibiotic while maintaining therapeutic efficacy is a very important principle in outpatient treatment of a patient. According to various authors, only 65% ​​of patients fully comply with the doctor’s prescriptions. Almost half of those receiving treatment as sexual partners of infected patients do not fully comply with the therapy regimen. According to Grob P. R., 1992, during the first 3-5 days of treatment, non-performance is observed in about half of the cases, on the 6-7th day its level increases to 71-81%.For these reasons, the preference is now given to treatment regimens that provide for a single dose or at least infrequent use of drugs. The long half-life of azithromycin from the body, the preservation of effective concentrations in the focus of infection for 4-5 days after the termination of treatment allows for shorter courses of therapy, which correspond in efficiency to 10-day courses of treatment with traditional antibiotics (Fomina I.P. et al., 1996 ). Azithromycin remains the only single dose antibiotic for the treatment of uncomplicated chlamydial infection today.Back in 1993, Lister P. J. et al showed that a single dose of 1.0 gram of azithromycin was not inferior in effectiveness to a 7-day course of doxycycline. The great ease of use of azithromycin for patients and the ability to control the intake of a single dose by medical personnel allows for almost 100% adherence to the treatment regimen (Petitta ABS et al, 1999).

    Azithromycin is metabolized in the liver, and 50% is excreted unchanged in the bile, about 6% is excreted in the urine.

    When taking azithromycin, side effects from the gastrointestinal tract (nausea, vomiting, diarrhea) and liver (increased transaminase activity, cholestasis, jaundice), as well as allergic reactions, may occur.

    The mechanism of action of azithromycin, like other macrolides, is due to the effect on the function of bacterial ribosomes. The drug binds to the 50S subunit of the ribosome ribosome and thus inhibits the biosynthesis of proteins of the microorganism, providing a bacteriostatic effect.The bactericidal effect of the drug begins at concentrations exceeding the MIC by several times.

    Despite the extensive data presented regarding the pharmacokinetics of azithromycin, many fundamental aspects of the interaction of chlamydia and antibiotics in vitro and in vivo remain unclear. Since chlamydiae are intracellular parasites, the assessment of their antibiotic sensitivity is possible only in cell culture. Such laborious and unique tests are not available in all laboratories.For example, in Moscow, these studies are carried out in the medical and biological center “Pasteur”. The laboratory uses a standardized and well-studied method for detecting chlamydia in cell culture, including hard-to-cultivate persistent forms of chlamydia, and also has a reference chlamydia strain necessary for quality control of studies. However, a clear correlation between the results of a study of the sensitivity of chlamydia in cell culture and the effectiveness of treatment has not yet been established, which may be associated with the complex life cycle of chlamydia.

    Azithromycin for urethritis of non-chlamydial etiology . Azithromycin is highly active not only against chlamydia, but also against other infections that can be transmitted through sexual contact: Ureaplasma urealyticum, Mycoplasma genitalium, Neisseria gonorrhoeae and Haemophilus ducreyi. Mycoplasma hominis is in most cases resistant to azithromycin.

    Azithromycin is also active against gram-positive ( St.aureus, St. epidermidis , including strains producing beta-lactamases, various streptococci species, with the exception of macrolide-resistant strains and enterococci) and gram-negative flora ( Haemophilus influenzae, Moraxella catarrhallis , etc.). These microorganisms can also be found in the genitourinary tract, but their role in urethritis has not been proven.

    Recommendations for the use of azithromycin in chlamydial infection . For the treatment of patients with chlamydial infection of the lower parts of the urogenital tract, all of the above guidelines as a method of choice recommend a single dose of azithromycin at a dose of 1.0 gram, 1 hour before meals or 2 hours after, if the drug is used in capsules, or regardless of food intake with taking pills.Another drug of choice is doxycycline, which is prescribed 100 mg 2 times a day for 7 days. The disadvantages of azithromycin in comparison with doxycycline could be attributed to the higher cost of azithromycin. However, according to the results of pharmacoeconomic studies conducted by the CDC, the higher cost of azithromycin compared to doxycycline is offset by the lower costs associated with the treatment of PID, ectopic pregnancy and infertility arising from inadequate therapy associated with non-adherence to the prescribed treatment regimen, which is much more common in the appointment of doxycycline.

    The advantages of azithromycin over doxycycline, in addition to higher compliance with treatment, include better tolerance, as well as the possibility of using it in adolescents.

    For many years, there were no reliable data on the isolation of strains C. trachomatis resistant to macrolides. The first reliable report on the isolation from 3 patients of strains C. trachomatis , in relation to which the MIC of azithromycin was higher than 4.0 μg / L, was published in 2000.(Somani J. et al, 2000). In addition to resistance to azithromycin, the isolated strains also showed resistance to doxycycline and ofloxacin. The mechanisms of resistance of C. trachomatis to macrolides have not yet been studied, and its identification is associated with significant methodological difficulties. The mechanism of resistance to azithromycin can be genetically determined by methylation of bacterial ribosomes, which prevents the binding of azithromycin to ribosome subunits. In this case, cross-resistance to other macrolides can be observed.So far, rare reports of antibiotic resistance of chlamydia to azithromycin have no clinical significance and have not led to a change in the existing recommendations for the treatment of chlamydial infection with this antibiotic.

    Conclusion . Thus, the unique pharmacokinetic characteristics of azithromycin are a long half-life, a high level of absorption and stability in an acidic environment, the ability of this antibiotic to be transported by leukocytes to the site of inflammation, a high and prolonged concentration in tissues, the possibility of penetration into the cell, as well as simple schemes of use, high clinical efficacy and compliance of treatment, low toxicity maintain the position of azithromycin as the main drug in the treatment of chlamydial urethritis in men and other pathologies associated with chlamydial infection.


    Gomberg M. A ., Doctor of Medical Sciences
    Soloviev A. M ., Candidate of Medical Sciences
    MGMSU , Moscow

    90,000 These quirky diseases of sexual behavior

    With whom you lead, from that you will gain. This popular wisdom is directly related to the risks of sexual behavior.
    About the originality of sexually transmitted infections (STIs), their diagnosis and prevention – conversation with the associate professor of the Department of Skin and Venereal Diseases of the Belarusian State Medical University , the secretary of the Belarusian public organization of dermatovenerologists and cosmetologists Alexander Navrotsky.

    Three dozen options

    – Alexander Lyudgerovich, the term “STI” appeared relatively recently. And what is behind it?

    – For me personally, the term “infections” is more acceptable, since the asymptomatic, latent nature of the course is typical. Sometimes there is no disease at all, but there is a carrier of bacteria and viruses. They are capable of causing a variety of pathologies of the genitourinary organs (urethritis, orchiepididymitis, prostatitis, endometritis, adnexitis, and much more).

    In the International Classification of Diseases 10th Revision (ICD-10), approved at the World Health Assembly in Copenhagen in 1989, there is a section “Infections, predominantly sexually transmitted”.These include 9 STIs: syphilis, gonococcal, chlamydial infections, anogenital herpes and human papillomavirus infections, trichomoniasis, as well as chancroid, inguinal granuloma and chlamydial lymphogranuloma (the last three are not found in our country).

    Up to two dozen diseases are also associated with sex, although they are sometimes caused not only by infectious, but also by other factors. For example, vulvar and vaginal candidiasis, bacterial vaginosis, pubic lice, molluscum contagiosum, hepatitis, cytomegaly, scabies (one in five becomes infected with a tick during sex).Of course, we must not forget about HIV, for which the sexual route is natural.

    The young are more vulnerable. Especially girls

    – How relevant is the STI problem for Belarus?

    – The incidence of most infections is declining. But in 2012, there was an increase in reported cases of urogenital chlamydia (+ 11.4%) and gonorrhea (+ 6%). Syphilis should not be removed from the agenda. The peak of the epidemic was
    in 1996 (21 616 cases), in 2012 for the first time less than a thousand – 977.However, the best indicator – 142 cases (1988) – is still far away.
    “Leader” for syphilis – Gomel region (244 cases). Note that the high incidence rate for a number of STIs may indicate a well-organized process of identifying patients, the introduction of modern diagnostic methods.

    The largest group of patients by social status is workers. In industrial areas of large cities, the incidence is higher.

    About 70% of those infected are between 15 and 29 years old. This feature is very upsetting, since this is the age of optimal reproductive capabilities.And one of the tragic consequences of STIs is infertility.

    Among young people, a risk group can be identified – girls aged 15-19 get sick 2-11 times (depending on the pathology) more often than their peers. From the point of view of sexology, 17–20 years is one of the peaks of a woman’s sexuality, when there is an active search for a future spouse. The vulnerability is greater than that of men, due to the peculiarities of the anatomy.

    Another risk group is adolescents who are registered with the police. Among them, the prevalence of STIs reaches 50%.

    – Does the official statistics differ from the real picture of the incidence?

    – These figures are just the tip of the pyramid. According to the skin and venereal service, in 2012, 32,039 cases of STIs were registered in Belarus. It’s good that this number is decreasing. In 2006, by comparison, there were 168,363 cases. However, this does not include data on morbidity in the police, the Armed Forces, other departments that have their own medical services, as well as information on patients of commercial medical centers.

    Although people have ceased to be afraid of doctors and to hide “shameful” illnesses, not all STI-infected patients seek medical help. Only 5% of those infected with syphilis in the past year came to the doctor themselves, noticing symptoms. It is not uncommon to find this ailment in hospitals, when people are treating other ailments, during prophylactic examinations, and sometimes when examining donors.

    The specificity of some STIs is a minimum of signs or their complete absence.

    In one of the WHO reports, it was said that every tenth inhabitant of the planet is sick with STIs every year.If you project it onto Belarus, you get about a million people. It is no coincidence that 10 years ago, our epidemiologists stated that genital infections are in third place in terms of prevalence after ARVI (during an epidemic) and helminthiasis.

    Friends with strangers did not get along

    Why are bacterial vaginosis and candidiasis not classified as STIs in some scientific sources?

    – Because the microorganisms that cause them are conditionally pathogenic. So, diseases can occur in pregnant women or in women who are not sexually active.Nevertheless, most often the ailment appears after changing the sexual partner, although the latter does not need treatment.

    Bacterial vaginosis used to be called gardnerellosis, mistakenly believing that the pathology is caused by the microorganism Gardnerella vaginalis. However, it is based on polymicrobial syndrome. Back in 1984, at an international congress in Sweden, they decided to use a new term – “bacterial vaginosis”.

    Lactobacilli predominate in the normal microflora of the vagina. With bacterial vaginosis, there is a qualitative and quantitative change in its composition.During sexual intercourse, a woman receives new microorganisms from a partner. In a certain situation, they begin to “crowd out” the main inhabitants and are able to “overthrow” them. In a smear, an increased amount of bacteroids, peptostreptococci, mobiluncus, prevotella, hemophilus, mycoplasma, corynebacteria, gardnerella, ureaplasma, fungi of the genus Candida and other microorganisms are found. The cells of the desquamated vaginal epithelium are covered with microbes on all sides (these are the so-called key cells – the main one of Amsel’s confirming criteria).But there is no inflammatory process.

    The diagnosis is established taking into account other laboratory criteria – homogeneous creamy grayish-white discharge, evenly distributed on the vaginal mucosa, positive amine test, vaginal discharge pH more than 4.5.

    Three positive criteria are available – means bacterial vaginosis.

    Mycoplasma Mycoplasma discord

    Mycoplasmas and ureaplasmas are also conditionally pathogenic microorganisms.Should they be found, should antibiotics be taken?

    – Scientists have clarified the role of mycoplasmas and attributed the urogenital pathology caused by mycoplasma genitalia to STIs. With the rest, not everything is so simple.

    Ureaplasma urealiticum and mycoplasma hominis are today classified as conditionally pathogenic urogenital flora. Ureaplasmas are present in the genital area of ​​5-10% of healthy men and 20% (according to some authors – up to 40%) of women.

    And now imagine the situation: he and she met, there was an intimacy.After a while, the man complained of discharge. The urologist diagnosed ureaplasmosis. The patient made a complaint against the woman. And that gynecologist said she was healthy. Which doctor is right? Both!

    Ureaplasma, which existed harmlessly in the female body, got into a new place for her – the male urethra, and made a “revolution” there. The change in microflora caused a sharp reaction of the body – an inflammatory process. There is no reason to blame your partner.

    It is necessary to be treated when the inflammation is caused by mycoplasma genitalia.If ureaplasma urealiticum or mycoplasma hominis are found and quantitative analysis shows that the pathogen content is more than 104 CFU (colony-forming units), then these microorganisms are “responsible” for the inflammatory process. If the pathogen is less, it has nothing to do with it. We need to look for another culprit.

    Whatever the search ends, the inflammatory process must be eliminated. If not, the doctor will decide what to do next. Sometimes therapy is indicated for sanitation and a healthy person – when his sexual partner is ill.

    Each pathogen has its own diagnostic method

    – Today, PCR diagnostics are actively advertised. Is this really the best solution for detecting STIs?

    – For chlamydia, the role of this molecular biological method is immutable. Alternative – RIF and ELISA – are significantly inferior in sensitivity. The first detects the pathogen in 40-60% of cases, the second – in 60-70%. And PCR – in 90%. But an even more reliable method (the so-called gold standard) is bacteriological.However, it is quite expensive and is used in scientific institutions.

    To establish a diagnosis, it is recommended to combine the two methods. And when monitoring the recovery (carried out no earlier than
    4 weeks after the end of therapy), you should not use ELISA to detect antibodies. It is more suitable for epidemiological research.

    There is no universal, 100% effective diagnostic option for all STIs. For syphilis, for example, in the first place are serological methods (they have been significantly improved recently).

    Today, enzyme immunoassay, a modified passive hemagglutination reaction, is widely used. In men with acute gonorrhea, a normal Gram-stained smear (sensitivity 90%) is sufficient. In women, gonococcus is detected in cervical tests only in 45–64% of cases, in urethral tests – in 16%. For patients, the main method is culture. However, PCR is not recommended to confirm these two infections.

    The range of examinations and methods will be determined by the doctor, based on the clinical picture, history and other circumstances.

    – Which STIs are more often asymptomatic?

    – A vivid clinical picture usually occurs with gonorrhea in men. Other infections have a long incubation period (2-3 weeks) and a more erased course. Viral infections may not show signs at all for years.

    In women, STIs are less pronounced. True, with trichomoniasis, acute vulvitis with itching, burning, pain when walking, and intercourse can develop.

    The severity of the course is not yet a criterion for establishing a diagnosis.There are about 330 laboratories in our country that research these infections. The diagnosis must always be laboratory confirmed.

    No need to be afraid of saunas

    – Is there a danger of contracting STIs in public places – saunas, baths, swimming pools?

    – For men – definitely not. In women, this is theoretically possible, but unlikely in life. For infection, it is necessary that the patient’s wet secretions, in which the pathogen remains for some time, fall on the genitals of a healthy person.
    A more dangerous option is to use a washcloth, an infected towel, which happens to little girls,
    who have the same personal hygiene items as the infected mother.

    Syphilis and herpes can be transmitted through saliva. And if you drink from the same bottle, mug, use someone else’s toothbrush, lipstick, razor, or smoke a cigarette (while having gum disease or a microcracked lips), infection is likely.

    Yet this is rarely the case.People are sanitary informed. But syphilis is an insidious disease. Today, in comparison with the mid-1990s, he has changed his “face”; for example, in 2012, 49% of cases were asymptomatic (early latent syphilis). Therefore, the main thing is to actively identify patients by testing various categories of the population.

    Barrier for pathogen – latex

    How reliable is a condom for STI protection?

    – I posed this question to Jean-Paul Coulet, WHO expert.I received the answer: “It is very difficult to conduct such large-scale studies. I think about 82%. ” Why not 100%? Because people make mistakes when using a condom, or it is of poor quality. If these factors are excluded, we can talk about a complete guarantee of reliability.

    – How is safe sexual behavior currently understood?

    – The first rule is not to have sex before adulthood. Very often, an early debut ends with a sad “venereal” experience.The average age of onset of intimate life in affected adolescents is 14.5 years. The link between STIs and premature sexual activity is clear.

    The second rule is choosing the right sexual partner. The third is loyalty to one person. The fourth is the elimination of casual contacts. Well, if the latter happens – to use barrier contraception (condom) correctly.

    – Remind exactly how …

    – It is advisable to buy a condom at a pharmacy. It should be made of a highly elastic material – latex, lubricated with lubricant.Before use, it should be checked for leaks: slightly squeeze the unopened package (it should not wrinkle, retaining air). Shelf life is no more than 5 years.

    Wearing a means of protection should be immediately upon the onset of an erection, in no case inside out. You need to remove it immediately after ejaculation, until the semen begins to flow out of it.

    Do not store condoms in places where the sun’s rays penetrate, carry them in the back pocket of your trousers (integrity can be damaged).If after opening the condom is sticky, it means that it is old and not suitable.

    Syphilis and gonorrhea. Separate conversation

    – When should I be tested for STIs?

    – If there was a change of partner – mandatory. With each new “love” infections can accumulate, it is more difficult for a doctor to understand and cure completely.

    It is very important to get tested for STIs before having children – to prevent complications of pregnancy and ensure the normal development of the fetus.In our country, all pregnant women undergo such screening.
    Those who are in close contact with children, work in public catering and some other specialists should also be tested for certain types of STIs during the prophylactic examinations.

    – From whom and where is it better to be treated?

    – From syphilis and gonorrhea – only at the dermatovenerologist. Only state dermatovenerological institutions have the right to establish these two diagnoses. In the Minsk city KVD, for example, up to 3 thousandanalyzes per day, and specialists in clinical laboratory diagnostics have been working in this area for many years. If those who have little experience begin to study, an incorrect laboratory answer is possible, and undiagnosed patients will continue to spread a dangerous disease.

    Commercial centers can do syphilis screening tests. But with a positive result, they are required to refer to a dermatovenerologist to confirm the diagnosis and treatment.

    Syphilis is not accidentally called the monkey of all diseases.He knows how to disguise himself as neurological, skin, eye, proctological ailments, ENT pathology and many others. If the doctor notices an atypical course – you should immediately remember about the “monkey” and test the patient for syphilis.

    Is the devil as scary as he is painted

    – What is the danger of STIs?

    – Most are fraught with infertility, pregnancy complications, and in men – erectile dysfunction, impotence. Often you have to observe the so-called.n. mixed infections – several at the same time. For example, gonorrhea in 70% of cases is combined with other STIs. That is why it is impossible to engage in treatment “on the advice of friends”: an effective “according to their experience” drug can kill one pathogen and only slow down the reproduction of others. As a result, a sluggish chronic process develops, which is even more difficult to cope with.

    The most severe infection is, of course, syphilis. If it is not treated, then the end is unambiguous – disability. The main target of this disease is the nervous system.

    The human papillomavirus (HPV) is also very dangerous. In women, it can lead to cervical cancer. The most carcinogenic HPV types are 16th, 18th, 45th and 56th.

    Has the approach to STI treatment changed recently?

    – Certainly. The first feature is that the therapy has become shorter. For example, you can get rid of gonorrhea today with one injection. For the treatment of syphilis, there are long-acting drugs that last up to 7 days. This is very convenient, because before you had to go to the hospital.

    Unfortunately, viral diseases are much more difficult to fight. Genital herpes and HIV infection are incurable. Human papillomavirus infection (anogenital warts) is chronic in some patients. But there is already a prophylactic vaccine against it. Girls 12-13 years old should be vaccinated before the onset of sexual activity. This can be done in government and commercial medical organizations.

    – What about chlamydia? People say that it is impossible to get rid of it….

    – He is curable. The effectiveness of therapy largely depends on the quality of laboratory diagnostics. One of the conditions for its reliability – for the analysis, one should take not the discharge (mucus, pus), but the epithelium (scraping from the urethra or cervical canal).

    Chlamydiae are intracellular parasites and are difficult to detect. In the early 2000s, the RIF method (immunofluorescence reaction) was actively introduced. In commercial centers offering such diagnostics, chlamydial bodies were determined visually in a smear.Laboratory doctors, who lacked experience, did not find chlamydia, but something that resembled them. But the patient still received treatment.

    Control tests showed a false positive result. Prescribed another course … This continued until the disappointed patient, who spent a lot of money and did not receive proper therapy, came to the dermatovenous dispensary. And it turned out that he did not have chlamydia, and perhaps never had.

    Difficulty in diagnostics often led to false negative results.Therefore, the examination “for chlamydia” must be carried out by two or more laboratory methods. And if there is PCR, then they must. In addition, a control study should be performed at least a month later, and preferably one and a half after the end of the course of therapy. If done earlier, you can get a false positive result.
    Fortunately, such situations are mostly in the past.

    There are enough effective drugs for the treatment of chlamydia – josamycin, clarithrimycin, ofloxacin, etc. An important role is played by the determination of the resistance of the STI pathogen to the prescribed antibiotics and the discipline of the patient.You can not skip taking the drug, have sex, even using a condom, in order to exclude re-infection.

    – For some STIs, treatment is compulsory, there is criminal responsibility …

    – This applies to syphilis and gonorrhea. The country’s Criminal Code contains article 158. A patient who has been diagnosed with such a diagnosis is warned about the possibility of infection of another person, the rules of treatment and personally signs the corresponding document. For those who ignore the doctor’s recommendations and infect a sexual partner, the punishment is imprisonment for up to several years or correctional labor.The measure is fair. In all civilized countries, the state protects the health of its citizens with the help of the law.

    The current organization of the treatment of sexually transmitted diseases (now this term is used less and less) is fundamentally different from the Soviet one, which was largely repressive. Every year, about a thousand people in the Union were sent to jail just for evading examination. Didn’t come to the doctor on call – on trial!

    At that time, there were special closed departments in dermatovenous dispensaries, where patients who evaded examination or violated the treatment regimen were placed.There were policemen on duty, there were locks on the doors, bars on the windows, and to go out for a walk, even the most obedient patient showed a pass. It’s hard to believe now. That is why people were afraid of dermatovenous dispensaries. However, such strict measures kept the incidence of STIs at a low level.

    Now a patient with any STI can be treated on an outpatient basis. The most convenient option is a day hospital. I arrived in the morning, had an injection – and went to work. After the start of treatment, a person is no longer dangerous in terms of household transmission of infection.

    Convenience of venereal care is also the organization of anonymous treatment rooms. There are three of them only in the capital. The patient will only be asked to identify himself if syphilis is found. This is too serious a disease, it can be transmitted to offspring. It is necessary to examine everyone who has had sexual and household contact with the infected person.

    What issues of STI prevention and diagnosis need to be taught to health workers?

    – First of all – the correct attitude towards patients.I am opposed to discrimination against such patients. Echoes of the time when these ailments were considered shameful and they tried to hide them still remain. There are examples of misunderstanding, disrespectful attitude towards STI patients. And a person, seeing the disgust and disgust of a physician, will never talk about his problems.

    Young people are showing great interest in issues of sexuality and sexuality. Practice shows that young people have sex, but knowledge of how to protect themselves is not enough. Education requires sensitivity and individuality.In my opinion, it is impossible to give lectures in schools “about this” indiscriminately. It is necessary to give information selectively, to someone who is already ripe for its correct perception. In my opinion, a gynecologist, urologist, therapist, pediatrician who communicate with adolescents and young people, could subtly advise how to behave, how to protect themselves from diseases and unwanted pregnancies.

    But the prevention of AIDS, STIs needs to be paid more attention, to be active. So that later it would not be excruciatingly painful for the fatal mistakes of youth and their consequences!

    Elena Kleshchenok
    Medical Bulletin , April 4, 2013

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    90,000 what threatens a kidney infection

    Pyelonephritis is the most common urological pathology, the development of which is based on nonspecific infectious inflammation of the pyelocaliceal system and parenchyma of one or both kidneys.The causative agents of pyelonephritis are most often gram-negative bacteria of the intestinal group, less often the disease is caused by chlamydia, mycoplasma, ureaplasma and yeast-like fungi that penetrate the urinary tract from nearby organs (for example, the intestine) ascending, as well as through the lymphatic or circulatory system.

    Often, pyelonephritis proceeds latently, reminding of itself only by periodic exacerbations, which misleads many patients and causes a frivolous attitude towards a dangerous disease.Meanwhile, an untimely visit to a doctor, delayed or irregular treatment cause serious, sometimes irreversible disorders of the structure and function of this vital organ.

    Most often, pyelonephritis affects young women aged 18 – 30 years after the onset of sexual activity, during pregnancy and childbirth, which is associated with the peculiarities of the anatomical structure of the urinary tract. For the same reason, in childhood, girls suffer from the disease more often than boys.In men after 60 years of age, the provoking factor of the disease is a violation of the outflow of urine against the background of hyperplasia (enlargement) of the prostate gland. Very often, hypothermia, reduced immunity, urolithiasis, congenital malformations of the kidneys, bladder and urethra, diabetes mellitus contribute to the development of the disease.

    Acute pyelonephritis (or exacerbation of the chronic form) is characterized by a sudden onset, accompanied by a sharp rise in body temperature to 39 – 40 ° C, excessive sweating, lack of appetite, general weakness, headache and muscle pain, as well as nausea and vomiting.In addition, a person is worried about dull one- or two-sided pain in the lumbar region, which can radiate to the lower abdomen. The pain often gets worse with exertion, brisk walking, or lifting weights. With prolonged chronic inflammation of one or both kidneys, the pain is vague, and the fever either does not occur at all, or has a certain frequency. As a result of the progression of chronic pyelonephritis, kidney function is impaired, and therefore the specific gravity of urine decreases, blood pressure rises, edema joins, and renal failure develops.

    As a rule, the identification of an acute form of pyelonephritis does not cause difficulties for the doctor, since it is characterized by a vivid clinical picture – a combination of very intense pain in the lumbar region with high fever, as well as frequent (sometimes painful) urination. At the same time, the urine becomes cloudy (with sediment) and acquires a dark yellow color. Laboratory and bacteriological examination of urine helps to confirm the presumptive diagnosis. Ultrasound and urography, and in some cases computed tomography of the kidneys, reveal structural changes in the organ.

    The main task of the treatment of pyelonephritis in the acute period is to quickly restore the disturbed outflow of urine and prevent the progression of inflammation, purulent “fusion” of the kidney and infectious-toxic shock. Treatment of acute pyelonephritis is carried out in stationary conditions and prescribes bed rest, a strict diet and complex drug therapy, the most important component of which is the use of antibacterial drugs. The doctor conducts a rational choice of the drug taking into account the sensitivity of the bacteria that were detected by sowing urine on the microflora.If the disease progresses without complications, surgery is not required. In some cases, catheterization of the ureters is required with special stents to restore the impaired outflow of urine from the affected kidney. After eliminating the acute inflammatory process, it is necessary to undergo an ultrasound of the kidneys twice a year, monitor the dynamics of laboratory parameters of blood and urine, follow a dairy-plant diet – exclude extractives, strong tea and coffee, canned food, spicy food, alcohol; limit the consumption of meat dishes and salt.

    Take care of your health: in case of pain in the kidney area, seek medical help immediately!

    Vladimir KHRYSHCHANOVICH, Doctor of Medical Sciences.

    Soviet Belarus № 119 (25001). Friday, 24 June 2016

    Date of publication: 20:58:24 23.06.2016

    Cystitis in men: description of the disease, causes, symptoms, diagnosis and treatment

    Cystitis is a disease in which the bladder mucosa is affected and its function is impaired.In men, the disease occurs much less frequently than in women. If we talk about medical statistics, then cystitis affects 0.8% of men over 45 years of age.

    The low prevalence of cystitis in men can be explained. In men, the urethra is longer, narrower, curved. As a result, the infection is delayed, that is, it is much more difficult for it to enter the bladder.

    In most cases, the cause of cystitis in men is bladder obstruction, that is, subvesical compression of the urinary tract (level of the urethra or bladder neck), which prevents the free flow of urine.

    Why does the disease

    develop

    A young man can easily avoid cystitis. You just need to carefully observe personal hygiene. With age, the reproductive and urinary system is most susceptible to various diseases, which, in turn, are the cause of the development of cystitis.

    In a woman, the leading role is assigned to an ascending infection, and in a man, the disease is a consequence of a pathological process, the localization of which is the urethra, epididymis, prostate gland, seminal vesicles.

    Also, the reasons for the development of cystitis in men include:

    • A urological disorder due to which urine is retained in the bladder. It often occurs with an overly narrowed urethra.

    • A mechanical barrier appeared. For example, a stone, a foreign body.

    • If prostate adenoma is diagnosed.

    • Diverticulum.

    • The presence of prostatitis, vesiculitis, urethritis. It is these internal diseases that contribute to the development of the inflammatory process in the bladder.

    • Latent infection. This happens with chlamydia, mycoplasmosis, gonorrhea.

    • An infectious and viral disease, the localization of which is the upper respiratory tract.This refers to the presence of sinusitis, tonsillitis, flu in a man. The penetration of bacteria into the urinary system occurs through the bloodstream. This means that the development of cystitis can serve as a complication of any infection, no matter where it is located.

    • They brought in the infection when the diagnostic procedures were carried out. For example, when placing a catheter or cystoscopy.

    • Peritoneal surgery performed, urological surgery.It is also on the list of causes of cystitis.

    • Malignant tumor of the prostate, urethra.

    In addition, a descending infection can occur due to renal tuberculosis or pyelonephritis. It is necessary to analyze in more detail tuberculosis as the cause of cystitis in a man. In most cases, there are no signs of the disease. A slight increase in body temperature may occur, the man notices the appearance of unexplained weakness.

    About 90 percent of the population is carriers of the infection. Most of them have reduced immunity. The body’s defenses can fall due to stress, excessive alcohol consumption, and poor nutrition. The above refers to the most favorable conditions for the latent phase of bacteria to pass into the active one.

    This phase contributes to the damage not only to the lungs, but also to other vital organs (kidneys, testicles, prostate).The most important danger is getting a false negative result when inoculating on Koch’s bacillus. The infection is disguised as another, not so dangerous, disease.

    Also, there are a number of additional factors that can provoke a drop in immunity. Such factors include hypothermia, lack of sleep, stress, diabetes, spinal or abdominal trauma.

    How cystitis manifests itself in men

    The main symptoms that accompany cystitis in men can be distinguished:

    • The acute stage of the disease is characterized by the need for frequent emptying of the bladder.In this case, the amount of urine excreted may not exceed 20 milliliters.

    • Urinary incontinence develops.

    • Emptying the bladder gives a man a lot of discomfort and pain. The man makes an effort to urinate. It is especially painful at the beginning and end of the urination process. The pain is intense or bearable. Burning and stinging often occurs. Between trips to the toilet, a man notes the presence of painful sensations in the groin, pubic region, and penis.

    • In some cases, the body temperature rises. It is accompanied by general symptoms of intoxication. A man often has a headache, chills, weakness and more. In the presence of such symptoms, hospitalization is indicated.

    • The severe course of the disease is the cause of the formation of hemorrhagic or gangrenous cystitis. The urine that is released becomes cloudy, there may be blood or mucous inclusions.The urine has a pungent, putrid odor. In addition, there is a decrease in fluids that are released during the day. The amount does not exceed 350 milliliters. The assigned volume is much larger.

    • Painful sensations are lubricated if the inflammatory process has acquired a chronic form. Mucous inclusions can be found in the urine. There is no blood. The lull is replaced by an aggravation.

    All causes of cystitis are divided into infectious and non-infectious.There are four ways a bladder can become infected:

    1. Descending – the penetration of the infection comes from the inflamed organ, that is, the kidney.

    2. Ascending – the initial localization of the infection that has entered the bladder is the external environment.

    3. Lymphogenous – lymphatic vessels are involved in the movement of the infection. Basically, the focus of infection is in the inflamed genital organ.

    4. Hematogenous – the spread of infection occurs through the bloodstream from a distant purulent focus.

    Non-infectious causes of cystitis:

    • An allergic reaction, which manifests itself in the form of an inflammatory process of the mucous membrane of the bladder.

    • Impaired work of the immune system, nervous system.

    • Chemical burn. The wrong drug was injected into the bladder, which was prescribed by the doctor. This can happen if the patient or medical staff is inattentive during medical procedures.

    • If your lower abdomen or pubis is undergoing radiation therapy.

    How is the disease treated

    If there is a complete list of signs or several of them, a man should immediately seek qualified help. Diagnostic measures and treatment are prescribed by a urologist. To make an accurate diagnosis, a man needs to undergo a thorough examination.

    The following diagnostic measures are included in the comprehensive examination scheme:

    1. Bacterial inoculation. This analysis helps to identify the pathogen. In addition, its sensitivity to a particular drug is determined.

    2. Urogenital smear. Detects a hidden infection that can be transmitted sexually.

    3. General analysis of urine. In the inflammatory process, leukocytes and erythrocytes increase.The normal occurrence is the absence of mucus in the urine. With an acidic reaction of urine, it can be suspected that a tuberculosis infection is present.

    4. Cystoscopy. Such a diagnostic method is carried out only if there is no acute phase of cystitis. Thanks to cystoscopy, the presence of neoplasms, stones and other foreign bodies is revealed. Also, during this technique, a biopsy is performed.

    If there are severe painful sensations, urinary retention has passed into an acute stage, and there is no effect of the anesthetic, the man must be hospitalized.In the hospital, complex diagnostics are carried out, due to which, the pathogen or concomitant pathology is identified.

    When carrying out therapy, a man should adhere to some recommendations:

    • Compliance with bed rest. A patient with an acute stage of cystitis should be in bed. If the body temperature is elevated, the doctor prescribes an antipyretic agent. It is necessary to drink a sufficient amount of fluids per day so that the infection is washed out as soon as possible.In addition, the man is assigned a special diet, that is, it is forbidden to eat sour and spicy foods.

    • Taking medications. The doctor will prescribe antibacterial agents to the patient. It should be remembered that the choice of such a medicine is carried out exclusively by a qualified specialist after the pathogen has been identified and its sensitivity to a particular drug has been clarified. In most cases, a man is prescribed to take nitrofurans, fluoroquinolones, cephalosporins.It is necessary to use a drug that belongs to one of these groups only after a medical recommendation. The average duration of one course does not exceed a week.

    • The use of herbal medicine. This is an indispensable item in the complex treatment of cystitis in men. Herbal tea is often prescribed, which has a diuretic and anti-inflammatory property. This tea consists of plant components (lingonberry, bearberry, horsetail). In the absence of an allergic reaction, a herbal medicine may be prescribed.Removing the intensity of the inflammatory process and reducing unpleasant symptoms is possible with the help of cystone, phytolysin, kanefron. To make it easier for the body to fight the infection, a man may be prescribed cranberry juice or juice, which you can prepare yourself. Herbal medicine does not have an immediate effect, it is used for a long time. It must be remembered that herbal preparations can only be an adjunct to medications prescribed by a doctor.

    • Pain medications.To stop the painful sensations that are a faithful companion of cystitis, an antispasmodic is used. A man is allowed to take no-shpa or papaverine. Also, it is possible to take a non-steroidal anti-inflammatory drug (diclofenac, nimesil).

    • PCR. If a man’s body has an infection that was transmitted through sexual intercourse, the treatment regimen is selected based on the type of causative agent of the disease. To identify a microorganism or virus, a PCR technique is used.

    Removal of an attack of cystitis

    In the acute form of cystitis, each attack is very painful. The first main rule, thanks to which an attack is facilitated, is the consumption of a large amount of liquid. It promotes the rapid elimination of pathogenic microorganisms from the body, as a result of which, the condition of the man is alleviated.

    In a more severe case, you can use medication.The best solution is antispasmodics. The spasm is eliminated, the tone of the smooth muscles of the bladder decreases. Painful sensations are eliminated not only by antispasmodics, but also by analgesics.

    Self-administration of antibiotics is strictly prohibited. This can change not only the picture of laboratory examination, but also complicate the identification of the source and cause of the disease. By self-medication, you can only get rid of the symptoms for a while, while the cystitis will become chronic.

    Risk factors

    There are factors that increase the likelihood of developing cystitis.This happens when:

    • sedentary lifestyle.

    • regular hypothermia of the body.

    • Constant use of tight underwear.

    • Frequent change of sexual partner when contraceptives are not used.

    • Failure to comply with hygiene rules.

    • Chronic disease of an internal organ.

    • Overwork, hypovitaminosis.

    • Impaired emptying of the bladder.

    • Reduced protective functions of the body.

    • The presence of a foreign body that is located in the bladder.

    What complications can arise

    Cystitis is not a harmless disease, therefore, self-medication and uncontrolled use of drugs is strictly prohibited.

    In the absence of timely treatment, the following consequences will occur:

    • Kidneys are affected. Medical statistics suggests that in almost all cases, with untreated cystitis, pyelonephritis and nephritis develop.A more severe consequence is renal failure. Its formation is associated with excessive poisoning of the kidney tissue by the waste products of the infection.

    • There is a return of urine from the bladder in the opposite direction, that is, to the kidneys. This happens on rare occasions.

    • Organic changes in the bladder. Due to epithelial degeneration, the bladder becomes less elastic.In addition, its size decreases, and the ability to regenerate is lost. As a result of this effect, the bladder can rupture.

    • In the absence of timely specific treatment, the likelihood that the disease will acquire a chronic form increases. With chronic cystitis, constant inflammatory processes appear. According to medical records, cystitis is not an isolated pathology. In most cases, nearby organs are affected.

    • An immediate complication of cystitis is the appearance of stress and depression. An incurable pathology develops into a chronic form. Cystitis often recurs, up to several times a month. During the illness, a man succumbs to the strongest psychological pressure. That is, a healthy member of society becomes a hostage to the toilet.

    • The sphincter of the bladder becomes weak.As a result, urinary incontinence develops. This is mainly observed in elderly patients.

    How to prevent the development of cystitis

    There are a number of recommendations that, if followed, reduce the likelihood of developing the disease.

    1. It is necessary to wash every day, once a day. For these purposes, use soap, preferably baby. It is free of flavors and dyes.

    2.Carefully monitor that the sexual partner follows basic rules of personal hygiene. She has to wash the external genitals every day.

    3. Before and after sexual intercourse, wash thoroughly. Use soap. This rule must be followed by both sexual partners.

    4. Always dress for the weather. It should be noted that cystitis is not the worst pathology that hypothermia can cause. In addition to cystitis, an inflammatory process develops in nearby organs, which is the cause of infertility and many years of visits to doctors.

    5. Monitor the state of your own immunity. If a person often has a cold, it can be judged that the immune system is reduced. To restore it, you need to contact a qualified specialist.

    6. Try not to restrain urination as much as possible. With prolonged urinary retention, an infection develops in the bladder.

    7. Drink plenty of fluids.

    8. A man should change his underwear every day. Thanks to this rule, the risk of developing the disease is minimized.

    9. After bowel movement, wipe from front to back.