Urogenital trichomoniasis
Introduction
Introduction to genitourinary trichomoniasis The genitourinary trichomoniasis is a protozoal infection of the genitourinary system caused by Trichomonas vaginalis, and is also a common female genital disease. Men are often infected by sexual intercourse or using contaminated underpants, items and utensils. The main infection sites are the urethra and prostate. Kidney trichomoniasis is a pyelonephritis caused by human vaginal trichomoniasis. It can be transmitted through sexual intercourse. It can also cause kidney infection by urethra ascending or by blood. It can be indirectly transmitted through underwear, swimming, bathing, and daily use. Insect cystitis is a bladder infectious disease caused by Trichomonas vaginalis. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of transmission: sexual transmission, contact transmission Complications: placental abruption urethral stricture
Cause
Etiology of genitourinary trichomoniasis
(1) Causes of the disease
Trichomonas parasitizes in the posterior or paraurethral glands of women's vagina. In men, it is parasitic in the bladder, urethra and prostate. This disease is mainly transmitted through sexual contact. It is a sexually transmitted disease with vaginal trichomoniasis. Women, more than 3% of spouses also suffer from trichomoniasis, but most of them have no obvious symptoms, so some scholars believe that trichomoniasis itself does not cause disease, but is related to secondary bacterial infection.
(two) pathogenesis
Trichomonas has strong adaptability to the environment. The reproduction rate is the highest at 35-37 ° C and pH 5-6. The normal intravaginal pH is maintained at 3.8-4.0, so it can inhibit the reproduction of Trichomonas. Before and after menstruation, the pH in the vagina increases, and the body's resistance decreases, which is prone to infection. The trichomoniasis carrier is the only source of infection.
Direct infection
Through sexual intercourse between men and women, the incidence rate is high among sexually disturbed people and prostitutes, and often with other sexually transmitted diseases such as gonorrhea, non-gonococcal cervicitis (mycoplasma, chlamydia infection), genital warts, bacterial vaginosis, etc. presence.
2. Indirect infection
It can be spread through panties, bathing suits, bath towels, sanitary napkins, toilets, toilet seats, bathtubs, and beds that are infected with trichomoniasis or unsterilized medical equipment.
Prevention
Urogenital trichomoniasis prevention
Actively treat patients and worms, conduct regular surveys of female workers and female students living in groups, improve public health facilities in factories and schools, strengthen health education, and pay attention to personal hygiene and menstrual hygiene. Female condoms also have a good preventive effect. If both spouses have an infected person (especially if the man has no symptoms after infection), both parties need to be treated with anti-trichomoniasis to avoid cross-infection after the cure.
Complication
Urogenital trichomoniasis complications Complications, placental abruption, urethral stricture
Pregnant women suffering from trichomoniasis may have placental abruption, resulting in fetal death, congenital malformation or fetal light weight. The baby girl is infected through the infection of the vaginal mother's vagina, so pregnant women with severe trichomoniasis can choose to have a cesarean delivery. Male patients are mostly asymptomatic or have mild symptoms. However, they are still contagious. Therefore, both husband and wife infected with trichomoniasis need treatment. Secondly, when there is ulcer in the urethra, it can cause urethral stricture after healing.
Symptom
Symptoms of genitourinary trichomoniasis common symptoms dysuria urinary urgency pain urinary frequency chills body discomfort edema urination poor urethra itching hematuria
Most of the patients are married middle-aged people, common in women, have a history of unclean sexual intercourse, or have a history of trichomoniasis infection.
Urethritis
Male patients may have urinary tract irritation, frequent urination, white secretion and hematuria, etc. Female patients have frequent urination, dysuria, poor urination, increased vaginal discharge, serous or purulent, may be accompanied by odor, suprapubic pain and Urethral edema and so on.
2. Prostatic seminal vesiculitis
Mainly manifested as increased secretion of prostate, end-to-end pain, rectal drop, perineal pain, rectal examination showed that the prostate is soft and large, the seminal vesicle tenderness is obvious.
3. Cystitis
Caused by ascending infection, frequent urination, urgency, dysuria and pyuria.
4. External genital inflammation
There may be foreskin, glans ulcers, burning sensation, and smear can be found in living tissue smears.
5. chills, fever,
Persistent pain in the kidney area, general discomfort and gastrointestinal reactions.
Examine
Examination of genitourinary trichomoniasis
Mix the urethral secretion or prostatic fluid with 1ml of warm saline and place it under the microscope. If you can see the active trichomoniasis, you can confirm the diagnosis, or you can dry it naturally after smear, for methylene blue staining, Gram staining, Acridine orange staining and other tests, for some patients with difficult diagnosis, the secretions or urine sediment after prostate massage can be cultured to improve the detection rate, the positive rate can reach 90%.
Cystoscopy: The posterior urethra, the bladder neck, the triangular area with congestion, the red small papillary polypoid bulge, and a thin layer of floccules adhered to it.
Diagnosis
Diagnosis and identification of genitourinary trichomoniasis
diagnosis
The discovery of Trichomonas in secretions or urine sediment is the basis for the diagnosis of this disease.
Differential diagnosis
Acute pyelonephritis
Also showed fever, frequent urination, urgency and other symptoms of bladder irritation, with pyuria, low back pain, but no history of vaginal trichomoniasis, and acute onset, obvious symptoms, pathogenic strains in urine culture, smear staining can not find hair drops insect.
Kidney tuberculosis
Also manifested as repeated frequent urination, urgency, dysuria and pyuria, accompanied by low fever, but renal tuberculosis patients often have a history of tuberculosis, no serous or purulent vaginal secretions, smear staining can not find Trichomonas, Acid-fast bacilli can be found by acid-fast staining of urinary sediment smears.
3. Gonococcal urethritis
In the early stage of the onset, there are also urinary tract itching, redness, tingling, and frequent urination, urgency, dysuria and other symptoms. There is a thin mucus secretion in the urethra, but the urinary pain is obvious in this disease, and the amount of urethral secretion is large. Gradually evolved into purulent secretions, generally have a history of unclean sexual intercourse, trichomoniasis can not be found in urethral secretions or urine, but gonorrhea can be found.
4. Chronic bacterial prostatitis
The performance is frequent urination, urgency, urinary terminal pain, lower abdomen, perineum, testicular pain, similar to trichomoniasis prostate seminal vesicle inflammation, but the patient has no history of dirty sexual intercourse, no urethral secretion or even accompanied by urethral drip; The rectal examination showed that the prostate was hard and accompanied by mild tenderness. The urine routine examination was generally free of pus, white blood cells, and prostatic fluid routine examination could not find trichomoniasis, which can be identified.
5. Acute cystitis
It also manifests as urinary frequency, urgency and other symptoms of bladder irritation, but the onset is acute, the symptoms are obvious; there are few secretions in the vagina or urethra, and the smear method of urine and secretion can not find Trichomonas.
6. Tuberculosis
Also manifested as repeated frequent urination, urgency, dysuria and pyuria, but patients often have a history of kidney or tuberculosis; but no serous or purulent vaginal secretions, smear staining can not find Trichomonas, and urine sediment Acid-fast bacilli can be found by smear acid-fast staining.
