Infectious diseases of the genital organs. Most common route of transmission of STIs

STI is an acronym that stands for "sexually transmitted infections." The development of these infections does not depend on the result of which contact they are received: vaginal, anal or oral. More recently, such diseases, as a rule, were called sexually transmitted diseases, now they are more often called STIs, but it is not their name that matters, but the fact that they can be transmitted by a person who does not even suspect that he is sick. There are a number of infections that can be transmitted during an injection (or accidental needle stick), sharing a needle, or breastfeeding a baby.

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Difference from STD

In the 1990s, these diseases were classified as venereal. There are currently 2 terms in use:

1. 1. Sexually transmitted infections (STIs).
2. 2. Diseases (diseases), sexually transmitted diseases (STDs).

If the term "infection" is used, this means that a person is affected by one or another virus, microbe or bacterium that is in his body, but so far there are no external signs and symptoms of the disease, although viruses are already infecting the body.

If the term "disease" is used, then in this case a virus, microbe or bacterium is not only present and damaging the body, but, in addition, there are obvious signs and symptoms of the disease.

If a person is sick, then he begins to notice deviations from the norm, he feels bad. The term "sexually transmitted infection" is considered broader and covers not only those who are clearly ill and who have all the manifestations of the disease, but also those who are its carriers, but who have not yet manifested themselves.

Often patients do not even suspect that they are infected with STIs, and continue to infect other people with them, so the term STD is used much less often than the term STI, which is more true.

Another feature of the term STD is that it can be used depending on the factors and means of transmission of the disease. For example, a disease such as meningitis can be transmitted sexually, but it is not considered an STI because its transmission during sexual intercourse is not the primary cause of contracting the disease.

There are a number of other infections that can be transmitted sexually, but this method is not preferred. STIs include those diseases that are mainly transmitted during sexual intercourse. If a person is sick with chlamydia or gonorrhea, then he could get such diseases only through sexual contact. But there are a number of pathologies that, in addition to the sexual path, can be transmitted in other ways, the list of them is long. For example, AIDS can be transmitted both through sexual contact and through blood, and SARS can be transmitted when a sick person sneezes or coughs.



Common classification

There are a large number of infections that can be transmitted during sexual contact, so there is a certain qualification for them, namely:

Bacterial infections include:

• bacterial vaginosis, which, although not an STI, is transmitted during sexual contact;
• venereal lymphogranuloma;
• staphylococcal infection;
• chancroid;
• non-gonococcal urethritis;
• syphilis;
• gonorrhea;
• donovanosis.



Diseases caused by fungi are:

• yeast infection;
• shingles.

The list of viral diseases is as follows:

• adenoviruses, they may be present in respiratory and fecal fluids;
• viral hepatitis: hepatitis B is transmitted both through sexual secretions and saliva, hepatitis A, E can be transmitted both by oral and fecal routes, hepatitis C is rarely transmitted during sexual intercourse, but can lead to liver cancer, hepatitis D is very rarely can be transmitted sexually, but such a possibility is not excluded;
• herpes - transmitted through the mucous membranes;
• HIV AIDS;
• genital papillomas;
• molluscum contagiosum;
• Kaposi's sarcoma;
• mononucleosis.
• scabies;
• pubic lice.

Abdominal infections include various bacteria, viruses, and protozoa that are transmitted during sexual contact, whether oral or anal. This can happen with the general use of sex toys, non-compliance with hygiene rules.



Oral infections such as influenza, adenoviruses, colds, papilloma, herpes, hepatitis B can be transmitted sexually.



Symptoms of infection

There are so-called internal and external symptoms of STIs. The first category includes deterioration in health, fever, muscle pain, i.e. symptoms similar to those of a cold.



If gonorrhea or trichomoniasis develops, then discharge appears from the urethra, the person experiences pain and pain during urination.

When identifying diseases such as cervical erosion, chronic prostatitis, infertility, it is imperative to check for the presence of STIs.

With the development of syphilis, sores begin to appear on the skin, which are often confused with the development of herpes. Some people treat the sores that appear with soap and they disappear. Despite this, if the body is affected by syphilis, then in the absence of external manifestations, the body continues to be damaged, and if treatment is not started, then serious complications develop.

The appearance of a rash may indicate both the development of scabies and syphilis. The size of the pubic louse is not more than 1-2 mm, infection occurs both through sexual contact and through linen or clothing. It develops in all areas where there is hair, except for the head. As a result of itching, the skin is combed, and infections penetrate the body.



If STIs are present in the mother, then they can be transmitted to the child in her womb, during childbirth or while breastfeeding.



Patterns of emergence and development

Most of these infections are easily transmitted through the mucous membranes that are on the penis, vulva, rectum, mouth, eyes. If we talk about the mucous membrane of the glans penis, then although it does not produce mucus, it contains it. The mucous membrane differs from the skin in that pathogenic microorganisms penetrate into it faster. They easily penetrate even in the presence of any damage to the skin, for example, a rush, cut or crack.



If we talk about the surface of the head of the penis, then during the friction that occurs during sexual contact, it becomes especially susceptible. Most infections are transmitted through genital secretions, followed by saliva and mucous membranes, followed in descending order by skin, feces, urine, and sweat. The number of microorganisms that is necessary to infect a person cannot be seen with the naked eye and, depending on the type of infection, it will be different.

Most infections are much more likely to be passed on during intercourse than with other types of contact. For example, deep kissing is much less likely to be infected than oral sex. If we talk about HIV, then there will be much more of it in the sexual secretions than in the saliva of a sick person.

Depending on the type of STI, the spread of infection can be both with and without signs of its presence. Herpes is more likely to be contracted in the presence of its external manifestations than when they are not present, and HIV can be infected even when the carrier does not have obvious signs of AIDS.

To reduce the risk of sexually transmitted diseases, it is recommended to use condoms. Although this method of protection is the most reliable and affordable, even it cannot fully guarantee security.



Carrying out diagnostics

When conducting a diagnosis, a survey can be performed for 1 infection or for several. Although there are rapid tests that can cover several infections at the same time, there is not yet an analysis that can be used to test for all STIs at one time.



Tests conducted to determine STIs are carried out:

• as a diagnosis, so that the symptoms of the disease can be determined;
• as a screening study, which can detect infections that occur without symptoms;
• to screen partners who intend to have unprotected sex, for example to conceive a child;
• a newborn to check if he was infected from his mother;
• before using donated blood or organs, to make sure they are from a healthy person;
• to ascertain the effectiveness of the treatment of the patient;
• for the purpose of conducting a mass epidemiological survey.

Many STIs are asymptomatic, and often symptoms do not appear until some time after the infection has occurred. Such infections lead women to develop pelvic pain. Both women and men can develop infertility, and in some cases it can be fatal.

Early diagnosis allows you to start treatment on time, which in this case is much more effective than in cases with an advanced form of the disease. Depending on the type of infection, the length of the "window", that is, the time after infection when the tests are negative, will be different, and during this time a person can continue to infect other people.

Testing for STIs should be done whenever you suspect that you have had contact with a sick person. First of all, you need to pass tests for sexual infections. If this is done immediately, then the doctor can conduct active prophylaxis, in which the external genitalia are treated with special preparations. This allows you to significantly reduce the time of treatment and prevent the development of serious complications.

For HIV or hepatitis, it is required to take a blood test, a smear for STDs is taken for urogenital infections. Reliable results upon receipt of a smear are obtained when the infection was introduced recently. With advanced diseases, bacteriological culture is performed, while the PCR method is used, a blood test is performed. In order to correctly diagnose STIs, a comprehensive analysis should be carried out, which includes several types of studies.



It is necessary to take tests for genital infections if you have had unprotected sexual contact with a stranger, even in cases where there are no signs of the disease.

Treatment methods

A high risk of STIs exists during rape, in which case a complex of drugs is prescribed, which include antibiotics. If an infection with gonorrhea or chlamydia occurs, then self-treatment is possible, but before that it is necessary to consult a doctor.



When carrying out such treatment, the doctor can use antibiotics, antimicrobials, it is much easier to carry out treatment when the disease is detected on time. Some people believe that there is a pill that is enough to drink to get rid of STIs, but this is not so, such infections require complex and long-term treatment.

The treatment process is especially difficult when several such diseases are detected at once, while there is a high risk of complications.

If a person has several infections, you have to take complex drugs or combine them.



In any case, it is necessary to carry out treatment, there are no cases of self-healing from such diseases. It can be misleading when the disease becomes chronic, and there are no external symptoms of its development. In this case, the person also continues to infect other people, and there is a high risk of developing serious complications. Self-treatment is also dangerous, treatment should be carried out only by a specialist after a full diagnosis.

Preventive actions

The best way to protect yourself is prevention, and the most affordable way is safe sex. It protects against direct contact with a possibly already infected partner, and if a condom is used correctly, the risk of infection is greatly reduced.



The ideal option would be when both partners are tested for STIs before having sex, then the risk of infection is minimized. It is not always possible to detect an infection immediately after infection, in many cases a certain period of time must pass for this. If you had a suspicious contact, then time should pass from this time to passing the test.

The immune system of a healthy person is only able to prevent infection when the viral load is low. If other viruses appear, the load on the immune system increases, and it can no longer cope with its functions on its own.

Some viruses, such as hepatitis B, can be protected by timely vaccination. Condoms only protect the area of ​​the body they cover, so areas of the body that are left open remain susceptible to infections. With HIV, the condom provides a high degree of protection, since it is not transmitted through intact skin.

You must be able to use a condom correctly, and in order to do this, you must adhere to the following rules:

1. 1. When putting on, 1-1.5 cm recede from the beginning of the condom, this is the place for the ejaculate. It must be put on carefully so as not to damage it.
2. 2. It should not be too loose, otherwise it will not be able to fully provide your protection.
3. 3. A used condom must not be turned inside out.
4. 4. Only latex or polyurethane condoms can protect against HIV.
5. 5. Do not use oil lubricants with latex products, as this may damage them.
6. 6. Flavored condoms are best used for oral sex only. The presence of sugar on them can cause a yeast infection in women when they penetrate.
7. 7. Do not use a condom repeatedly, as this increases the chances of damage to it, and it cannot fully perform its barrier function.

The most effective way to protect against STIs is to completely abstain from all sexual contact. Few can decide on this, so it is necessary to give preference to secure contacts, to have relationships with 1 trusted partner.

If unprotected contact occurs, it is immediately recommended to douche, flush the external genitalia with a solution of chlorhexidine or miramistin. This must be done immediately, otherwise this procedure will not work.

If you see a doctor in the first days after infection, he may inject drugs that block the development of certain infections. This is a good method of prevention, but it is often not recommended to resort to it.

Sexually transmitted diseases or sexually transmitted infections are a group of diseases that are caused by bacteria and protozoa, fungi and viruses. This group of infections has spread among people who are promiscuous and do not use condoms, who are prone to antisocial existence, alcoholism and drug addiction. Without exception, all STIs have long-term consequences, including damage to the central nervous system, liver, bones and other organs.

Causes of STIs

Sexually transmitted infections, predominantly sexually transmitted, are not in vain named after the goddess Venus - infection by them in most cases occurs during close contact with the carrier of the disease. Most often this occurs during intercourse without the use of barrier contraceptives.

The causative agents of the infection may be:

• in the saliva of the carrier;
• on the skin (most often near the mouth, in the perianal region, in the perineum);
• in seminal fluid and vaginal secretions.

It is possible to get an STD without direct contact with the carrier. Often, infection occurs when using shared dishes, towels, razors, sponges and washcloths. This way of transmission is called domestic.

Important! Even bar soap can become a source of infections. Despite its ability to destroy pollution, it is a good breeding ground for many pathogens of STIs.

Sexual infections are not as harmless as it might seem at first glance. Among the complications arising after the transfer of STIs, infertility and miscarriage in women, prostatitis and impotence in men, diseases of the liver and central nervous system are mentioned.

What diseases are STDs?

Important! Candida and nonspecific urethritis and colpitis, bacterial vaginosis, provoked by conditionally pathogenic microflora, do not belong to sexually transmitted diseases.

Bacterial infections

Bacterial infections, predominantly sexually transmitted, are considered the most numerous among all STIs. This category of diseases includes:

• inguinal and venereal granulomas;
• syphilis;
• chlamydia;
• gonorrhea;
• mycoplasmosis;
• ureaplasmosis.

There are other bacterial infections that are predominantly sexually transmitted, which are extremely rare in Russia and the post-Soviet space. For example, soft chancre, the causative agent of which is the bacterium Haemophilus ducreyi, is diagnosed mainly in the inhabitants of Africa and America.

Viral infections

Sexually transmitted viral infections are less numerous than bacterial ones, but the number of people infected by them reaches impressive figures.

According to the statistics of the World Health Organization, at least 50% of sexually mature people on the planet are infected with the human papillomavirus, and this disease also belongs to the category of STIs.

A feature of viruses that can be infected during sexual contact is that they can be in an inactive state for a long time, and manifest themselves with a decrease in immunity or against the background of other diseases. The following viral sexual infections are among the most common:

• human immunodeficiency virus (HIV);
• herpes simplex virus;
• human papillomavirus (HPV);
• cytomegalovirus;
• Hepatitis B.

This is not a complete list of viral sexual infections. They also include Kaposi's sarcoma, the Zika virus and other diseases that are diagnosed in a relatively small number of people.

Protozoal infections

Protozoal infections include diseases of the reproductive system, the causative agent of which is Trichomonas vaginalis. According to statistics, trichomoniasis is the most common disease among all sexually transmitted infections.

According to the World Health Organization in 2000, at least 10% of all people on Earth, including newborns and the elderly, are infected with these microorganisms.

Fungal infections

Fungal infections that are sexually transmitted are represented by thrush. Its occurrence is due to the increased activity of the conditionally pathogenic microorganism Candida albicans, a yeast-like fungus that lives on the mucous membranes of the mouth, vagina, and large intestine.

The disease develops against the background of a decrease in general and local immunity, an imbalance of microflora, after prolonged use of antibiotics.

• phthiriasis (pubic pediculosis), the causative agent of which is the pubic louse;
• scabies, the causative agent of which is the scabies mite.

Almost all sexually transmitted infections, even if they are asymptomatic, are fraught with complications. Most often they are manifested by infertility, miscarriage, chronic inflammation of the uterus and appendages, the prostate gland. Certain types of STIs provoke the formation of benign and malignant tumors.

Diagnostics

For the diagnosis of genital infections, a standard set of methods is used:

• visual inspection;
• laboratory research;
• instrumental research.

Based on complaints and the results of an external examination, the doctor can assume which infection is present in the patient:

Laboratory diagnosis of STIs includes a number of studies of biological samples:

• direct and fluorescent smear microscopy;
• cultural method of smear examination;
• detection of antigens of causative agents of sexual infections in the blood - direct immunofluorescence and enzyme immunoassay;
• detection of DNA of causative agents of STIs by polymerase chain reaction;
• detection of antibodies to pathogens of sexual infections in the blood.

Additionally, instrumental studies may be prescribed - ultrasound of the pelvic organs (uterus and appendages, prostate gland), liver and abdominal organs (if hepatitis is suspected) and others.

Treatment

Methods of treatment of genital infections depend on the type of disease and pathogens found during the diagnosis. The basis of therapy is the intake of medicines inside and their use externally. Additionally, immunomodulatory and immunostimulating agents and drugs are prescribed that help restore the functions of organs and systems affected by the disease.

The groups and names of drugs used to treat sexually transmitted infections are shown in the table:

Treatment for sexually transmitted infections may also include surgery and minimally invasive interventions. Especially often they are used when signs of HPV (genital warts) appear on the genitals and in the perianal region. Neoplasms are removed with a laser, radio wave method or excised with a conventional scalpel.

Important! HIV, AIDS, herpes types I and II, HPV and hepatitis C cannot be cured forever. Patients will have to adapt to life with them and take special medications constantly or in separate courses.

The elimination of genital infections will be effective only if both sexual partners undergo a course of therapy. At the time of treatment, it is advisable to refuse sex, or use barrier contraceptives.

STI prevention

The first step in preventive measures is to inform young people about what infections are sexually transmitted and how dangerous they are. According to statistics, more than 20% of venereologist patients do not know the elementary rules of contraception or ignore them. Meanwhile, to avoid unpleasant diagnoses and their negative consequences, it is enough:

• use barrier contraceptives, condoms are best;
• lead an orderly sex life and do not change partners too often;
• avoid casual sexual contact;
• observe personal hygiene;
• do not use other people's personal hygiene items (toothbrush, shaving machine, etc.).

In the prevention of sexually transmitted infections, a special role is played by the timely detection of diseases. It is recommended that men and women of puberty be regularly tested for dangerous infections such as hepatitis C, HIV, syphilis and others. Such analyzes are mandatory for pregnant women and those whose work involves direct contact with people: doctors, cooks, attendants, teachers, drivers and others.

If you suspect an STD infection, it is advisable to undergo a complete examination. Today, this can be done anonymously in private clinics and laboratories. It is necessary to treat sexual infections immediately after their detection and only under the guidance and supervision of a venereologist.

Sexually transmitted viral infections are a group of diseases, the most common way of affecting which doctors call sexual. It should be noted that these pathologies most often affect the organs of the genitourinary system, and only in advanced cases can they spread to other tissues. Modern medicine divides these processes into venereal ones, which can be contracted through sexual contact, and which can be transmitted in other ways. In short, the whole group of diseases is called STIs.

Among those processes that can be transmitted not only through unprotected intercourse, the most famous are HIV, viral hepatitis B and C. These diseases have a parenteral route of transmission, that is, through the blood. There is also a vertical path, that is, from mother to child. This is how chlamydia and HIV infection can be transmitted.

The direct contact route is characteristic of scabies, while the airborne contact route is characteristic of Ebola. It should be noted that not all scientists regard Ebola and scabies as infections that can be transmitted sexually.

Infectious and viral processes are distinguished. There is a group of diseases that does not belong to sexually transmitted diseases, since their pathogens are considered as conditionally pathogenic microflora. This is candidal colpitis, gardnerellosis. At the same time, doctors usually consider these pathologies together with sexually transmitted diseases, since their therapy is very similar.

Infectious, that is, bacterial infections, are the following:

Viral infections include:

• HIV AIDS;
• hepatitis B and C;
• genital warts;
• molluscum contagiosum;
• herpes;
• Kaposi's sarcoma - as an independent pathology or as a complication of AIDS.

Viral infections

To date, an impressive number of various viruses have been released, infection with which is possible through sexual contact. The following are considered the most famous and widespread of them.

HIV

One of the most terrible pathologies for which there is no cure to this day. There are only a few antiviral drugs that can somewhat slow down the rate of development of the disease. The terminal stage of HIV infection is AIDS, in which the human immune system suffers significantly. It is characterized by the development of many different infectious diseases.

Herpes

For the reproductive system, only the second type of virus is dangerous, and the pathology is called genital herpes. The first type of microorganism provokes a process on the face. It should be noted that herpes affects the nervous system and poses a high risk for those who have weak immunity, for example, for people suffering from AIDS, congenital immunodeficiency, after organ transplantation (a condition due to immunosuppressive therapy). This group also includes cytomegalovirus.

Genital warts

Outwardly, they resemble cauliflower, painted in body color. These growths develop on the genitals or in the perianal region, and during oral sexual intercourse, they can be localized in the oral cavity. The causative agent is papillomavirus. It is transmitted exclusively to humans and can cause changes in the growth of healthy tissue.

More than 100 species of this microorganism are isolated, and about a third is tropic to the genitals. Some of the rest may not harm the human body, and another part provokes the development of warts, which can become malignant in the future.

Viral parenteral hepatitis B and C

They belong to the hepadnavirus family. They are very resistant to environmental factors, most chemical agents, temperature effects. They also survive freezing. On a razor blade, a needle from a syringe or a dried drop of blood without special treatment, that is, sterilization, these viruses can persist for up to several weeks under normal conditions.

Blood heated to 30 C can contain living cells of microorganisms for up to six months, and at a temperature of -15 C, the life span reaches 20 years. In order to neutralize it, it is necessary to carry out sterilization in an autoclave or dry-heat cabinet.

The disease caused by these viruses can be secretive for a long time, but with decompensation of hepatitis, cirrhosis of the liver and severe liver failure occur. As with HIV, there is currently no effective cure for viral hepatitis.

Kaposi's sarcoma

By its nature, it is a viral disease, but most doctors consider it as an oncological process of the skin. The name of the disease was due to Moritz Kaposi, who first described the pathology;

molluscum contagiosum

Like Kaposi's sarcoma, it is a skin process. Occurs under the influence of viruses belonging to the group of ospaviruses. The lesions can be the dermis and mucous membranes. It most often develops in children under 10 years of age.

Transmission of infection occurs during contact of the child with personal hygiene products that have been contaminated. In a typical course, hemispherical nodules are noted on the genitals, thighs or lower abdomen. Their color is usually identical to normal skin, but sometimes it can stand out a little.

The center of the nodules is somewhat depressed, and the formations themselves are painless. Their size can reach 1 cm. If you press a little on these elements, then a curdled discharge comes out of them, as happens with typical acne. This is the only pathology that should not be treated, since it usually disappears after six months.

Possible routes of transmission

The peculiarity of any sexual infection is that this group of diseases does not tolerate environmental factors. This necessitates direct contact, in which pathogens are transmitted.

The World Health Organization has developed the concept of safe sexual behavior in order to prevent the spread of STIs. It includes simple postulates.

1. Protected sex with condoms.
2. Use of local bactericidal preparations.
3. Examination of young people living an active sexual life.
4. If an STI is detected, the necessary treatment is carried out, sexual abstinence and notification of sexual partners in order to prescribe therapy to them.
5. Vaccination against viruses that can cause cancer. These include parenteral hepatitis, papillomavirus.

Sexually transmitted infections can also be passed to another person through oral contact, kissing, through all kinds of sex toys. Moreover, such a situation is possible even when a condom was used during sexual intercourse, but not for the use of toys or during oral sex.

The broad understanding of sexually transmitted infections implies other modes of transmission. For example, papillomaviruses can be transmitted at home through various objects, and Trichomonas persist for a long time at high humidity.

An intermediate stage of this pathogen can be a towel. Scabies can be contracted through any household items.

The vertical transmission path deserves special attention. It implies infection of the fetus from the mother's body. The most dangerous disease that can occur in this way is HIV. It should be noted that HIV, along with hepatitis, can also be transmitted parenterally.

Diagnostic measures

To detect an STI, the doctor must conduct an initial examination of the patient and collect anamnestic data. After that, smears, a general blood test are performed. It must be borne in mind that symptoms such as pain or the presence of any discharge may be absent. Usually, instrumental methods of examination are quite subjective, and therefore have a slight error. This means that it is necessary to use several methods at once:

• microscopy;
• cultural method - in other words, the culture is sown on an environment that is comfortable for growth;
• determination of antigens using enzyme immunoassay;
• DNA detection by polymerase chain reaction.

Principles of treatment

With genital warts, radio wave destruction is used. The herpes virus, in addition to general therapy, responds better to local treatment. The drug of choice is Acyclovir.

Among the preventive measures, the use of a condom should be highlighted. This is especially true for those individuals who do not have one permanent sexual partner. It must be borne in mind that even barrier methods of contraception do not give a 100% guarantee.

What are “hidden” infections, sexually transmitted infections (STIs)?

• gonorrhea;
• syphilis;
• soft chancre;
• venereal lymphogranulomatosis;
• donovanose;
• HIV - infections;
• viral hepatitis B, C, D;
• chlamydia;
• mycoplasmosis;
• ureaplasmosis;
• trichomoniasis;
• garnerellosis;
• genital herpes;
• genital warts;
• cytomegalovirus infection;
• sexually transmitted skin diseases (scabies, pubic lice, molluscum contagiosum).

The following reproductively significant genitourinary infections are distinguished:

Absolutely pathogenic.

• Trichomonas vaginalis
• Clamydia trachomatis
• Mycoplasma genitalium
• Nesseria gonorrhoeae
• Treponema pallidum
• Papillomavirus hominis(6;11;16;18;45)
• Hepatitis B, C, virus
• Mumps virus (>18 years old)
• human immune deficiency virus

Conditionally pathogenic.

• Bacterii (enterobacteriaceae, enterocci, anaerobes, staphylococci, streptococci)
• Mycoplasma hominis
• Ureaplasma urealyticum T960
• Ureaplasma parvum
• candida albicans
• Herpes simplex virus I-II
• Cytomegalovirus

How does the process of contracting sexually transmitted infections occur?

For different infections, the incubation period ranges from 2-3 days to several weeks and even months. Quite often, after contracting an STI, there are no symptoms at all, or they are mild, so it is very important to be screened for the presence of genital infections after each casual connection. Infection occurs through sexual contact, and not only with genital, but with the same probability with oral or anal. From the moment of infection to the development of the disease, it can take several months, this period is called the incubation period. As a rule, in the first three days after infection, it is impossible to detect chlamydia and other “hidden” STIs even with the most sensitive diagnostic methods.

What to do if you suspect you have a sexually transmitted infection?

If you have had a new sexual relationship and found out that your sexual partner had an STI, felt characteristic symptoms, or simply doubts that you do not have an STI, you need to undergo a special medical examination. Never try to self-medicate or take the advice of a non-specialist. This can lead to chronic inflammation and the development of complications. The saddest thing is that many infections can be hidden. A person does not know and does not guess that he is sick. He remains ignorant and can infect his partners. The following symptoms may indicate that you or your partner is sick:

• inflammation in the genital area;
• sores;
• bubbles;
• warts;
• rash and plaque on the genitals;
• discharge from the genitals;
• urethra;
• rash on the surface of the body;
• unreasonable temperature rises;
• yellowness of the skin and whites of the eyes.

How reliable are methods for diagnosing sexually transmitted infections?

Laboratory diagnostics is the main thing for prescribing adequate treatment. Modern methods for diagnosing STIs: polymerase chain reaction (PCR), immunofluorescent method (IF), enzyme immunoassay (ELISA), isolation of pathogens in cell cultures, etc. are extremely reliable (up to 90%). However, in conditions of shortage of funds, not all laboratories in our country have sufficiently high-quality reagents and equipment. Another problem is that it is not always possible to identify exactly the infectious agent.

Who is eligible to treat sexually transmitted infections?

According to the International Agreement adopted in Riga in 1990, doctors can treat sexually transmitted infections: dermatovenereologist, urologist, gynecologist. Competently conduct an examination, make a diagnosis and prescribe a systemic, targeted treatment can only be a qualified specialist.

What complications are caused by sexually transmitted infections?

The main danger lies in the consequences of STIs - their complications, which are dangerous for both women's health and men's: prostatitis, inflammatory diseases of the uterus and appendages, often requiring surgical intervention, neoplasms of the genital organs, adhesive processes, cervical cancer (human papillomavirus) and liver cancer (hepatitis C), various pathologies of the fetus, the birth of a non-viable or sick child. Chronic forms of venereal diseases lead to damage to the nervous system, bones, brain, intestines, cardiovascular system, and oncological diseases develop. STIs have a particularly significant impact on the reproductive function of men and women. According to some reports, up to 80% of the causes of male and female infertility are caused by STIs. There may be acute conditions requiring surgical intervention, intrauterine infection of the fetus, a violation of the course of pregnancy and childbirth, the birth of a non-viable or sick child, and even the death of the infected person himself. Possible complications of STIs in men can be: infertility, epididymitis, narrowing (stricture) of the urethra, prostatitis, urethritis and others. The share of urogenital chlamydia accounts for up to 60% of all non-gonococcal urethritis in men. The most common complication of chlamydia in men is epididymitis (inflammation of the epididymis). In women, these are some diseases of the cervix, salpingitis (inflammation of the appendages) and tubal infertility. Chlamydia can cause serious pathology of the fetus and newborn, be the cause of pelvioperitonitis and perihepatitis in women. Chlamydia also leads to Reiter's disease, a severe disease of the joints and eyes. To identify the presence of an infection, it is necessary to undergo a thorough medical examination using modern laboratory methods that will help identify the presence of an infection at different stages of the disease. Examination with a sexual partner is an important factor in preventing re-infection and effectively treating STIs. Under no circumstances should you self-medicate or take "magic pills", this can lead to irreversible consequences and turn the disease into a chronic stage, the treatment of which is extremely difficult.

How difficult is it to treat sexually transmitted infections?

With a good qualification of the doctor, the correct selection of an antibacterial drug, its dosage and duration of treatment, as well as the patient's compliance with all the doctor's recommendations, success is guaranteed with a probability of 85-90%. In addition to antibiotic treatment, other drugs are also prescribed: immunostimulants, enzymes, vitamins, physiotherapy is carried out. The duration of treatment for acute and subacute infections is from 1 to 7 days, chronic infections can be up to 14 days, and complicated ones up to 1 month or more. It must be remembered that a number of infections are lifelong and are not completely cured. In the complex therapy of infections, phased treatment is necessary: ​​"anti-film preparations", anti-infectious herbal and pharmacological preparations, immunomodulators, probiotics and prebiotics. Due to the increase in the number and prevalence of infections of the genitourinary system, the number of men with inflammatory diseases of the prostate gland (prostatitis), seminal vesicles (vesiculitis), and seminal tubercle (calliculitis) has also increased. Currently, 98% are latent chronic forms of these diseases. Prostatitis, vesiculitis, calliculitis contribute to the development of congestion in the pelvic organs, form potential foci of infection, weaken testosterone metabolism (which leads to androgen deficiency), contribute to vegetative-neurotic disorders in the pelvic organs, weaken general and local immunological reactions. And the anatomical proximity of the prostate gland, seminal vesicles and seminal tubercle often leads to mutual infection of these glands, the occurrence of premature ejaculation and a decrease in reproductive function. Quite often, the treatment of inflammatory diseases in men is based only on anti-infective therapy, which in turn can lead to a relapse of the disease and a chronic process. The use of prostate massage in some situations is an effective method, but it only has a mechanical effect on the prostate, which is often painful for the patient.

A well-chosen pathogenetic treatment should be based on five basic rules:

1. Antibacterial / antiviral therapy (depending on the causative agent of the disease);
2. Improving arterial inflow and venous outflow of blood (this ensures the full delivery of antibacterial / antiviral agents to the site of inflammation, restoration of previous functions). Lack of arterial blood supply and venous stasis in the prostate gland adversely affect the course of the inflammatory process, reproductive and erectile functions in men;
3. Improving the outflow of prostate secretion and seminal vesicles (can be achieved by contracting the muscles of the pelvis, perineum and muscle fibers of the prostate gland);
4. General and local immunocorrection;
5. Comfort and minimal time costs, multiplied by the high efficiency of the therapy.

The use of electromagnet laser therapy devices makes it possible to achieve in a complex all the necessary effects on the diseased organ: restore the physiological processes altered by the disease and activate the body's natural protective functions against pathology. Since the combination of laser, magnetic and electrotherapy simultaneously provides an anti-inflammatory effect, stimulation of various muscles, elimination of congestion, improvement of lymph and blood flow. The therapeutic effect is based on biostimulation and mobilization of the existing energy potential of the body.

What physical therapy techniques are used to treat sexually transmitted infections and complications?

Magneto-infrared laser therapy is successfully used. The most commonly used urethral irradiation. Possible impact on the perineum and the area above the bosom. Low-intensity laser radiation has a pronounced anti-inflammatory effect, stimulates local immunity, improves microcirculation in the focus of inflammation, affects the permeability of the vascular wall, and has an analgesic effect. Intravenous laser blood irradiation (ILBI) is the most effective and versatile method of laser therapy. Unlike local laser therapy procedures, the therapeutic effect is due to the activation of systemic therapeutic mechanisms of the whole organism, an increase in the efficiency of the functioning of blood supply systems, immune, other organs and systems, as well as the whole organism as a whole.

In chronic inflammation, electrophoresis of antibiotics, uroseptics is used. The current strength is selected until a slight tingling appears. Intraorganic (urethral, ​​rectal and urethrorectal) electrophoresis with medicinal substances is used. With a protracted course of inflammation and an increase in signs of sclerosis in the prostate, it is possible to conduct an endourethral electrophore with collalisin.

Widely used transurethral or transrectal thermotherapy or hyperthermia. In the treatment of sexually transmitted infections, superficial heating of the mucosa of the urethra and prostate to a depth of no more than 5 mm is required in order to sanitize the urogenital tract or provide better conditions for subsequent local drug therapy. Provides heating of the urethra and gland by transurethral or transrectal technique evenly along the length of the urethra with a smooth rise in temperature from 39 to 45°C and automatic control of it directly in the urethra or rectum. Indications for the use of hyperthermia are: chronic urethritis, prostatitis, colpitis, cervicitis, ganglioneuritis.

When using magnetotherapy, it becomes possible to simultaneously use urethral and rectal heating against the background of exposure to a traveling magnetic field. This possibility allows you to optimize the impact and reduce the duration of treatment with the maximum percentage of favorable outcomes even in advanced cases. Magnetotherapy has an anti-inflammatory and analgesic effect, normalizes blood circulation, changes the course of redox and tissue enzymatic processes, creates conditions for a more effective action of antibiotics on the inflammatory process.

What are the most common causes of treatment failure for sexually transmitted infections?

The most common cause is re-infection, which occurs as a result of new sexual intercourse during treatment, untreated sexual partner, sexual contact without the use of a condom by a couple undergoing treatment. Other reasons for unsuccessful treatment of STIs are incorrect diagnosis, an incorrectly selected antibacterial drug, a violation of patient treatment, and antibiotic resistance of the infection.

What should I do after completing treatment for a sexually transmitted infection?

The control of the cure of infections is carried out no earlier than 2 weeks after the completion of the antibiotic. The patient should be aware that some symptoms of the disease may remain for several weeks or even months after successful treatment. It is possible to resume sexual life without a condom with a permanent sexual partner (partner) only after a control examination, which showed the absence of infections and inflammation.

What is the prevention of sexually transmitted infections?

It is necessary to conduct a scheduled inspection at least once every six months. You cannot take medications on your own. Uncontrolled intake of antibiotics and anti-inflammatory drugs distorts the clinical picture, transforms the disease into an asymptomatic form, leads to a chronic process and severe complications. Sexually transmitted infection is a problem that affects everyone. The best tactic is not to get sick at all. The best way to prevent STIs is to use a condom. It should be put on and taken off correctly and used for all types of sex, including oral. If, nevertheless, unprotected contact has occurred, there are methods of personal prevention when the genital tract is washed with an antiseptic solution. This must be done in the first 2-4 hours after contact, not later. For some infections, special medications may be used for prevention. Their choice should be discussed with the doctor.

How do urinary tract infections affect a man's body?

The infectious process and its complications can affect in isolation or successively various organs of the genitourinary tract: the prostate gland, seminal vesicles, vas deferens, testicles and their appendages. With inflammation in the organs of the reproductive system, regardless of the infectious factor, there may be damage as a result of the action of active oxygen radicals and other products of inflammation. In the future, tissue sclerosis and the development of subtotal or total obstruction of the vas deferens may occur. Leukocytes in inflammatory processes lead to agglutination of spermatozoa. The emerging chronic inflammatory process in the gonads causes a toxic effect on the spermatogenic epithelium, violations of the testicular barrier, rheological properties and chemical components of the seminal fluid, the appearance of ASAT. Violations of the physicochemical properties of seminal plasma - the habitat of spermatozoa, naturally leads to pathozoospermia, most often in the form of asthenozoospermia or the induction of "false" antisperm antibodies associated with infections. Infectious agents can enter the genitals through the blood (eg, mumps virus, Mycobacterium tuberculosis, or Mycobacterium leprae) or ascending from the urethra.

Among the possible consequences of an infectious lesion of the genital tract in men:

1. The spread of a disease that leads to the development of a disease or infertility in a woman, infection of the eggs and embryo, miscarriage, abnormalities of the embryo and fetus;
2. Change in germ cells, Sertoli cells, Leydig cells, which leads to male infertility (sterility);
3. Leukocyte infiltration of the genital tract is a T-cell mediated response to spermatozoa and autoimmune infertility;
4. Decrease in the formation of testosterone and, as a result, cachexia, male infertility;
5. Integration of the viral genome into the genome of a germ cell with a possible risk of transmission to subsequent generations.

The role of infections in violating the fertilizing ability of spermatozoa is ambiguous. Despite a lot of work on the presence of pathogens in the genital tract, there are conflicting conclusions regarding their role, which they play in the occurrence of infertility. First of all, this is due to the fact that these infections are often detected in both fertile and infertile couples.

• Mycoplasma genitalium - this type of mycoplasma is 100% pathogenic. It is the leading causative agent of non-gonococcal urethritis (10-30% of cases) in men. M.genitalium often causes acute urethritis in men, but there are also asymptomatic recurrent or asymptomatic forms. There is evidence of the relationship of M. genitalium infection with infertility and pregnancy. Indications for the treatment of M.genitalium are: confirmed infection caused by this pathogen of any localization, detection of M.genitalium in a sexual partner, clinical symptoms of inflammatory diseases of the lower urinary tract in the absence of a diagnostic examination for the presence of M.genitalium.
• Ureaplasma urealiticum and Mycoplasma hominis are opportunistic pathogens that occur in 10-50% of practically healthy individuals of reproductive age. Under certain conditions, they can cause infectious and inflammatory processes of the genitourinary organs, often in association with other pathogens. Ureaplasmas can reduce sperm motility by attaching directly to them. This was proven by the detection of a large number of ureaplasmas. Indications for treatment (in the absence of other significant pathogens) U.urealiticum and M.hominis: clinical or laboratory signs of inflammation of any organ of the genitourinary system, detection of M.hominis or U.urealyticum in an amount > 10 4 CFU / ml, upcoming surgical or invasive treatments -diagnostic manipulations in the genitourinary organs, complicated course of this pregnancy with the risk of infection of the fetus, aggravated obstetric and gynecological history.
• Trichomonas colonize in the genital tract of men, manifesting various symptoms up to hematospermia and epididymitis. It has been proven that the presence of Trichomonas may be associated with male infertility, and its presence in semen causes a violation of sperm motility and viability. The mechanism of influence of this infection on fertility is due to the creation of favorable conditions for the manifestation of other infectious agents in the genital tract, as well as a possible decrease in the content of fructose in semen.
• A significant inhibitory effect of Candida albicans was found in semen samples with an initial concentration of microorganisms of 2x107/ml in vitro. There is an assumption that mycotic vaginitis negatively affects sperm motility and enhances their agglutination.
• The role of viruses is largely unknown. Viral DNA is detected by polymerase chain reaction (PCR) in the ejaculate of infertile men in 56% of cases (herpes simplex virus - in 49% of cases, Epstein-Barr virus - in 17% of patients, cytomegalovirus - in 7% of cases).
• Only the presence of herpes simplex virus (HSV) is associated with a decrease in the number of spermatozoa and a decrease in their motility. HSV types 1 and 2 are found in the testicles, prostate, sperm and this can lead to infertility, azoospermia, oligozoospermia. According to some reports, treatment with acyclovir of both partners with positive tests for HSV DNA leads to pregnancy.
• Cytomegalovirus (CMV) is found in the prostate, seminal vesicles, semen and can cause hematospermia, a decrease in CD4 cells. The role of CMV as a possible etiological factor in hematospermia has been discussed. In studies, its definition was associated with a decrease in the concentration and motility of spermatozoa. In studies, its definition was associated with a decrease in the concentration and motility of spermatozoa.
• If the human papillomavirus (HPV) was present in the semen, the incidence of asthenozoospermia was significantly higher.
• The mumps virus is found in the testicles, mumps lead to orchitis, testicular atrophy, sterility, decreased androgen secretion, possibly testicular cancer.
• Staphylococcus aureus, Escherichia coli, group B hemolytic streptococcus have high spermicidal activity, while in micrococci, enterococci, white staphylococcus, diphtheroids and non-hemolytic streptococcus, this activity was noted at a concentration of more than 10 5 CFU / ml. When the ejaculate contains a large number of not only bacteria, but also leukocytes, spermatozoa have low mobility and agglutination. Some microorganisms can reduce sperm motility by attaching directly to them. This has been proven by the detection of large numbers of Escherichia coli.

The material was prepared by a urologist-andrologist, physiotherapist, dermatovenereologist Akimov Oleg Viktorovich.

Diseases that are sexually transmitted, are widely used today. At the same time, the existing medical statistics testify only to official data. Indeed, quite often a person is in no hurry to contact medical institutions, as he may simply not be aware of the existence of some diseases that are sexually transmitted. Often trichomoniasis , gardnerellosis develop in women without pronounced symptoms.

A number of sexually transmitted diseases are dangerous due to the possibility of intrauterine transmission of infection to the fetus. In addition, such an infection can also be transmitted with saliva, breast milk, in the process of blood transfusion.

Spread of sexually transmitted infections

Viral infections are the following viruses: herpes simplex virus , AIDS virus , hepatitis b virus , .

You can become infected with such an infection not only during genital intercourse, but also during oral or anal sex. Depending on the disease, it takes from three days to two weeks before the first signs of the disease appear.

Causes of infections

It is an undeniable fact that sexually transmitted diseases are, first of all, a consequence of people's too low sexual culture. In particular, we are talking about promiscuous sexual relationships, multiple sexual partners, as well as ignoring diagnostics after casual and risky sexual contacts.

An equally important condition for preventing the spread of STIs is the need to be examined and the person who suspects the development of such an ailment, and his sexual partner.

Symptoms

Speaking about the symptoms and signs of such diseases, it should be noted that quite often patients do not feel any changes in their own condition at all, or the signs are very weakly expressed. But in this case we are talking about the so-called oligosymptomatic and asymptomatic forms of such ailments.

The main symptoms of STIs directly depend on which pathogen has entered the human body, as well as on the state of his body as a whole.

However, in most cases, after , sexually transmitted diseases are manifested by a number of similar signs. The patient has discharge from the genitals, which over time become more and more intense. The sensation of itching and burning in the genital area also gradually increases, and spots or small ulcers may appear on the skin in the genital area. During the act of urination or during sexual contact, an infected person sometimes feels pain. In addition, he may noticeably increase.

Complications of sexually transmitted infections

If the treatment of the disease is not carried out in a timely manner, then sexually transmitted infections can provoke not only symptoms that relate to the state of the genital organs, but also a general lesion of the body. One of the serious complications that occur over time with the development of STIs is.

The ascending course of infections (and this invariably happens if timely therapy has not been provided) leads to the development of inflammatory processes in the organs of the genitourinary system. With progression ureoplasmosis and chlamydia men sometimes develop, and women with such ailments eventually get sick inflammation of the uterus and appendages . In addition, the development of venereal diseases leads to a strong decrease in a person and, as a result of such negative changes, diseases of the internal organs of a person may occur.

Sexually transmitted infections and women's health

Such infections have a very negative effect on the body of a woman. Unpleasant consequences can take place in relation to the reproductive capacity of a young woman. In addition, STIs can be transmitted from the mother to the baby. In women who have suffered some inflammatory diseases resulting from genital infections, it develops much more often. Some types of papillomavirus rapidly increase the risk of cancer in women.

During pregnancy in women with syphilis, in about 40% of cases, pregnancy ends with the birth of a dead child. Approximately the same situation is repeated in pregnant women with gonococcal infection . Children born to mothers with untreated chlamydial infection and gonorrhea very often suffer from a serious eye infection (so-called neonatal blenorrhea) immediately after birth. If left untreated, the child will burn completely blind.

Diagnosis of venereal infections

For a correct diagnosis in the case of a suspected STI, the patient must undergo a complete laboratory testing. But in view of the possibility of making a diagnosis using a syndromic approach, doctors pay special attention to the existing symptoms. Certain sexually transmitted infections have clear signs that are easy to recognize. The syndromic approach to the diagnosis of sexually transmitted diseases is based on the use of specially designed schemes that specialists use to make a diagnosis and subsequent treatment. Therefore, such a diagnosis will be more accurate.

But the most important point in the process of diagnosing such diseases is still timely seeking help. If the disease is detected as early as possible, then due to the correct therapy, severe consequences can be avoided completely.

When any signs or symptoms appear, the patient should not be guided by the hope that they will disappear on their own, or feel fear or embarrassment. Lost time can become decisive, and as a result, the disease will become chronic, and it will become much more difficult to cure it completely.

Latent sexual infections

The so-called hidden sexual infections are transmitted from person to person also during sexual contact. However, such infections are more difficult to diagnose and treat.

Among the most common STIs of this type, it should be noted chlamydia . This disease manifests itself as a consequence of infection of the human body with chlamydia. These organisms are considered to be intermediate between bacteria and viruses. Infection occurs during sexual intercourse, but in rare cases, the infection can be transmitted when visiting a sauna or swimming pool, by airborne droplets, and by other means. To determine the presence of this pathogen in the body, a person should undergo a special study using the DNA diagnostic method.

In most cases, this ailment goes away without severe symptoms. However, in men against the background of chlamydia, inflammatory diseases of the genitourinary system sometimes develop. In addition, today it has already been proven that chlamydia can damage the genetic structure of spermatozoa. In this case, chlamydia can enter the female body along with spermatozoa. Under the influence of chlamydia, a woman can also develop inflammatory diseases. Moreover, it is quite possible that obstruction of the fallopian tubes , which threatens infertility and miscarriage in the future.

In addition, chlamydia can have a negative impact on other body systems, in particular, on the cardiovascular system. In the process of treating the disease, it is very important that the patient's sexual partner also be tested for a sexual infection and receive adequate treatment. This should be done even for those who do not have visible signs of chlamydia.

Another common infection of this type is papilloma virus person. There are about seven dozen different types of papillomaviruses. At the same time, their clinical manifestations are invisible for a very long time. The consequence of infection with papillomavirus is the appearance of papillomas and genital warts on the skin of the genitals and other organs. In addition, papillomaviruses can provoke precancerous changes in the cervix in women. The transmission of the virus occurs during sexual intercourse, at home, and also when a newborn passes through the birth canal.

Other common sexually transmitted infections

Very often, modern doctors diagnose patients with gonorrhea . With this infectious disease, the mucous membranes of various organs are affected. Gonorrhea causes gonococcus , which most often enters the body with a variety of sexual contacts. Much less often, a person becomes infected in everyday life, through household items. The child becomes infected from a sick mother when passing through the birth canal.

At syphilis the patient affects not only the mucous membranes, but also the skin, internal organs, nervous system, bones, joints. The causative agent of this dangerous disease is pale treponema . Its transmission most often occurs sexually, much less often - in everyday life. The treatment of syphilis is based on the correct selection of antibiotics, the treatment of those infections that develop in parallel, as well as general strengthening therapy.

Trichomoniasis is very dangerous for expectant mothers, since with such a disease, rupture of the amniotic membranes and miscarriage are possible. The disease is characterized by the appearance of itching in the genital area, intense discharge.

Virus hepatitis B affects a person through transmission during a variety of sexual contacts, as well as through the sharing of needles for intravenous injections. The intrauterine mode of transmission of the virus is also relevant.

Acute hepatitis is manifested by severe, nausea, rash on the skin. The patient has a stomachache and a headache. Sometimes the symptoms are especially acute: severe itching of the skin, jaundice,. In about ten percent of cases, hepatitis B becomes chronic, which is characterized by the development of inflammatory processes in the liver. In turn, this is fraught with development in the future. liver cancer which threatens to be fatal. The disease can be completely cured if the diagnosis is made in time and the prescribed treatment regimen is strictly followed.

Prevention

The most effective method of preventing STIs is considered to be complete abstinence from sexual activity or sexual relations with only one uninfected partner. It is important to completely avoid any sexual contact with people infected with STIs.

Some sexually transmitted infections can be prevented by using condoms correctly during sexual intercourse. It is necessary to use a condom for all types of sexual intercourse, while it is important to ensure that the protective equipment is of high quality and is used correctly.

After unprotected sexual intercourse, it is imperative to apply some preventive measures that, to some extent, reduce the risk of developing the disease. The genitals can be thoroughly washed with solutions chlorhexidine or . However, this method of prevention is advisable only in the first hours after contact.

In addition, when contacting a dermatovenereologist, a patient may receive an injection of a special drug with an antibacterial effect, which can prevent the development of a number of sexually transmitted diseases. Such prophylaxis is possible in the first days after risky contact. However, it is important to consider that this measure can be applied only in the most urgent cases.