However, not all ureaplasmas cause disease - several types are pathogenic for our body: Ureaplasma urealyticum(Ureaplasma urealiticum) and Ureaplasma parvum(ureaplasma parvum).

How does infection with ureaplasma occur?

Sexual route of infection
Undoubtedly, the most common method of infection is sexual intercourse. However, in fairness, it is worth noting that about 20-40% of those infected do not feel any symptoms of the disease itself - therefore they are only carriers. Under unfavorable conditions for the body, these symptoms may appear, but as long as the immune system keeps the ureaplasma population under control, the patient may not even be aware of the disease. It should be noted that infection with ureaplasmosis is possible through such types of contact as: kissing, oral or genital sexual contact without barrier protection.

Vertical route of infection (from mother to fetus at birth)
This type of transmission of infection is possible precisely because the favorite habitat of ureaplasma is the mucous membrane of the genital tract - through which a child passes during natural childbirth.

Contact and household transmission route
At present, there is no convincing evidence of the possibility of infection by this method. Therefore, you should not seriously consider the possibility of infection in the pool, through a shared toilet lid or household items.

Symptoms of ureaplasmosis

Symptoms of ureaplasmosis in men

	The first thing to notice is the symptoms of inflammation of the urethra (urethritis). In this case, discomfort and burning occurs in the urethra, which intensifies with urination until severe pain occurs. Also during sexual intercourse there are painful sensations that intensify with ejaculation.
Discharge from the urethra	Usually they are not abundant, more mucous in nature, liquid in consistency.
Inflammation of the epididymis	In severe cases, lesions of the testicles may occur - in this case, the patient feels heaviness and bursting painful sensations in the testicles, which intensify when palpated.
Symptoms of prostatitis	They usually occur some time after the onset of symptoms of urethritis. This indicates the progression of the infection. With prostatitis, the symptoms include soreness in the perineal area, pain can intensify when sitting, when palpating the perineal area. Prostatitis can also manifest itself as decreased libido and shortened erection duration. Sexual contact can be painful.
Male infertility	Long-term prostatitis and orchitis (inflammation of the testicles) can lead to persistent male infertility.

Symptoms of ureaplasmosis in women

Urethritis (inflammation of the urethra)	Pain and burning in the urethra. The pain is also characterized by a sharp increase in urination. The mucous membrane of the external urethral os is inflamed.
Discharge from the vagina and urethra	The discharge is not abundant, as a rule, it is mucous in nature.
Pain during genital intercourse	It occurs as a result of additional mechanical irritation of the inflamed mucosa.
Bloody issues from the vagina after sexual genital contact	The cause of this symptom may be inflammation of the vaginal mucosa, its increased sensitivity to mechanical influences.
Pain in the lower abdomen	This symptom may indicate the progression of infection through the genital tract, affecting the lining of the uterus and fallopian tubes. Which can cause complications such as endometritis, adnexitis.
Female infertility	With inflammation of the genital tract and damage to the endometrium of the uterus, normal conception and intrauterine development of a child is impossible. Therefore, female infertility or frequent miscarriages in the early stages of pregnancy may occur.

Complications of ureaplasmosis

Unfortunately, in Lately Increasingly, there is an increase in the number of complications caused by the long course of ureaplasmosis. As mentioned above, ureaplasmosis can be the cause of male or female infertility, along with damage to the genitourinary system, the development of autoimmune diseases, so-called rheumatic diseases, is possible.

• Male infertility can develop both as a result of ureaplasma damage to the prostate and to the testicles. When the prostate becomes inflamed, the secretion of the portion of sperm it secretes decreases, while the qualitative composition of the sperm changes, which makes the process of sperm movement through the woman’s genital tract impossible.
• Impotence – with the development of prostatitis, painful erection or its absence can be the cause of persistent organic pathology, which requires adequate treatment under the supervision of a specialist.
• Female infertility - damage to the uterine mucosa leads to the fact that the process of implantation of a fertilized egg becomes impossible. Moreover, even if conception has taken place, the inflammatory process in the endometrium can cause early miscarriage.
• Premature birth - in some cases, if pregnancy occurs against the background of ureaplasmosis, you should be more careful early development labor activity. There is also a high probability of having a low birth weight baby.
• Rheumatic diseases - a long-term chronic form of ureaplasmosis can be one of the triggering factors for the development of an autoimmune process. Therefore, ureaplasmosis may be a risk factor in the development of rheumatic diseases.

Diagnosis of ureaplasmosis

It is impossible to make a diagnosis of ureaplasmosis based on external symptoms - only laboratory data are a reliable basis for making a diagnosis. However, a gynecological examination and laboratory tests must be present.

How to prepare for a visit to a gynecologist if you suspect sexually transmitted infections?

You should know for sure that to diagnose such diseases, a gynecological examination (examination in mirrors) will be carried out. This study is carried out in order to visually assess the presence or absence of discharge, their properties, the condition of the mucous membrane of the vagina and cervix, the condition of the external os of the cervical canal, and the condition of the mucous membranes of the external genitalia.

The presence of mucopurulent discharge, a strong ammonia odor and inflammation of the mucous membranes of the vagina and urethra will indicate ureaplasmosis and other sexually transmitted diseases.
A visit to a doctor should be preceded by preparation:

• 2 days before your appointment with the doctor, you must abstain from any sexual contact.
• Within 2 days before the examination, you must stop using any vaginal suppositories, gels and other drugs administered vaginally.
• It is necessary to stop douching and using vaginal tampons.
• The evening before visiting the doctor, you should wash yourself with warm water, preferably without using soap.
• On the day of treatment, washing is contraindicated.

Lab tests
Laboratory tests to detect ureaplasmosis are performed with various types of biomaterial - this is the patient’s blood and a smear from the genital mucosa.

Bacteriological analysis, PCR research, culture - these types of diagnostics use material obtained as a result of taking a smear. Serological studies that detect antibodies against a specific infectious agent are carried out using the patient’s blood.

Currently, only PCR diagnostics are considered effective in diagnosing ureaplasmosis. All other diagnostic methods are either uninformative or are produced for scientific purposes. Let's consider the advantages and disadvantages of each of the methods used.

Bacteriological examination of a smear for ureaplasma- is not produced, since mycoplasmas are simply not visible when examining a smear using a microscope - they are so small. However, this examination is carried out because in 80% of cases of diagnosis of sexually transmitted diseases, ureaplasmosis is combined with several other types of infections, and this method can also identify concomitant bacterial or fungal vaginosis, which must be cured before prescribing the main treatment against ureaplasma. Therefore, you should not refuse this examination - it is necessary to prescribe complex treatment.

Culture from a smear or genital tract discharge– not effective against ureaplasma. However, as already mentioned above, this method is of some value in identifying concomitant sexually transmitted infections.

PCR diagnostics- allows you to reproduce and identify the genetic material of the pathogen. This method has maximum reliability and sensitivity. Therefore it is the diagnostic of choice.

Serological studies (ELISA, PIF)– these studies make it possible to identify antibodies to the infectious agent. They are difficult to interpret due to the fact that the body does not develop stable immunity to ureoplasma infection, and the number of carriers of this infection is much greater than those who have developed symptoms of the infectious process.

Conducted clinical and laboratory studies make it possible to identify ureaplasmosis and concomitant infectious diseases of the genitourinary system with a high degree of probability. It is high-quality diagnosis and identification of all infectious lesions that allows us to prescribe adequate treatment and hope for a complete recovery. You should pay attention to the fact that your sexual partner must also be examined in full - after all, the effectiveness of treatment of only one of the infected sexual partners in this case will be minimal.

Treatment of ureaplasmosis

It’s worth mentioning one important point right away - treatment of ureaplasmosis should be carried out according to the following rules:

• Treatment is prescribed to both partners at the same time, and the appointment of treatment should be preceded by a full diagnosis.
• If concomitant infectious diseases are detected, treatment is prescribed according to an individual scheme depending on the identified spectrum of infections.
• During the treatment period, any sexual contact is prohibited, including using barrier methods of protection.
• The treatment carried out requires a follow-up examination to diagnose cure within the time frame established by the doctor.
• Treatment should be carried out with the drugs prescribed by the attending physician with strict adherence to the prescribed treatment regimen. Premature termination of treatment is possible only after repeated consultation with the attending physician.

The use of antibacterial drugs in the treatment of ureaplasmosis

Before informing you about standard treatment regimens for infectious processes, we draw your attention to the fact that: treatment of infectious and inflammatory diseases with the use of antibacterial drugs is possible only under the supervision of a specialist attending physician.

Antibiotic name	Daily dosage and frequency of use	Duration of treatment
Doxycycline	100 mg twice daily	10 days
Clarithromycin	250 mg twice daily	7-14 days
Erythromycin	500 mg 4 times a day	7-14 days
Levofloxacin	250 mg once daily	3 days
Azithromycin	500 mg once on the first day, 250 mg once a day	4 days
Roxithromycin	150 mg twice daily	10 days

Immune stimulation
In order to effectively fight ureaplasma infection, antibiotics alone are not enough. After all, antibacterial agents only help the immune system cope with bacteria that harm the body. Therefore, whether a complete cure will occur depends largely on the condition immune system.
To stimulate the immune system, it is necessary to adhere to a rational regime of work and rest; nutrition should be balanced and contain easily digestible protein, vegetable fats and vitamins A, B, C and E.
Also, to stimulate the immune system, they often resort to medications - such as Immunal or St. John's wort tincture.

Adequate treatment of infectious and inflammatory diseases is possible only under the supervision of a specialist attending physician!

How to determine whether a cure has occurred?

After completing the course of drug treatment, a month later, a diagnosis of cure can be made. The same methods are used for this laboratory research, as for identifying the disease - PCR diagnostics and bacteriological examination of a smear from the vaginal mucosa. A negative test result indicates a complete cure. If there is a positive result, the attending physician may suggest repeating the course of treatment using a different antibiotic.

Prevention of ureaplasmosis

Currently, the question of whether it is worth using drug treatment among people who are carriers of ureaplasma, but they do not have any symptoms of ureaplasmosis, is being actively debated. This circumstance indicates that ureaplasma can be classified as opportunistic infections that appear only under certain unfavorable conditions.

What needs to be done to avoid becoming infected with ureaplasmosis, and if infection occurs, what should be done to avoid complications?

• Reducing or eliminating casual sexual contact.
• In case of casual sexual contact (regardless of the type of contact), it is necessary to use individual barrier protective equipment.
• Treatment should be comprehensive and result in a negative control test result.
• Maintaining immunity at a high level will allow the body to cope with this infection on its own.

How does ureaplasmosis manifest in pregnant women? What is the treatment? Why is this dangerous?

Previously, doctors often recommended induced termination of pregnancy to pregnant women who were diagnosed with ureaplasmosis. Nowadays the tactics have changed. Most often, a woman can carry her pregnancy to term and give birth to a child. However, the disease negatively affects both pregnancy and the condition of the fetus. Therefore, it is better to get tested and treated in advance.

Features of ureaplasmosis during pregnancy:

1. A pregnant woman has a reduced immune system. Even if ureaplasma is present in the body in small quantities, it can cause an infection.
2. Antibiotics should not be taken in early pregnancy. Antibacterial drugs have side effects and can negatively affect the fetus.
3. Against the background of reduced immunity, ureaplasmosis opens the gates to sexually transmitted infections. If a woman becomes infected with an STD, this will have an even more negative impact on the course of pregnancy.

Possible complications of ureaplasmosis during pregnancy:

• Miscarriage. In the early stages, the disease can lead to miscarriage.
• Premature birth. The child is born premature and weakened. This occurs due to the fact that with ureaplasmosis the cervix loosens. It can be sutured, but this can also negatively affect the child’s condition.
• Violation of uteroplacental blood flow.
• Hypoxia(oxygen starvation) of the fetus.
• Intrauterine developmental delay.

Features of treatment of ureaplasmosis during pregnancy:

• If pregnancy proceeds without complications against the background of infection, and there is no threat of miscarriage, then treatment is prescribed from the 22nd week. At earlier stages, there is a high risk of negative effects of antibiotics on fetal development.
• Antibacterial drugs from the group are usually used macrolides (erythromycin) in combination with immunotherapy (Thymalin, T-activin) And probiotics (lactusan, colibacterin, bifidumbacterin).
• Treatment is selected individually. Your doctor may also prescribe other medications.

Is it possible to treat ureaplasmosis with folk remedies?

Ureaplasmosis is an infectious disease that can lead to a number of complications. His effective treatment possible only with the use of antibacterial drugs prescribed by a doctor. Folk remedies can be neither the main method of treatment nor an alternative to medications. But, as an addition to the main therapy, they can improve the condition, reduce symptoms, and speed up recovery.

Before using any folk remedies be sure to consult your doctor .Some recipes are presented below for informational purposes only.

Some folk recipes for ureaplasmosis

Recipe No. 1
Ingredients:

• succession grass – 3 parts;
• raspberry leaves – 3 parts;
• rose hips – 3 parts;
• dill fruits - 1 part;
• nettle leaves - 1 part;
• primrose root - 1 part;
• birch leaves - 1 part;
• lungwort (herb) - 1 part;
• violet (herb) - 1 part;
• plantain – 2 parts;
• meadowsweet flowers - 2 parts.

Cooking method:
Grind and mix all ingredients thoroughly. Take 1 tablespoon of the resulting mixture and pour one glass of boiling water. Leave for 9 hours.

Mode of application:
Take 1/3 cup 3 times a day before meals.

Recipe No. 2
Ingredients:

• licorice root - 1 part;
• Leuzea root - 1 part;
• penny root - 1 part;
• chamomile flowers - 1 part;
• alder cones - 1 part;
• string grass - 1 part.

Cooking method:
Grind all ingredients thoroughly and mix. Take one tablespoon of the resulting mixture and pour boiling water over it. Leave for 9 hours.

Mode of application:
Take one third of a glass 3 times a day, before meals.

Recipe No. 3
Ingredients:

• thyme - 1 part;
• series - 1 part;
• yarrow herb - 1 part;
• Leuzea root - 1 part;
• burnet root - 1 part;
• wild rosemary - 1 part;
• birch buds - 1 part.

Cooking method:
Grind and mix all ingredients thoroughly. Take one tablespoon of the resulting mixture and pour a glass of boiling water. Leave for 9 hours.

Mode of application:
Take ½-1 glass per day, immediately before meals.

Recipe No. 4
Ingredients:

• boron uterus – 1 part;
• wintergreen – 1 part;
• winter lover - 1 part.

Cooking method:
Grind and mix all ingredients thoroughly. Take one tablespoon of the mixture and add 500 ml of water. Let it brew for 12 hours.

Mode of application:
Take ½ glass 4 times a day.

What is ureaplasmosis 10 to 4 degrees?

One of the methods for diagnosing ureaplasmosis is inoculating the pathogen on a special medium. This study helps not only to detect microorganisms, but also to determine their quantity (titer).

People who are diagnosed with ureaplasma do not always have symptoms of the disease. So, according to statistics, ureaplasma positive are 15-70% of sexually active women and up to 20% of men.

Thus, doctors need a clear criterion that would help identify a high risk of developing the disease. The titer of the pathogen became such a criterion. If it is 10 to the 4th power or less, this is considered normal. A higher rate indicates a high degree of risk or a confirmed diagnosis of ureaplasmosis.

But even if the titer is low and the person has no symptoms, ureaplasma positivity may have some negative consequences:

• A carrier can infect a sexual partner, who will develop the disease.
• A Ureaplasma-positive woman can infect her child during childbirth (the probability of infection is 50%).
• With a decrease in immunity, a ureaplasma-positive person may develop an infection.

Sometimes carriage of ureaplasma is transient (temporary), and sometimes persists throughout life.

How does ureaplasmosis manifest in newborns? How dangerous is this disease?

Despite the fact that a woman with ureaplasmosis can carry a pregnancy to term and give birth to a child, the pathogen negatively affects the condition of the fetus, and infection of the newborn is possible.

Routes of transmission of the pathogen from mother to fetus:

• through the placenta ( transplacental);
• upon contact with the birth canal during childbirth.

If the infection develops early in pregnancy, it can cause serious damage to the fetus. frozen pregnancy and have a miscarriage.

At a later stage it develops fetoplacental insufficiency, fetal hypoxia. The child is born prematurely, underweight, and weakened. If the fetus experiences severe oxygen starvation, then the child may subsequently develop mental disorders.

There is evidence that ureaplasma can disrupt the development nervous system. Because of this, in the past, doctors often recommended induced termination of pregnancy for infected women. Today the tactics have changed.

Diseases of newborns that can be caused by ureaplasma:

• pneumonia(pneumonia);
• bronchopulmonary dysplasia– a chronic disease that develops in newborns after artificial ventilation;
• sepsis(blood poisoning);
• meningitis– inflammation of the dura mater.

The probability of infection of the child during childbirth is 50%.

Cases of ureaplasma affecting the respiratory system and testicles in schoolchildren have been described.

Can ureaplasmosis occur in the mouth? How does it manifest?

Ureaplasmosis can be contracted through kissing and oral sex. But the pathogen is not always transmitted through kissing.

If this is an ordinary friendly kiss on the cheek or touching the lips, then infection is unlikely. This also applies to children and parents. If you kiss a child, you most likely will not infect him. The risk of infection is even lower if the sick person carefully observes oral hygiene.
plan pregnancy.

During pregnancy, there is a risk of miscarriage, prematurity, and fetal infection. The only effective preventative measure is timely preliminary treatment.

Can ureaplasmosis occur in a virgin? Where does it come from?

The detection of ureaplasma in a virgin can have different reasons:

• In fact, the girl is not a virgin and hides it. The infection occurred during sexual intercourse.
• The infection occurred during a kiss or oral-genital contact.
• The household route of infection (through common objects, including personal hygiene items, through the toilet rim, bathtub, etc.) has not been proven. But it is not excluded either.
• Often, ureaplasmosis is detected in girls whose mothers suffered from this disease during pregnancy. In this case, the girl received the infection from her mother.

If a girl or girl has symptoms of inflammation of the genital organs and ureaplasmosis is detected, this does not mean that she became infected recently. It is possible that carriage occurred for a long time, and then, under the influence of certain factors, the infection was activated.

Thus, even in the absence of sexual contact and protected sex, there is a possibility that a girl or young man will be diagnosed with ureaplasma.

Are mycoplasmosis and ureaplasmosis the same thing?

Both diseases are caused by microorganisms belonging to the Mycoplasmataceae family. It is divided into two genera: Mycoplasma and Ureaplasma. Thus, mycoplasma and ureaplasma are “relatives”. They cause the same inflammatory processes in genitourinary system, infections manifest themselves with the same symptoms. Treatment methods are also practically the same.

After treatment for ureaplasmosis, itching appeared. What to do?

If, after a course of treatment for ureaplasmosis, itching, vaginal discharge, or peeling of the skin in the genital area appear, you must visit the doctor again and undergo an examination. There is a possibility that the disease was not fully treated (especially if control tests for ureaplasma were not carried out), or re-infection occurred from an untreated partner. In addition, due to decreased immunity, ureaplasma can open the gates to other infections.

Often the problem is the development of vaginal dysbiosis after a course of antibiotics. This is common among women who have received antibiotic therapy for genitourinary infections. Treatment of vaginal dysbiosis is carried out using eubiotics, probiotics, immunomodulators.

What is ureaplasma parvum and urealiticum?

These are two types of ureaplasma that can cause ureaplasmosis. It is these two microorganisms - Ureaplasma parvum And Ureaplasma urealyticum, - they try to detect it in the laboratory when diagnosing the disease.

The causative agent Ureaplasma urealyticum was first discovered in 1954 by researcher M. Shepard in a patient who suffered from urethritis of non-gonococcal origin. Since then, several more species of these bacteria have been discovered: Ureaplasma cati, Ureaplasma canigenitalium, Ureaplasma felinum, Ureaplasma diversum, Ureaplasma parvum, Ureaplasma gallorale.

Ureaplasmas are unique microorganisms that, in their structure, occupy an intermediate position between viruses and bacteria. They are classified as transient microflora: these microorganisms are not typical for a healthy person, but can be present in the body for a long time without causing harm, and when the defenses are weakened, they can cause an infection.

Ureaplasmosis very widespread, being one of the most common sexually transmitted infections (STIs). However, it is still unclear whether such a disease actually exists or is it a fantasy of doctors. Thus, pathogens of ureaplasmosis colonize the vagina of a healthy woman in 60% of cases, and in newborn girls in 30% of cases. In men, ureaplasma is detected less frequently. Recently, they have received the definition of opportunistic pathogens. That is, their hostility towards humans is in question.

The causative agent of ureaplasmosis

Ureaplasmas are close in size to large viruses and have neither DNA nor a cell membrane. This is a small defective bacterium, its inferiority lies in the fact that during evolution it has lost its cell wall.
They are sometimes considered as a kind of transitional step from viruses to bacteria. Ureaplasma got its name because of its characteristic feature - the ability to break down urea, which is called ureolysis. Ureaplasmosis, as a rule, is a urinary infection, because ureaplasma cannot live without urea.
Transmission of the infection occurs mainly through sexual contact, but intrauterine infection from a sick mother during childbirth is also possible. Also, children often become infected from their parents in early childhood through household means.

Symptoms of ureaplasmosis

It is believed that the incubation period of ureaplasmosis is about one month. However, everything depends on the initial health status of the infected person. Once in the genital tract or urethra, ureaplasma can behave quietly and not manifest itself in any way for many years. The resistance of the genital organs to the effects of microorganisms is provided by physiological barriers. The main protective factor is normal microflora. When the ratio of various microorganisms is disrupted, ureaplasma begins to multiply quickly and damage everything that gets in its way. Ureaplasmosis occurs. It should be noted that ureaplasmosis manifests itself with minor symptoms that bother patients little, and often does not manifest itself at all (especially in women). Sick women complain of occasional clear vaginal discharge that differs little from normal. Some may experience a burning sensation when urinating. If the patient’s immunity is very weak, then ureaplasma can move higher along the genital tract, causing inflammation of the uterus (endometritis) or appendages (adnexitis) Characteristic features endometritis are menstrual irregularities, bleeding, heavy and prolonged menstruation, nagging pain in the lower abdomen. With adnexitis they are affected the fallopian tubes, an adhesive process develops, which can lead to infertility and ectopic pregnancy. Repeated exacerbations can be associated with alcohol consumption, colds, and emotional overload.

The presence of ureaplasma in the body should not be considered as the main cause of infertility. The possibility of getting pregnant is influenced not by the presence of the pathogen itself, but by the presence of an inflammatory process. If there is one, then you should immediately undergo treatment, and always together with your regular sexual partner, because ureaplasmosis also disrupts the reproductive function of men.

The course of pregnancy with ureaplasmosis

Ureaplasmosis is one of those infections for which a woman should be examined before her intended pregnancy. Even a small amount of ureaplasma in the genitourinary tract of a healthy woman during pregnancy can become active and lead to the development of ureaplasmosis. At the same time, if ureaplasmosis is first detected during pregnancy, this is not an indication for termination of pregnancy. Correct and timely treatment will help a woman carry and give birth to a healthy baby.

It is believed that ureaplasma does not have a teratogenic effect, i.e. does not cause developmental defects in the child. At the same time, ureaplasmosis can cause miscarriages, premature birth, polyhydramnios and fetoplacental insufficiency - a condition in which the baby lacks oxygen and nutrients.

As for the fetus, during pregnancy infection occurs in very rare cases, since the fetus is reliably protected by the placenta. However, in about half of the cases, the baby becomes infected while passing through the infected birth canal during childbirth. In such cases, ureaplasma is found on the genitals of newborns or in the nasopharynx of infants.

In addition, in some cases after childbirth, ureaplasmosis becomes the cause of endometritis, one of the most severe postpartum complications.
To reduce the risk of infection of the child and the threat of premature birth to a minimum, ureaplasmosis is treated during pregnancy after 22 weeks with antibacterial drugs prescribed by the attending physician, an obstetrician-gynecologist.

Diagnosis of ureaplasmosis

Diagnosis of ureaplasmosis is not too difficult for modern medicine.
For reliable laboratory diagnosis of ureaplasmosis, today a combination of several methods is used, selected by a doctor. Several techniques are usually used to obtain more accurate results:

1.Bacteriological (cultural) diagnostic method. Material from the vagina, cervix, and urethra is placed on a nutrient medium, where ureaplasma is grown for several days (usually 48 hours). This is the only method that allows you to determine the amount of ureaplasma, which is very important for choosing further tactics. Thus, with a titer of less than 10*4 CFU, the patient is considered a carrier of ureaplasma and most often does not require treatment. A titer of more than 10*4 CFU requires drug therapy. The same method is used to determine the sensitivity of ureaplasmas to certain antibiotics before prescribing them, which is necessary for the correct selection of antibiotics (drugs that help one patient may be useless for another). Typically such a study takes about 1 week.

2.PCR(polymerase chain reaction, which allows identifying the DNA of the pathogen). A very fast method, it takes 5 hours to complete. If PCR shows the presence of ureaplasma in the patient’s body, this means that it makes sense to continue the diagnosis. A negative PCR result almost 100% means the absence of ureaplasma in the human body. However, PCR does not allow determining the quantitative characteristics of the pathogen, therefore a positive result with PCR is not an indication for treatment, and the method itself cannot be used for control immediately after treatment.

3.Serological method(detection of antibodies). Detection of antibodies to antigens (characteristic structures) of ureaplasmas is used to determine the causes of infertility, miscarriage, and inflammatory diseases in the postpartum period. For this study, blood is taken from a vein.

4. In addition to the listed methods, in the diagnosis of ureaplasmosis they sometimes use direct immunofluorescence method (DIF) and immunofluorescence analysis (ELISA). They are quite widespread due to their relatively low cost and ease of implementation, but their accuracy is low (about 50-70%).

Treatment of ureaplasmosis

Diagnosis ureaplasmosis It is placed only when, using cultural analysis, it is revealed that the amount of ureaplasma in the body exceeds the norms permissible for a healthy person. In this case, ureaplasmosis requires treatment. Preventive treatment of ureaplasmosis with a small number of ureaplasmas is prescribed only to women planning pregnancy.

Treatment is usually carried out on an outpatient basis. The causative agent of this disease very easily adapts to various antibiotics. Sometimes, even several courses of treatment turn out to be ineffective, because the right antibiotic it can be extremely difficult. Culture of ureaplasmas with determination of sensitivity to antibiotics can help in the choice. Outside of pregnancy, tetracycline drugs (tetracycline, doxycycline), fluoroquinolones (ofloxacin, pefloxacin) and macrolides (azithromycin, vilprafen, clarithromycin) are used. During pregnancy, only some macrolides, tetracycline drugs and fluoroquinolones can be used are strictly contraindicated.

Of the macrolides used for the treatment of ureaplasmosis erythromycin, vilprafen, rovamycin. In addition, local treatment and immunomodulators (drugs that increase the body's immunity) are prescribed as necessary.

During treatment, it is necessary to abstain from sexual intercourse (in extreme cases, be sure to use a condom), follow a diet that excludes the consumption of spicy, salty, fried, spicy and other irritating foods, as well as alcohol. Two weeks after the end of antibacterial therapy, the first control analysis is performed. If the result is negative, another control test is performed a month later.

Prevention of ureaplasmosis

Methods for preventing ureaplasmosis do not differ from methods for preventing sexually transmitted diseases (STDs). First of all, this is the use of a condom during sexual intercourse and avoidance of casual sex.
Another means of prevention: timely detection and treatment of this disease in patients and their sexual partners.

An infectious inflammatory disease of the genitourinary organs caused by the pathological activity of ureaplasmas. In 70-80% of cases, the disease occurs in the form of asymptomatic carriage. May manifest as nonspecific dysuric symptoms, an increase in the amount of clear vaginal discharge, nagging pain in the lower abdomen and disturbance reproductive function. To make a diagnosis, bacterial culture, PCR, ELISA, and PIF are used. Etiotropic treatment involves the prescription of antibacterial drugs - macrolides, tetracyclines and fluoroquinolones.

General information

Ureaplasma was first isolated from a patient with nongonococcal urethritis in 1954. Today, the pathogen is considered an opportunistic microorganism that exhibits pathological activity only in the presence of certain factors. 40-50% of sexually active healthy women are carriers of bacteria. The microorganism is detected on the genitals of every third newborn girl and in 5-22% of schoolgirls who are not sexually active. Although, according to the results of various studies, ureaplasma were the only microorganisms found in some patients with infertility and chronic diseases of the urogenital area, ureaplasmosis is not included as an independent disease in the current International Classification Illnesses.

Causes of ureaplasmosis in women

The causative agent of the disease is ureaplasma - an intracellular bacterium without its own cell membrane, which has a tropism for the columnar epithelium of the genitourinary organs. Of the 6 existing types of ureaplasma, pathogenic activity was detected in two - Ureaplasma urealyticum and Ureaplasma parvum. Infection occurs through unprotected sexual contact or during childbirth. Convincing evidence about the contact-household method of transmission of ureaplasmosis does not exist today.

In most cases, carriage of ureaplasma is asymptomatic. The main factors contributing to the development of the inflammatory process are:

• Dishormonal conditions. The pathogen can exhibit pathogenic activity during pregnancy, when the endocrine function of the ovaries is disrupted.
• Decreased immunity. Inflammation of the urogenital tract more often occurs in women with diseases that reduce immunity and while taking immunosuppressive drugs (in the treatment of cancer pathology) .
• Vaginal dysbiosis. Disturbance of the normal microflora of the vagina due to irrational antibacterial therapy and hormonal imbalance activates opportunistic microorganisms, including ureaplasma.
• Invasive interventions. The trigger point for the development of ureaplasmosis in some cases is abortion, instrumental treatment and diagnostic procedures (hysteroscopy, urethro- and cystoscopy, surgical methods for treating cervical erosion, etc.).
• Frequent change of sexual partners. The bacterium is activated in association with other STI pathogens that penetrate a woman’s genitals during unprotected sex with casual partners.

Pathogenesis

The pathogenesis of uroplasmosis in women is based on the adhesive-invasive and enzyme-forming properties of the microorganism. When it enters the mucous membrane of the genitourinary organs, the bacterium attaches to the cell membrane of the columnar epithelium, merges with it and penetrates the cytoplasm, where it multiplies. The microorganism produces a special enzyme that breaks down immunoglobulin A, thus reducing the immune response to infection. In asymptomatic cases, local inflammatory and destructive changes are weakly expressed. An increase in the pathogenic activity of the pathogen under the influence of provoking factors leads to the development of inflammation - a vascular reaction, increased tissue permeability, and destruction of epithelial cells.

Classification

The main criteria for identifying clinical forms of ureaplasmosis in women are the nature of the course and the severity of pathological manifestations. In particular, specialists in the field of gynecology distinguish:

• Carriage of ureaplasma. Most women whose examination reveals this microorganism do not have any signs of inflammatory processes.
• Acute ureaplasmosis. It is observed extremely rarely and is accompanied by clinically pronounced signs of damage to the genitourinary organs and general intoxication.
• Chronic ureaplasmosis. Signs of acute inflammation are absent or appear periodically in the presence of provoking factors; reproductive function disorders and chronic inflammation of the urogenital tract are possible.

Symptoms of ureaplasmosis in women

In 70-80% of cases, there are no clinical manifestations indicating infection of the body with ureaplasma. The disease has no specific symptoms and during periods of exacerbation it manifests itself with signs characteristic of inflammatory processes in the genitourinary system. A woman may complain of discomfort, pain, burning, and painful sensations when urinating. The volume of clear vaginal discharge increases slightly. With the ascending development of infection with damage to the internal reproductive organs, aching or nagging pain in the lower abdomen may bother you. In acute cases and during periods of exacerbations, the temperature rises to low-grade levels, the patient notes weakness, fatigue, and decreased performance. Chronic ureaplasmosis may be indicated by treatment-resistant urethritis, vaginitis, endocervicitis, adnexitis, inability to become pregnant, spontaneous termination or pathological course of pregnancy.

Complications

With a long course, ureaplasmosis in women is complicated by chronic inflammatory processes in the uterus and appendages, which lead to infertility, miscarriages and premature birth. The situation is aggravated by infection of the partner, who may develop male infertility due to the disease. In some cases, inflammation, vascular and autoimmune processes in the endometrium cause primary placental and secondary placental insufficiency with disruption of normal fetal development, the risk of abnormalities and increased perinatal morbidity. Since pregnancy is a provoking factor for the activation of the microorganism, and treatment infectious disease involves the prescription of drugs that can affect the fetus; during reproductive planning, it is important to identify the pathogen in a timely manner.

Diagnostics

Data from a vaginal examination, bimanual examination and the clinical picture of the disease are nonspecific and, as a rule, indicate the presence of an inflammatory process. Therefore, special research methods that allow detection of the pathogen play a key role in the diagnosis of ureaplasmosis in women:

• Tank. culture for ureaplasma. When inoculating biomaterial (excretions, smears) on a nutrient medium, ureaplasma colonies are detected, after which their sensitivity to antibacterial drugs is determined.
• PCR. Using the polymerase chain reaction, the genetic material of the pathogen can be detected in the patient’s biomaterial within 24 hours.
• Serological study. During immunofluorescence analysis (ELISA) and direct fluorescence (DIF), antibodies to the bacterium are detected in a woman’s blood and their titer is determined.

In differential diagnosis, it is necessary to exclude infection with other pathogens - chlamydia, trichomonas, gonococci, mycoplasmas, etc. The basis for the diagnosis of ureaplasmosis is the presence of inflammatory processes in the genitourinary organs of a woman in the absence of any other STI pathogens other than ureaplasma. Along with the gynecologist, a urologist is involved in counseling the patient.

Treatment of ureaplasmosis in women

The key goals of therapy for ureaplasma infection are reducing inflammation, restoring immunity and normal vaginal microflora. For patients with clinical signs of ureaplasmosis, the following are recommended:

• Etiotropic antibiotic therapy. When choosing a drug, it is necessary to take into account the sensitivity of the pathogen. Usually a 1-2 week course of tetracyclines, macrolides, and fluoroquinolones is prescribed.
• Vaginal sanitation. The introduction of suppositories with an antibiotic and antifungal drug complements the antibacterial treatment.
• Immunotherapy. To restore immunity, immunomodulating and immunostimulating agents, including those of plant origin, are indicated.
• Normalization of vaginal microbiocenosis. The use of probiotics locally and orally allows you to restore the vaginal microflora, which inhibits the pathological activity of ureaplasmas.
• Enzyme preparations. Enzymes have an anti-inflammatory effect and enhance tissue regeneration processes.
• Vitamin therapy. With a general strengthening purpose in complex treatment For ureaplasmosis in women, multivitamin and vitamin-mineral complexes are used.

It is important to note that the indications for prescribing etiotropic antiureaplasma treatment are limited. As a rule, antibiotics are used when ureaplasma is detected in patients with treatment-resistant chronic inflammatory processes and reproductive dysfunction in the absence of other STI pathogens. Also, an antibacterial course is recommended for carriers of ureaplasma who are planning a pregnancy.

Prognosis and prevention

The prognosis for ureaplasmosis in women is favorable. Etiotropic treatment allows you to completely get rid of the bacterium, however, due to the lack of passive immunity and the high prevalence of the pathogen, re-infection is possible. Since ureaplasma is an opportunistic microorganism, a rational sleep and rest schedule, seasonal maintenance of immunity, justified prescription of invasive methods for diagnosing and treating diseases of the female genital area, use of barrier contraception. To prevent pathological activation of the pathogen during planned pregnancy, prophylactic antibiotic therapy is recommended for women with ureaplasma carriage.

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Introduction

Ureaplasmosis is one of the most common and so-called “commercial” diagnoses in urology and gynecology, which is often used by unscrupulous doctors. This diagnosis can be made to almost half of men and 80 percent of women.

But is ureaplasmosis so dangerous? Does it need to be treated? And where does it actually come from? Let's try to figure out all these questions.

What kind of beast is ureaplasma?

Ureaplasma was first discovered in 1954 by the American doctor Shepard in the secretions of a patient with nongonococcal urethritis. Further research has shown that most people who are sexually active are carriers of ureaplasma. However, it is not at all necessary that they will have any external signs of infection. Ureaplasma can remain in the human body for years and even decades and not manifest itself in any way.

Ureaplasma is a tiny bacterium, which in the microbiological hierarchy occupies an intermediate position between viruses and single-celled microorganisms. Due to the multilayer outer membrane that surrounds the bacterium on all sides, it is very difficult to detect under a microscope.

In total, five varieties of ureaplasma are known, but only two of its types are dangerous to humans - Ureaplasma urealyticum and Ureaplasma parvum. They are the ones who have a special weakness for epithelial cells located in the genitourinary tract. Ureaplasma is almost never found in other parts of the body.

By the way, the closest “relative” of ureaplasma is mycoplasma. Due to the great similarity in structure and preferences, both microorganisms are often colonized in the genital tract at the same time, and then doctors talk about mixed infections, i.e. diseases caused by mixed microflora.

Where does ureaplasma come from?

Normally, a huge number of microorganisms live in the human genitourinary tract, and all of them, to one degree or another, take part in maintaining the cleanliness of the vagina or urethra. As long as immunity is at the proper level, microorganisms do not pose a danger. But as soon as the body’s resistance decreases, the microflora of the genital tract is disrupted, some microorganisms begin to multiply rapidly, and then they become dangerous to human health.

The situation is exactly the same with ureaplasma. Many people live with it for a long time and do not even realize that they are carriers of this bacterium. It is most often discovered by chance, when the patient consults a doctor for some completely different reason, and sometimes simply out of curiosity. For a full examination, the doctor sends smears to the laboratory. And this is where the fun begins. The analysis reveals ureaplasma, and the patient is immediately treated. And even the fact that a person has no complaints does not stop some doctors from taking active steps aimed at “expelling” the microbe from the human body.

The main argument in favor of urgent treatment is that in the absence of it, a man or woman will (possibly!) suffer from infertility, and the likelihood of giving birth or conceiving a child will become zero. And a long battle with ureaplasma begins. Carriers undergo multiple courses of drug treatment, which leads to the appearance of many side effects. They, in turn, are often attributed to the manifestation of other hidden infections, etc. This can be many years of, and, unfortunately, useless running around in a vicious circle.

By the way, foreign specialists have long stopped treating ureaplasma as an absolute evil. They do not refute the fact that a microorganism can cause disease, but only in cases where the biocenosis in the genital tract is disrupted and the acidic environment characteristic of a healthy person has changed to alkaline. In other cases, ureaplasma should be considered as a conditionally dangerous cohabitant, and nothing more. Taking care of your health, a well-ordered sex life, proper nutrition and physical activity are the key to well-being in the genitourinary area.

After many years of scientific discussions, it was decided that only those people who have symptoms and complaints from the urogenital tract need treatment, and the presence of other pathogens is excluded. In other cases, no active influence on the microflora is required.

What does it mean? For example, a patient comes to the doctor with complaints of frequent cystitis (inflammation of the bladder). The doctor prescribes a series of tests aimed at identifying the cause of the disease. If studies have not revealed any other pathogens, then ureaplasma, and sometimes mycoplasma, is considered the root cause of the disease. In this situation, targeted treatment of ureaplasma is really necessary. If there are no complaints from the patient, then the prescription of any treatment remains at the discretion of the doctor.

There is still a lot of debate about the involvement of ureaplasma in secondary infertility, miscarriage, polyhydramnios and premature birth. Today, this issue remains debatable, because not a single specialist has been able to reliably confirm the guilt of ureaplasma in these pathologies. Of course, if you need to identify ureaplasma in the genitourinary tract, then this is quite simple to do. As stated above, the carrier of this microorganism is the sexually active population, and therefore, if desired (or necessary), it is not difficult to sow ureaplasma.

Some researchers still try to prove the pathogenicity of ureaplasma, using as arguments its frequent presence in diseases such as urethritis, vaginitis, salpingitis, oophoritis, endometritis, adnexitis, etc. However, in most cases, treatment aimed only at eliminating ureaplasma does not give a positive result. From here we can draw a completely logical conclusion - the cause of inflammation of the pelvic organs is a different, more aggressive flora.

How can you become infected with ureaplasma?

Ureaplasma is very unstable in the environment and dies very quickly outside the human body. Therefore, it is almost impossible to become infected in public places, for example, saunas, baths, swimming pools, public restrooms.

For infection, close contact with a carrier of ureaplasmosis is necessary. Infection is most likely to occur during sexual intercourse, which one - oral, genital or anal - does not matter significantly. However, it is known that slightly different ureaplasmas live in the oral cavity and rectum, which are dangerous to humans in much rarer cases.

The detection of ureaplasma in one of the sexual partners is not a fact of treason, because a person could have become infected many years ago, and sometimes during fetal development, or during childbirth from his own carrier mother. By the way, another conclusion follows from this - the infection can be detected even in infants.

Some people believe that ureaplasma is a “bad” sexually transmitted infection. This is fundamentally incorrect; ureaplasma itself does not cause sexually transmitted diseases, but it can accompany them quite often. It has been proven that the combination of ureaplasma with Trichomonas, gonococcus, and chlamydia really poses a serious danger to the genitourinary system. In these cases, inflammation develops, which almost always has external manifestations and requires immediate treatment.

How is ureaplasmosis treated?

Strictly speaking, such a disease as ureaplasmosis does not exist in the international classification of diseases. As a result, we will talk about what drugs ureaplasma bacteria are sensitive to.

Antibiotics against ureaplasma

All microorganisms are “afraid” of antibiotics to one degree or another, and ureaplasma in this case is no exception. Unfortunately, not every antibacterial agent is able to suppress the activity of bacteria, because Ureaplasma lacks a cell wall. Drugs such as penicillin or cephalosporins have virtually no beneficial effect. The most effective antibiotics are those that can affect the synthesis of protein and DNA in the microbial cell. Such drugs are tetracyclines, macrolides, fluoroquinolones, aminoglycosides, Levomycetin.

The best indicators for ureaplasma infection are Doxycycline, Clarithromycin, and in the case of ureaplasma infection in a pregnant woman, Josamycin. These antibiotics, even in minimal doses, can suppress the growth of bacteria. As for other antibacterial drugs, they are used only if ureaplasma is sensitive to them, which is determined during a microbiological study.

Indications for treatment

To prescribe antibacterial treatment, at least one of the following conditions must be present:

• The presence of obvious symptoms and convincing laboratory signs of inflammation of the genitourinary system.
• Laboratory confirmation of the presence of ureaplasma (ureaplasma titer must be at least 104 CFU/ml).
• Upcoming surgery on the pelvic organs. In this case, antibiotics are prescribed for prophylactic purposes.
• Secondary infertility, provided that other possible causes are completely excluded.
• Repeated complications during pregnancy or recurrent miscarriage.

You need to know that if ureaplasma is detected, both sexual partners must undergo the prescribed treatment, even if one of them has no signs of infection. In addition, it is recommended to protect yourself with condoms for the entire treatment period to prevent cross-contamination.

Drugs affecting ureaplasma

There is an opinion among some doctors that the growth of ureaplasma can be suppressed with a single dose of Azithromycin in the amount of 1 g. Indeed, the instructions for the drug and medical recommendations for the treatment of sexually transmitted infections indicate that Azithromycin effectively affects non-gonococcal and chlamydial urethritis nature in men and chlamydial cervicitis in women. However, numerous studies have proven that after Azithromycin taken in such a dosage, the destruction of ureaplasma does not occur at all. But taking the same drug for 7-14 days is almost guaranteed to get rid of the infection.

Doxycycline and its analogues - Vibramycin, Medomycin, Abadox, Biocyclinde, Unidox Solutab - are recommended drugs for the treatment of ureaplasma infection. These drugs are convenient because they need to be taken orally only 1-2 times a day for 7-10 days. A single dose of the drug is 100 mg, i.e. 1 tablet or capsule. It must be borne in mind that on the first day of treatment the patient must take double the amount of medication.

The best results from taking Doxycycline were obtained in the treatment of infertility due to ureaplasmosis. After the treatment course, in 40-50% of cases, a long-awaited pregnancy occurred, which proceeded without complications and ended successfully in childbirth.

Despite this high effectiveness of the drug, some strains of ureaplasma remain insensitive to Doxycycline and its analogues. In addition, these drugs cannot be used in the treatment of pregnant women and children under 8 years of age. It is also worth noting quite frequent side effects, primarily on the part of the digestive system and skin.

In this regard, the doctor may use other medications, for example, from the group of macrolides, lincosamines or streptogramins. Clarithromycin (Klabax, Klacid) and Josamycin (Vilprafen) have proven themselves to be the best.

Clarithromycin does not have any negative effects on the gastrointestinal tract and can therefore be taken with or without food. Another advantage of the drug is its gradual accumulation in cells and tissues. Thanks to this, its effect continues for some time after the end of the course of treatment, and the likelihood of reactivation of the infection sharply decreases. Clarithromycin is prescribed 1 tablet twice a day, the course of treatment is 7-14 days. During pregnancy and children under 12 years of age, the drug is contraindicated; in this case, it is replaced with Josamycin.

Josamycin belongs to the group of macrolides and is able to suppress protein synthesis in ureaplasma. Its effective single dosage is 500 mg (1 tablet). The drug is taken 3 times a day for 10-14 days. Josamycin has the ability to accumulate, so at first it has a depressing effect on ureaplasma, preventing its reproduction, and upon reaching a certain concentration in the cells it begins to have a bactericidal effect, i.e. leads to the final death of the infection.

Josamycin causes virtually no side effects and can be prescribed even to pregnant women and children under 12 years of age, including infants. In this case, only the form of the drug is changed; not a tablet drug is used, but a suspension for oral administration. After such treatment, the threat of miscarriage, spontaneous abortions and cases of polyhydramnios are reduced by three times.

In cases where the development of ureaplasma inflammation in the urogenital tract occurs against the background of reduced immunity, antibacterial agents are combined with immunomodulatory drugs (Immunomax). Thus, the body’s resistance increases and the infection is more quickly destroyed. Immunomax is prescribed according to the regimen simultaneously with taking antibiotics. A single dose of the drug is 200 units, it is administered intramuscularly on days 1-3 and 8-10 of antibacterial treatment - a total of 6 injections per course. It is also possible to take tableted immunomodulatory drugs - Echinacea-Ratiopharm and Immunoplus. They have a similar effect, but are taken 1 tablet daily during the entire course of antibacterial treatment. At the end of such combined treatment, in almost 90% of cases, ureaplasma goes away irrevocably.

Naturally, if, in addition to ureaplasma, another pathology of the genitourinary tract was found, then additional treatment aimed at eliminating concomitant diseases may be required.

When to treat ureaplasma - video

Conclusion

As a summary, I would like to emphasize the following: ureaplasma is transmitted mainly through sexual contact with a bacteria carrier or a sick person. Moreover, his infection could occur at any time period of life, starting from the moment of birth.

Ureaplasma affects the epithelial cells of the genitourinary system and tends not to manifest itself for a long time. When immunity decreases, hormonal imbalances, malnutrition, frequent stress, hypothermia, the likelihood of activation of ureaplasma increases with the development of symptoms characteristic of inflammation of the vagina or urethra.

It is impossible to say unequivocally that ureaplasma infection is a sexually transmitted infection. The fact is that the causative agent is Ureaplasma urealyticum, which belongs to the genus of mycoplasmas, which can be present in a woman’s genital tract and, accordingly, transmitted through sexual contact. However, the influence of this pathogen on the development of the inflammatory response is quite ambiguous, so it is often classified as an opportunistic infection.

Often, ureaplasma manifests its pathological activity when the body's resistance decreases (the course or exacerbation of a general disease, after menstruation, abortion, childbirth, insertion or removal of an intrauterine device).

Ureaplasma attaches to the epithelium, leukocytes, sperm and destroys the cell membrane, penetrating into the cytoplasm. Ureaplasma infection can occur in both acute and chronic forms (the disease is more than two months old and has an asymptomatic course). Clinical picture for this infection it is quite blurred, in most cases it is combined with chlamydia, trichomonas, gardnerella, and this makes it difficult to establish their role in the pathological process (the main cause of the disease or a concomitant agent).

Transmission routes.
Sexual contacts and infection at the household level are unlikely. Sometimes there is a vertical route of transmission due to ascending infection from the vagina and cervical canal.

Ureaplasma can be transmitted from mother to child during childbirth. They are usually found on the genitals, most often in girls, and the nasopharynx of newborn babies, regardless of gender. Intrauterine infection of the fetus with ureaplasma occurs in the rarest cases, since the placenta perfectly protects against any infection. There are cases when newborn infected children experience self-healing from ureaplasma (more often in boys). In school-age girls who are not sexually active, ureaplasma is detected only in 5-22% of cases.

The average incubation period is two to three weeks.

Often, ureaplasma is detected in people who have an active sexual life, as well as in people who have three or more sexual partners.

Diagnosis of the disease in women.
To confirm the diagnosis, the following studies are performed:

• Culture study on selective media. Such an examination reveals the culture of the pathogen in three days and separates ureaplasmas from various mycoplasmas. The materials used for the study are scrapings from the urogenital tract, as well as the patient’s urine. Thanks to this technique, it is possible to determine the sensitivity of pathogens to antibiotics. This method is used for the simultaneous detection of Mycoplasma hominis and Ureaplasma urealyticum.
• Detection of pathogen DNA using the PCR (polymerase chain reaction) method. Within 24 hours, the pathogen and its species are identified in a scraping from the urogenital tract.
• Serological tests to determine the presence of antigens and antibodies to them in the blood. This is especially important in the presence of relapses of the disease, as well as in the development of complications and infertility.

Examination for the presence of ureaplasma is often recommended for women who have suffered inflammation of the appendages and uterus, suffer from miscarriage and infertility, have cervical erosion and menstrual irregularities, and also suffer from chronic colpitis.

Symptoms.
The patient, as a rule, has no idea about the disease for a long time. In most cases, ureaplasma does not have any symptomatic manifestations, or these manifestations are limited to scanty transparent vaginal discharge and uncomfortable sensations when urinating. It is worth noting that the first symptoms disappear quite quickly, which cannot be said about the ureaplasma itself, which remains in the body and when the immune system is weakened (hypothermia, excessive exercise, illness, stress, etc.), acute ureaplasmosis develops with more pronounced symptoms .

In general, the manifestations of ureaplasmosis in women are similar to the symptoms of inflammatory diseases of the genitourinary organs. Less commonly, it is characterized by more pronounced symptoms and occurs in the form of acute and subacute vulvovaginitis, and the inflammatory process often affects the cervix and urethra. If ureaplasma causes inflammation of the uterus and appendages, then the symptoms are pain in the lower abdomen of varying intensity. If the infection occurred through oral sexual contact, then the signs of ureaplasmosis will be sore throats and pharyngitis with their corresponding symptoms.

Mixed infections (ureaplasma-chlamydial and others) have more pronounced symptoms.

Other, but rare, symptoms of ureaplasma infection are the appearance of endometritis, myometritis, and salpingo-oophoritis.

In case of latent carriage of ureaplasma, the development of an infectious process can be provoked by:

• the addition of infections of various origins;
• changes in hormonal levels associated with the phase of the menstrual cycle;
• pregnancy, childbirth;
• decrease in the body's defenses.

If ureaplasma has spread to the deeper parts of the urinary system, urethral syndrome may develop. In 20% of cases, ureaplasma was found in urinary stones during urolithiasis. Cases of acute hemorrhagic cystitis against the background of mycoureaplasma infection, with damage to the upper and lower parts of the genitourinary system, have also been recorded.

Ureaplasma during pregnancy.
When planning a pregnancy, the first thing a woman needs to do is get tested for the presence of ureaplasma. This is due to two reasons. Firstly, the presence even minimum quantity ureaplasma in the genitourinary system of a healthy woman during the period of bearing a child, leads to their activation, as a result of which ureaplasmosis develops. And secondly, in the early stages of pregnancy it is impossible to treat ureaplasmosis (by the way, during this period it is most dangerous for the fetus), since antibiotics negatively affect the growth and proper development of the fetus. Therefore, it is better to identify ureaplasma, if any, in advance, before pregnancy, and be cured. This disease is also dangerous for the fetus because during childbirth the infection is transmitted to the child through the birth canal.

If a pregnant woman has become infected with ureaplasmosis, she should definitely consult a doctor to clarify the diagnosis.

To prevent infection of the baby during childbirth, postpartum infection of the mother's blood, as well as to reduce the risk of premature birth or spontaneous miscarriages in the early stages, a pregnant woman with this disease is given antibacterial therapy after twenty-two weeks of pregnancy. The medications are selected by the attending physician. In addition to antibiotics, drugs are prescribed to increase the body's defenses in order to reduce the risk of secondary infection.

Treatment of ureaplasma.
Treatment of this infectious disease is carried out comprehensively using antibiotic drugs to which microorganisms are sensitive (tetracycline antibiotics, macrolides, lincosamines), drugs that reduce the risk of side effects during antibacterial therapy, local procedures, drugs that enhance immunity (immunomodulators Timalin, Lysozyme, De- caris, Methyluracil), physiotherapy and vitamin therapy (vitamins B and C, hepatoprotectors, lactobacilli) to restore vaginal and intestinal microflora. A certain diet is also prescribed: exclusion of spicy, fatty, salty, smoked, fried foods and inclusion of vitamins and fermented milk products). After treatment, several follow-up examinations are carried out.

Indicators of the effectiveness of the treatment:

• negative test results for ureaplasma, in particular PCR diagnostics;
• restoration of vaginal microflora;
• absence of clinical symptoms of ureaplasmosis.

As noted above, it happens that symptoms go away on their own without treatment for ureaplasma. Only some may experience relapses of symptoms in the future, while others may not. The reasons for this phenomenon have not yet been clarified, so ureaplasmosis continues to be a mysterious disease for doctors.

If the presence of ureaplasma is suspected, both sexual partners should be examined.

Since ureaplasma can be a normal vaginal microflora for some women and a disease for others, only a qualified specialist can decide whether to treat this disease or not.

Prevention of ureaplasmosis in women is the presence of a permanent and reliable sexual partner, mandatory protection in the case of casual sexual contact, and examination by a gynecologist.