Trichomonas urethritis
Introduction
Introduction to trichomoniasis urethritis Trichom urethritis (trichomOilalurethritis) is also known as urethraltrichomo-niasis. Both males and females can occur, but they are more common in women. Women infected with Trichoderma vaginalis (trichoil20nasVginaIis referred to as vaginal trichomoniasis) by swimming, bathing, sexual intercourse, etc., parasitized in the vagina. After the urinary tract infection, and through sexual intercourse, men are infected. In addition to trichomonal urethritis, it can cause cystitis and prostatitis. basic knowledge The proportion of illness: 0.003% Susceptible people: more common in adult men and women Mode of infection: contagious Complications: endometritis pelvic inflammatory disease
Cause
Cause of trichomoniasis urethritis
There are three conditions for the pathogenesis of trichomoniasis urethritis, which are the source of infection, the route of transmission and the susceptible.
Pathogenic bacteria
Trichomonas vaginalis is a flagellate, belonging to the protozoa, without a cystic period, only a trophic period. The trophozoites are pear-shaped and are about 7-32 microns long, slightly larger than the lobular nucleus. The white is transparent and refractive. Its front end has 3-5 flagella, an average of 4, the side has a undulating membrane, the nucleus is oval, there are particles in the cytoplasm, followed by a flagellum, shorter than the front end. Trichomonas vaginalis is highly adaptable to the surroundings. Like wet, can live 21 days at 3-5 °C, can still live 20-40 minutes at 46 °C, and grow at 25-42 °C, with 35-37 °C, pH 5-6 when the rate is the fastest. In the semi-dry heat, you can still live for about 6 hours, so the trichomonas can spread after leaving the human body.
Source of infection
Females infected with Trichoderma vaginalis (trichoil20nas V. ginaIis, referred to as vaginal trichomoniasis) by swimming, bathing, sexual intercourse, etc., parasitized in the vagina. After the urinary tract infection, and through sexual intercourse, men are infected. In addition to trichomonal urethritis, it can cause cystitis and prostatitis.
The source of infection is trichomoniasis patients and worms, which are mainly transmitted directly through sexual intercourse, and can also be transmitted indirectly through public baths, swimming pools, sitting toilets, etc. Causes female trichomonas vaginitis, which in turn makes the urethra suppurate. The cause of trichomonal urethritis is through sexual intercourse, trichomoniasis into the male urethra, causing male trichomonal urethritis and prostatitis. Some scholars are suspicious about whether trichomoniasis can cause urethritis. Many scholars have learned about trichomoniasis in urethral secretions. They also learned that pathogens are preserved, such as common colony, Chlamydia trachomatis, and mycoplasma. Wait. Therefore, when there are excluded pathogens, Trichomonas can cause disease.
way for spreading
As for the direct transmission of sexual transmission, that is, sexual life transmission and indirect communication. In foreign countries, vaginal trichomoniasis is mainly transmitted through sexual life, so it belongs to sexually transmitted diseases. In China, the mode of communication is different. Due to the large population of China and the relatively backward public health facilities compared with developed countries, the spread of public places has also become an important means of transmission. For example, a toilet in a public bath or a toilet in a public toilet is contaminated by the secretions of a worm, and then a latecomer may be infected if sitting directly on a seat or a toilet. The basins of public baths, the dense and sterilized swimming pools in the summer, the wearing of other people's underwear, the rental of swimsuits, etc., may cause the spread of trichomoniasis. In addition, the use of bath tubs and iatrogenic cross-infection among family members is also the cause of indirect transmission of trichomoniasis.
Pathogenic mechanism
Trichomonas vaginalis is generally parasitic in the genitourinary system. When the larvae grow on the vaginal wall epithelial cells, they consume glycogen, which hinders the lactic acid production of lactic acid bacteria in the vagina, and changes the pH of the vagina from normal acidity to neutral or alkaline, suitable for worms and bacteria. Growth, which destroys the so-called "self-cleaning effect" of the vagina. Therefore, women should use the phlegm pH4 weakly acidic female care solution for daily cleaning of the private parts. The pH4 weakly acidic female care solution can maintain the "self-cleaning effect" of the vagina and inhibit the infection of Trichomonas vaginalis. In addition, in vitro experiments have shown that the worm can secrete a variety of factors, which play a role in adhesion and contact killing of the host tissue.
Clinical incubation period
It is 4 to 28 days.
Prevention
Trichomonas urethritis prevention
8 recommendations away from trichomonas urethritis
1. Develop hand washing habits: Trichomonas vaginalis has strong adaptability to the surroundings. They can invade the urethra to cause infection by dissolving this link, so it is also important to develop good hygiene habits, especially before and after meals.
2. Regularly clean the vulva and anus : pay attention to the order when washing, first wash the vulva and then wash the anus, you must not do the opposite; towels and basins must be dedicated, otherwise bacteria can easily invade the urethra.
3. Sanitary napkin selection : It is necessary to use the Ph4 weak acid formula to prevent the inferior product from destroying the normal flora of the human body, but to reduce the local resistance. Buy sanitary napkins should pay attention to product quality, and should not be stored for a long time, so as not to breed bacteria, cause vulvar and vaginal infections, when there are symptoms of genital itching, increased vaginal discharge should go to the doctor as soon as possible.
4. Drink as much water as possible : clinically prove that drinking plenty of water every day, urinating once every 2-3 hours, can avoid the reproduction of vaginal trichomoniasis in the urinary tract, which can reduce the incidence of urinary tract infection, which is the most practical to prevent urinary tract infection. effective method. Therefore, this pollution-free approach has an irreplaceable role in the pre-onset or remission phase of urethritis.
5. Pay attention to personal hygiene : take a bath, do not advocate bathing, clothing should be stored separately; always change underwear, especially new underwear or long-wearing underwear, wash and dry before wearing; good penetration, strong hygroscopicity Cotton underwear, as little as possible to wear tight pants or jeans, more penetrating skirts, which is very important to protect women's health.
6. Choose cotton underwear: avoid wearing tight pants and underwear, choose cotton underwear that absorbs sweat comfortably to keep the genitals clean and dry, and reduce the chance of vaginal trichomoniasis growth.
7. Ensuring adequate sleep and regular sexual life: The role of sleep is self-evident, and it plays a decisive role in the prevention and treatment of all diseases. Therefore, remember not to stay up late, otherwise it will reduce your body's resistance to disease. It is also necessary to grasp the frequency of sexual life. If the sex life is more than 3 times a week, the incidence of urinary tract infection is greatly increased, and the number of times should be appropriately reduced in the special stage of summer.
8. Urination as soon as possible after sexual intercourse: The purpose of urination is nothing more than washing away bacteria, reducing accumulation, and washing the private parts with warm water.
Male urethritis prevention
1. Deaf patients avoid sexual behavior before they are cured; prohibit alcohol, do not eat spicy food, drink plenty of water.
2. Do the necessary isolation in the home, bath towels, bathtubs, washbasins, toilets, etc., or disinfect after use.
3. Male urethritis patients need to understand what is safe sex, what is dangerous behavior, how to avoid dangerous sexual behavior.
4. Encourage the use of condoms.
Prevention of female urethritis
Under normal circumstances, women's treatment of urethritis is relatively easy to repeat, which is generally related to the special physiological structure of women, so pay attention to the usual life:
(1) insist on drinking plenty of water
The urine excreted by the kidneys acts as a flushing action on the bladder and urethra, which is beneficial to the discharge of bacteria. Drinking plenty of water every day, urinating once every 2 to 3 hours, can avoid the proliferation of bacteria in the urinary tract, and can reduce the incidence of urinary tract infections. This is the most practical and effective way to prevent urinary tract infections. In the stage of the onset or remission of the disease, drinking plenty of water every day is also conducive to the recovery of the disease. Tea drinking or light bamboo leaves also have a certain preventive effect.
(2) Try to avoid using urinary tract infection devices and intubation
Urinary tract instruments are easy to bring bacteria at the distal end of the urethra into the bladder and upper urinary tract. Continuous bacteriuria is prone to occur after urinary intubation. Therefore, it should be avoided. When it is necessary to use it, it should be strictly disinfected. After 48 hours of use of the urinary tract device, urine culture should be used to observe whether a urinary tract infection occurs. Before using urinary tract instruments, patients with bacterial urine should control infection first. Some patients had no bacterial urine at the time, but had a history of recurrent urinary tract infections or urinary tract abnormalities. Antibiotics should be taken at the urinary tract examination or 48 hours before and after to prevent infection. In the first three days of indwelling catheterization, administration of an antibacterial agent can prevent or delay the occurrence of urinary tract infection, but administration after 3 days has no preventive effect.
In addition, the closed drainage system is connected to the urinary indwelling catheter, which can significantly reduce the incidence of urinary tract infection.
Complication
Trichomonal urethritis complications Complications endometritis pelvic inflammatory disease
Complications in male patients: epididymitis, prostatitis, seminal vesiculitis, etc.
Complications of women with endometritis: endometritis, salpingitis, pelvic inflammatory disease, peritoneum, etc.
Intraurethral infection can spread directly to the bladder or prostate causing cystitis or prostatitis. If the acute urethritis is improperly treated, it can be accompanied by paraurethral abscess. Abscess can penetrate the penis skin and become urethral fistula. Fibrosis can cause urethral stricture during the healing of urethral inflammation.
Symptom
Trichomonas urethritis symptoms Common symptoms Urethral outflow secretions urinating when the vulva is burning... Fever with frequent urination, urine...
Symptoms of male trichomoniasis
Symptom 1: The incubation period of trichomonal urethritis is usually 4-7 days. In severe cases, the vulva and the inner thigh have itching and burning sensation. At the same time, infection of the urinary tract, urethritis and cystitis, may have frequent urination, urgency, dysuria and other symptoms and hematuria. Retrograde infection leads to chills, low back pain, high fever, general malaise and gastrointestinal reactions in pyelonephritis. Physical examination has rib angle tenderness and sputum pain. Symptoms and signs are the same as general bacterial urinary tract infections.
Symptom 2: There is pain during urination. In the morning, there is a little secretion in the urethra, which is serous and even purulent.
Symptoms of female trichomonas urethritis
Symptoms of trichomoniasis urethritis mainly manifest as persistent vaginitis, increased vaginal secretions, serous or purulent, thinner, small foam in the secretions, smelly, yellow-green. There is pain during sexual intercourse. Difficulties in urination, itching of the vulva. In severe cases, there is itching and burning in the vagina, vulva and inner thighs. At the same time, infection of the urinary tract, urethritis and cystitis, may have frequent urination, urgency, dysuria and other symptoms and hematuria.
Retrograde infection leads to chills, low back pain, high fever, general malaise and gastrointestinal reactions in pyelonephritis. Physical examination has rib angle tenderness and sputum pain.
Examine
Examination of trichomoniasis urethritis
Common examination items: vaginal trichomoniasis examination, urine routine, blood routine, stool routine, urethral secretion examination, urethral examination, middle urinary bacterial culture count.
Urine routine examination showed leukocytosis or pyuria, accompanied by erythrocytosis, a small number of gross hematuria. Three cups of urine test, it can be found that a large number of pus cells and red blood cells exist in the first cup, while the second cup and the third cup are basically normal. The number of urinary cell culture bacteria in the first stage was significantly higher than that in the middle stage. Stenosis of urethra or vaginal secretions, gonococcal urethritis can be seen intracellular or extracellular gonorrhea, non-specific urethritis can be cultured with secretions or anterior urethra swabs, see a large number of bacterial growth. No secretions were found in the smears and cultures of the secretions, that is, the possibility of infection with mycoplasma and chlamydia, and special methods of culture or PCR examination were possible.
Diagnosis
Diagnosis and identification of trichomonas urethritis
Diagnostic criteria
1. Symptoms and signs of urinary tract itch, burning pain, frequent urination, urgency, dysuria and terminal hematuria. The urethra is red and swollen with a small amount of colorless and transparent thin or milky secretions. A little secretion adhered to the urethral opening in the morning.
2. Laboratory examination of fresh urethral secretions or urine, prostatic fluid, plus saline smear microscopy, can be found active Trichomonas.
The perineum and urethral opening should be cleaned before the specimen is taken. When collecting specimens, the test tubes should be placed close to the urethra. Specimens should be kept warm before inspection. It can be checked repeatedly and cultured if necessary.
3. Bladder urethroscopic examination can be observed in the posterior urethra, bladder neck, triangle area with congestion, red small papillary polypoid bulge, and adhered with a thin layer of floc.
Identification of trichomoniasis urethritis
Gonorrhea
The urethritis caused by gonorrhea is the main manifestation of the infection of the genitourinary mucosa. Early urinary tract itching, redness and tingling; with frequent urination, urgency and terminal hematuria; the urethra has thin mucus secretions. However, its urethral secretions are numerous and gradually evolve into purulent. There is generally a history of smelting. Gram-negative gonorrhea can be found in urethral secretions.
2. Non-gonococcal urethritis
Urethritis caused by sexually transmitted contact with Chlamydia, Mycoplasma, or viruses. There is urination pain and a small amount of urethral secretions, showing a thin white mucus. There is generally a history of smelting. Smears of urethral secretions, a large number of neutrophils, no gonococcal and vaginal trichomoniasis.
