Gonorrhea is a sexually transmitted infection. The causative agent of gonorrhea is gonococcus, which lives and multiplies in the mucous membrane of the genitourinary system, intestines, throat. There is a lesion of the mucous membrane of the eyes.

The consequences can be extremely unpleasant and dangerous, because the disease itself can be acute, and most often - imperceptibly and asymptomatic. In such cases, we have to talk about a chronic, advanced form of gonorrhea.

It happens that a disease is recognized so late that irreversible consequences take place, which are expressed in organic lesions and changes. A sad consequence of the chronic form is infertility.

Consequences of gonorrhea in women

Infertility in this case is the most common form of complication of gonorrhea. It can also be caused by any inflammatory diseases of the uterus and appendages in acute and chronic forms. The risk of such complications increases with the use of an IUD (intrauterine device). This type of complication is also observed, such as the risk of an ectopic pregnancy arising from inflammatory diseases in the fallopian tubes.

• lower abdominal pain;
• vaginal bleeding;

With inflammation of the fallopian tubes, there is an accumulation of exudate in the lumen of the tube. It can be a clear yellowish liquid, and in the case of stagnation and infection, this liquid becomes purulent, significantly aggravating the patient's condition.

This disease is called hydrosalpinx, and at the same time it is life-threatening for a woman, because a rupture of the fallopian tube and the release of purulent contents into the abdominal cavity can occur. This can lead to peritonitis and is fatal! Hydrosalpinx is manifested by pulling pains in the lower abdomen, in the lumbar region, and intoxication of the body. At the same time, the fallopian tube is greatly increased in size.

After infection with gonorrhea, bartholinitis (inflammation of the large vestibular glands) may develop. This inflammation begins about 2-3 weeks after infection with gonorrhea. Gonococci invade the glandular ducts and cause inflammation. At the same time, painful cords appear in the groin, with pressure on which it is possible to discharge pus.

If the mouth of the gland closes, then a painful swelling may occur, the size of which can be from a small pea to the size of a chicken egg. This tumor is mobile, it can protrude from the genital crevice. There is a strong soreness in the groin, the area of ​​the external genital organs, there is pain when walking, sitting.

There may be an increase in temperature to subfebrile numbers and above. After a certain time, this tumor may rupture, pus is poured out and some improvement in well-being, a decrease in temperature is noted. If you do not take action, then there is a re-accumulation of pus.

The problem of preventing the occurrence of complications in chronic gonorrhea in women is very important. These complications can be as sluggish and asymptomatic as gonorrhea itself. Sometimes it happens that the inflammatory process in the uterus and its appendages proceeds with the presence of a number of characteristic signs:

• lower abdominal pain;
• vaginal bleeding;
• headache, fever, feeling unwell.

Infertility can be a sad consequence of gonorrhea in women.

Complications of gonorrhea in men

The most severe complication of this disease in men can be in the form of inflammation of the testicle (orchitis), its epididymis (orchiepididymitis) and inflammation of the prostate gland (prostatitis).

Inflammation of the epididymis with gonorrhea develops sharply, is expressed in an increase in temperature, redness and swelling of the scrotum. There are severe pains in the affected testicle, which makes walking very difficult. Spermatogenesis is sharply inhibited. The ability to fertilize is lost. Ultimately, male infertility develops as a consequence of gonorrhea.

The consequence of gonorrhea in men can also be expressed in the form of prostatitis, which can be acute and chronic. Chronic gonorrheal prostatitis is a common cause of impotence and infertility.

It is also possible the appearance of inflammation of the seminal vesicles (vesiculitis) and narrowing of the lumen of the urethra. It is important to start treatment on time, to avoid hypothermia, heavy physical exertion, alcohol consumption, leading to the development of gonorrheal complications in men. Temporary cessation of sexual activity is also important.

In severe cases, the spread of gonococcal infection leads to dissemination and damage to the brain, heart, joints, skin, liver. It is very important to identify the disease in time, because the incubation period for gonorrhea in men can be relatively long, although usually the onset of symptoms of the disease occurs faster than in women.

If pathogenic microflora gets into the eyes, then gonococcal conjunctivitis develops. Gonoblennorrhea is a severe complication of gonorrhea that leads to blindness. With this complication, there is a strong swelling of the eyelids, the release of purulent contents from the eyes. If you do not start active complex treatment in time, you can lose the organ of vision.

The hidden danger of gonorrhea

Gonorrhea is a rather hidden and insidious enemy of health, because, having the likelihood of an asymptomatic course, this disease increases the risk of severe disorders and damage to organs and their systems.

So why is it dangerous? The most unpleasant thing is that gonococcal infection is most often found in combination with a number of other pathogenic microorganisms (chlamydia, Trichomonas, ureaplasma).

Diagnosis of gonorrhea in such cases is significantly difficult. Very often, gonococci can be detected only after the destruction of Trichomonas, etc. Also, it should be noted that complications of concomitant infections are treated even more difficult and time-consuming.

It is very important to prevent the occurrence of gonorrhea, because a number of preventive measures aimed at preventing the onset of the disease will help to avoid not only the troubles associated with the treatment of this infectious disease, but also qualitatively help to preserve not only your own health, but also the health of loved ones!

Gonorrhea is an infection caused by a sexually transmitted bacterium. This infection affects both men and women. It most commonly affects the urethra (urethra), rectum, and throat. In women, this infection sometimes affects the cervix.

In the common people, this disease is called gonorrhea. Most often, this infection is transmitted through sexual contact. However, there are times when an infected pregnant woman passes the disease on to her baby during childbirth. When this happens, babies usually develop an eye infection. It is very important to get regular diagnostics - especially for sexually active young people. Otherwise, very serious complications can develop, which you will learn about from this article.

Gonorrhea: symptoms not to be ignored

Sexual infections are very insidious. They are not manifested by everyone, and when they make themselves felt, they can go unnoticed. Gonorrhea symptoms are no exception. Many infected people do not even know that they are carriers of this disease. When the symptoms do make themselves felt, in the case of gonorrhea, different parts of the body can be affected. But most often it is the genitals that are affected. According to scientists from Harvard University, symptoms of the disease usually appear within 10 days of infection.

If symptoms involve the genitals

Symptoms of gonorrhea in men include:

• Painful urination
• Discharge from the opening of the penis that looks like pus
• Pain or swelling in one testicle.

Gonorrhea symptoms in women include:

• Profuse vaginal discharge
• Painful urination
• Vaginal bleeding between periods, such as after intercourse,
• Pain during intercourse
• Pain in the abdomen or pelvic area.

If gonorrhea affects other parts of the body

In addition to the organs of the genitourinary system, the following may suffer:

• Rectum (gonococcal). In this case, anal itching appears, similar to pus discharge, specks of bright red blood on toilet paper and the need to overextend during the bowel movement.
• Eyes. There is pain, increased sensitivity to light, and pus-like discharge from one or both eyes.
• Throat (gonococcal). If gonorrhea affects the throat, symptoms appear that can be confused with a common viral infection - sore throat and swelling of the cervical lymph nodes.
• Joints. If the bacteria affects one or more joints (septic), they can be very painful, warm, red, and swollen — especially when the person moves the affected joint.

When should you go to the doctor?

If you notice one or more of the symptoms of gonorrhea, especially painful urination, as well as purulent discharge from the vagina, penis or rectum, go to the doctor.

You also need to go to an appointment if your sexual partner has been diagnosed with gonorrhea. Get diagnosed and treated even if you don't have any symptoms. If you ignore this recommendation, you run the risk of re-infecting your partner - even after he has fully recovered.

What are the causes of gonorrhea?

This infection is caused by a bacterium called Neisseria gonorrhoeae. It is usually transmitted through sexual contact, including vaginal, oral, or anal sex. The easiest to get infected:

• Young, sexually active people,
• If gonorrhea has already been diagnosed before,
• For persons who have recently acquired a new partner,
• If your sexual partner has a violent sex life "on the side",
• People who practice polygamous sex (many different partners at the same time),
• Persons who have other genital infections.

Complications of gonorrhea, or what will happen if not treated?

Untreated infection can have serious consequences. Among them:

• Infertility among women ... The bacteria can spread to the uterus and fallopian tubes, as well as provoke pelvic inflammatory disease. In turn, the inflammatory disease can cause scarring and blockage of the fallopian tubes. If this happens, the woman runs the risk of facing infertility. If she does manage to get pregnant, she may have problems during pregnancy. In addition, pelvic inflammatory disease itself is a serious infection that requires immediate treatment.
• Infertility in men ... With an untreated gonorrhea, men are at risk of experiencing epididymitis. This is an inflammation of the epididymis, in which sperm are located. If epididymitis is left untreated, it can lead to.
• Spread of infection on joints and other parts of the body. The bacteria Neisseria gonorrhoeae can enter joints and other parts of the body through the bloodstream. In this case, there is a high fever, rashes, the formation of wounds on the skin, as well as pain, swelling and decreased mobility in the joints.
• Increased risk of contracting HIV / AIDS. When gonorrhea is present, the body becomes more susceptible to infection with the human immunodeficiency virus (HIV). People who have both gonorrhea and gonorrhea are more likely to transmit both diseases to their partners.
• Complications in newborns. If a baby gets infected from a pregnant mother, it can develop blindness, scalp ulcers, and other infections.

Diagnostics of the gonorrhea

To detect the bacteria Neisseria gonorrhoeae, doctors examine a sample of cells that is collected in two ways:

1. Analysis of urine. This test helps detect bacteria in the urethra.
2. A smear from the affected area of ​​the body. A swab is taken from the throat, urethra, vagina, or rectum. The contents are then sent to a laboratory where they are examined for the presence of bacteria.

For a complete diagnosis, the patient is examined for all sexually transmitted infections. Thus, several birds with one stone are "killed" at once. There are good reasons for this recommendation. According to American experts, 15-25% of men and 35-50% of women with gonorrhea also have chlamydia. You will read about this disease in.

By the way, if you live in Kiev (and especially in Troyeshchina), you can get diagnostics for everything at the Persomed Medical Center.

Treatment of gonorrhea

Antibiotics are prescribed for adults. With the emergence of new strains of Neisseria gonorrhoeae that are resistant to drugs, scientists at the Centers for Disease Control and Prevention recommend that mild to moderate forms of gonorrhea be treated with the antibiotic ceftriaxone alone. It is given by injection, in combination with either azithromycin or doxycycline. These two antibiotics are taken by mouth.

Some studies show that oral gemifloxacin or gentamicin injections in combination with azithromycin is a very effective treatment for gonorrhea. This protocol may be suitable for patients who are allergic to cephalosporin antibiotics such as ceftriaxone.

To prevent re-infection, both partners need to be diagnosed and treated. This is a prerequisite. It is also necessary to refrain from close relationships throughout the course of treatment and for another week after its completion.

Prevention of gonorrhea

To reduce the risks of contracting this dangerous infection, you must:

• To lead a monogamous relationship is to be faithful to a single, beloved person.
• Always use condoms. The surest way to avoid infection is to abstain from sex completely. However, for the vast majority, this option is not suitable, therefore, it is necessary to use a condom with each intercourse. This applies not only to vaginal sex, but also to oral and anal sex.
• Asking your new partner to be diagnosed for genital infections. If you trust your partner, do it together as a preventive measure.
• Refrain from having sex with someone who has any unusual symptoms. If your potential sexual partner has symptoms of gonorrhea or another genital infection, in no case agree to intimacy.
• Undergo annual diagnostics for young people and people at risk. The latter include sexually active people under the age of 25 and homosexuals.

In our medical center you can undergo diagnostics and treatment for all sexually transmitted infections. If you are young and sexually active, be sure to make an appointment with or.

Sources:

1. Gonorrhea, Mayo Clinic,
2. Gonorrhea, Harvard Medical School,
3. Gonorrhea - CDC Fact Sheet, Centers for Disease Control and Prevention.

Instructions

Gonorrhea is one of the most common sexually transmitted infections. According to statistics, about 80% of cases of sexually transmitted infections are caused by gonorrhea. This indicator is so high due to the fact that, as such, there are no first signs of the development of the disease. Many carriers of gonorrhea for a long time do not even know about its presence, continuing to infect their partners. In the later stages of development, the symptoms of gonorrhea in many ways resemble more harmless sexually transmitted diseases, for example, chlamydia. The main risk group for the incidence of gonorrhea is represented by people aged 20 to 30 years. Many young people are frivolous about such a disease as gonorrhea, conceived without even knowing how serious the spread of this infection throughout the body can cause.

Gonorrhea in women can cause equally serious complications. The most common is bacterial infection of the fallopian tubes, cervix, urethra, and Bartholin glands. In addition, in the absence of adequate treatment, the rectum and all organs of the small pelvis can be affected. Affecting the reproductive organs of the female reproductive system, bacteria leave a large number of scars. The most serious consequences of gonorrhea include infertility and ectopic pregnancies, which are not uncommon for women who have had gonorrhea or have a chronic form of it.

Gonorrhea belongs to a special group of infectious diseases that are infected mainly during sex. Anyone who is sexually active can get sick. It proceeds with severe symptoms, but often there are no manifestations, especially if the disease becomes chronic. In any case, the infection does not pass without consequences. The disease affects reproductive health, complicates the onset and course of pregnancy. The infection is dangerous to the fetus. It is important to diagnose gonorrhea in women in a timely manner. With the help of effective drugs, they successfully fight it.

Content:

Features of the disease, ways of infection

Gonorrhea (gonorrhea) is a highly contagious infectious disease. The main route of spread of infection is sexual. The likelihood of infection is equally high with both traditional and oral or anal intercourse. Infection often occurs even with a single sexual contact. In women, the likelihood of infection is especially high due to the anatomical features of the genitals. The infection quickly spreads from the genitals to the uterus and ovaries, leading to severe inflammation.

Gonorrhea is caused by gonococcus bacteria. In the human body, they are viable for a long time, but in the external environment they quickly die (especially in dry conditions and when the temperature rises to 50 ° and above). Antiseptics and soapy water are also detrimental to these bacteria. Therefore, contamination by contact and everyday life is rare. However, the likelihood of such an event is not completely excluded, since gonococci can be in fresh secretions, from where they get onto hygiene products or bedding. Even a child can get infected from parents if he sleeps with them. It is possible that the baby becomes infected during childbirth.

For gonococci, resistance to many antibiotics is characteristic, since they are able to quickly get used to their action.

Note: Often there is an infection with a whole bunch of infectious diseases, as their causative agents usually coexist. Simultaneously with gonococci, infection with fungi, chlamydia, Trichomonas, herpes viruses and other pathogens can occur. In this case, diagnosis and treatment are significantly complicated.

Gonococci belong to the causative agents of "latent" infections, as they are able to penetrate into the cells of various tissues (for example, blood cells). However, they are difficult to detect under a microscope, and they become immune to the action of antibacterial drugs.

The prevalence of gonorrhea is facilitated by the prevalence of sluggish forms of the disease. As a rule, gonorrhea is infected from sexual partners in whom it is asymptomatic or at an early stage of development. Often this happens due to the lack of basic concepts in people about the consequences of infection with specific infections and the dangers arising from unprotected sexual intercourse.

In the high-risk group are women who often change sexual partners, enter into casual relationships. The presence of other types of infections in the body, non-observance of the rules of intimate hygiene contributes to the disease of gonorrhea.

The introduction of infection into the mucous membranes is facilitated by their damage during abortions, operations, and the installation of a spiral. The likelihood of contracting gonorrhea is especially high when having sex during your period.

Video: Ways of infection with gonorrhea. Analysis methods

How gonorrhea proceeds, the first signs of infection

The incubation period can last from 5 days to 1.5 months. How quickly gonococci begin to develop in the body depends on their localization and state of immunity.

The first signs of infection are cramps and burning during urination. It becomes more frequent. Disturbed by irritation and swelling in the genital area, general malaise occurs, slight thick yellowish discharge appears. Usually, this condition does not cause much anxiety; they try to overcome it on their own, without going to a doctor. The disease is diagnosed most often only at the stage of its transition to a neglected form. Sometimes gonorrhea in women is discovered by chance, if a smear from the genital tract is taken during a routine examination or the patient is examined in connection with a man's illness.

Types and forms of gonorrhea

Reproduction of gonococci after infection usually occurs in the cervix, urethra and rectum. The acidic environment of the vagina, supported by beneficial microflora, is unfavorable for them. Therefore, vaginitis (inflammation of the vagina) occurs only when the natural microflora is disturbed or the mucous membrane is too thin (as, for example, in young girls or women of menopausal age).

Depending on the localization of gonococci, the following types of disease are distinguished:

1. Gonorrhea of ​​the lower genitourinary system. One of the manifestations may be bartholinitis (inflammation of the gland located in the vestibule of the vagina).
2. Gonorrhea of ​​the upper reproductive organs and pelvic organs. The most serious condition occurs with gonorrhea of ​​the uterine appendages.
3. Gonorrhea of ​​other organs (eg, eyes, mouth). In this case, there are diseases such as gonococcal conjunctivitis, gonococcal tonsillitis. Perhaps gonococcal damage to the joints, heart muscle, brain, the occurrence of peritonitis.

There are 2 main forms of gonorrhea in women.

Fresh form. The manifestations of the disease are observed for a maximum of 2 months and disappear after treatment. This form of gonorrhea is divided into acute (with pronounced symptoms), subacute (with smoothed symptoms) and torpid (there are almost no signs of infection, but a person is a distributor of gonococci).

Chronic form. The disease lasts more than 2 months. There are periods of calm and exacerbation periodically.

Symptoms of various types of gonorrhea

The characteristic symptoms of acute gonorrhea of ​​the genital organs are pain in the lower abdomen, purulent abundant thick vaginal discharge, causing itching and burning, with a putrid odor. An increase in body temperature up to 39 ° is possible. A gynecological examination reveals redness and swelling of the tissues at the mouth of the urethra, as well as inflammatory changes in the mucous membrane of the cervix.

When the infection spreads ascending, endometritis, inflammation of the fallopian tubes and ovaries develops. Blood impurities appear in the purulent discharge. The timing of the arrival of menstruation is violated.

If gonorrhea becomes chronic, the symptoms of genital lesions are less pronounced, but during menstruation, aching pains in the lower abdomen and lower back intensify, the intensity of mucous purulent-bloody discharge increases. Chronic inflammation in the uterine cavity and appendages leads to infertility.

When gonococci enter the rectum, symptoms such as itching in the anus, mucous discharge or bleeding from it, pain during bowel movements are added. Inflammation of the peritoneum in the pelvic area (pelvioperitonitis) can be a dangerous complication of gonorrhea. When it occurs, a woman has sharp spasmodic pains in the lower abdomen, it is swollen, and the body temperature rises.

After oral sex, gonococcal tonsillitis causes a sore throat, similar to angina.

If you suspect that you have been infected with gonorrhea, you should contact your venereologist or gynecologist.

Video: Gonorrhea - symptoms, consequences, how the diagnosis is carried out

The consequences of gonorrhea in the absence of treatment

The consequence of chronic gonorrhea in women can be inflammation of the pelvic organs, scarring of tissues, the formation of adhesions, obstruction of the fallopian tubes, the spread of gonococci throughout the body through the blood vessels (dissemination of the infection). Dissemination often occurs in chronic gonorrhea. Such a process can occur with a sharp decrease in immunity (for example, during pregnancy), damage to the mucous membranes or their swelling during menstruation.

Infection of various organs leads to the occurrence of diseases such as purulent polyarthritis, meningitis, toxic hepatitis, endocarditis. Possible necrotic skin lesions, sepsis.

The disease is dangerous at any stage of pregnancy. The risk of ectopic development of the embryo increases. If the infection occurs in the first weeks of pregnancy, it can lead to his death and miscarriage.

At a later date, infection with gonorrhea is dangerous because gonococci penetrate the membranes and the placenta. In this case, placental insufficiency develops, the supply of the fetus with oxygen and nutrients deteriorates. As a rule, due to this, labor begins prematurely. As a result of infection of a child with gonorrhea when passing through the birth canal, he has damage to the eyes and internal organs. In girls, the infection gets into the genitals. If intrauterine infection of the fetus occurs, then it dies due to sepsis.

Addition: For the purpose of prophylaxis, an antiseptic agent is instilled into the eyes of children immediately after birth, and girls are also given antiseptic treatment of the genitals. Expectant mothers are examined several times at different stages of pregnancy. If a gonococcal infection is found in them, treatment with antibiotics that are safe for the child is mandatory.

How is gonorrhea diagnosed?

The main diagnostic methods are:

1. Bacteriological analysis (culture). Mucus samples are placed in a special nutrient medium for growing a colony of gonococci and subsequent study of their sensitivity to various antibiotics. The result is received in a week.
2. Microscopic examination of smears. This is a method for quickly detecting pathogens by examining samples under a microscope. The accuracy of the results is approximately 60-70%, so the analysis is only preliminary.
3. PCR analysis of a smear (polymerase chain reaction). Gonococci are identified by their DNA. It is possible to obtain false positive results, therefore, as a rule, they are rechecked by a culture method.
4. ELISA (enzyme-linked immunosorbent assay). The presence of antibodies to gonococci is determined with great accuracy. The analysis is done quickly. However, the necessary equipment is available only in some laboratories.

The causative agent of gonorrhea is detected during laboratory tests of mucus from the urethra, vagina and cervix. A swab is taken during a pelvic exam.

Treatment

First of all, antibiotic treatment is carried out. When prescribing drugs, the severity of the symptoms and the time elapsed since their onset, as well as the sensitivity of bacteria to specific antibiotics, are taken into account. The most effective for gonorrhea in women are Ciprofloxacin, Ofloxacin, Cefixime and other quinolones. After the symptoms disappear, such drugs must be taken for another 2 days. Most often, when gonococci are affected, chlamydia is also found in the patient's body, for the destruction of which Azithromycin or Doxycycline is prescribed.

If gonorrhea is accompanied by candidiasis, antifungal drugs are prescribed on an individual basis. Also used are antibacterial agents of local action (in the form of vaginal suppositories), such as Betadine, Hexicon, Metronidazole.

In the treatment of chronic, gonorrhea, complex therapy is carried out using immunomodulators, physiotherapeutic procedures (electrophoresis, laser irradiation). To eliminate the effects of inflammation, surgical treatment is sometimes carried out (for example, to remove adhesions, purulent formations in the fallopian tubes).

When treating pregnant women, the choice of antibiotics is especially strict. The safest are fluoroquinolones (Ofloxacin, Tsiprobay). The use of sulfa drugs such as Biseptol is strictly prohibited. In addition to antibiotics, pregnant women are also prescribed drugs that strengthen the placenta (Trental, Curantil).

Antibacterial treatment is carried out not only for the patient herself, but also for her sexual partner. Close patients, including her children, are examined. During treatment, sexual intercourse and the use of alcoholic beverages should be completely excluded.

After the end of the treatment course, control tests for gonococci are taken. The survey is periodically repeated for another 3 months.

To prevent infection and the development of severe consequences, it is recommended to observe preventive measures (exclusion of accidental sexual intercourse, use of condoms, regular gynecological examinations).

Gonorrhea is an infectious pathology with a predominantly purulent lesion of the mucous membrane of the genitourinary system. It belongs to anthroponous sexually transmitted diseases. Self-healing is impossible, in the absence of adequate therapy, gonorrhea becomes chronic and leads to complications.

Etiology

The cause of the disease is the penetration and reproduction in the human body of a special bacterium Neisseria gonorrhoeae, which was first described by A. Neisser in 1879. This pathogen belongs to gram-negative diplococci, has a bean-like shape and is located in pairs. He does not have the ability to move independently.

The small villi (pili) on the surface of the gonococcus contribute to its attachment to the surface of the mucous membranes and penetration into the cells. In addition, these pili carry antigenic information that can change during the development of the disease and under the influence of factors unfavorable for the bacteria.

Gonococcus has the ability to transform into a protective L-form. This enables him to survive when absorbed by phagocytes and with insufficiently intensive antibiotic therapy. But the L-form does not protect from the action of antiseptic agents and environmental factors; outside the body, the gonococcus is rapidly destroyed when the secretions dry. Therefore, the household route of infection is rare, it is possible only with abundant contamination of objects and a short time interval between the release of bacteria to the outside and their contact with another person.

Pathogenesis

Gonorrhea in men occurs most often during sexual contact with a partner with gonorrhea, who may not have obvious external pathological signs. The causative agent is contained in vaginal secretions and urethral secretions. With oral contact, the presence of a gonococcal lesion of the nasopharynx is important, and with anal intercourse, gonorrheal prostatitis. The homosexual partner transmits the pathogen with sperm and prostate secretions. Infection occurs in 25-50% of cases and is not associated with the activity of the immune system.

After entering the body of a man, gonococci attach to the surface of the mucous membrane, without migrating far beyond the zone of penetration. In most cases, they affect the urethra and prostate gland, settle on the sperm and sometimes end up in the end portions of the vas deferens. With concomitant infection with trichomoniasis, gonococci can penetrate into Trichomonas, in this case, antibacterial drugs are not dangerous for them.

A characteristic feature of gonococci is the ability to multiply within leukocytes, which is called endocytobiosis. Therefore, the protective phagocytic reaction of the immune system of an infected person is ineffective and even leads to the spread of the pathogen. Inside the cells of gonococci, they exist for a long time in an inactive form, which can lead to an erased clinical picture of chronic gonorrhea in men.

Bacterial infection causes inflammation of the mucous membranes with purulent discharge. The gradual destruction of the inner lining of the urethra leads to the release of gonococci into the lymphatic and blood vessels, their spread to the underlying tissues. In response to the penetration of pathogens, the immune system begins to produce antibodies, but they are not able to protect the man's body from further development of the disease. Gonorrhea does not lead to the formation of immunity, reinfection is often noted.

Symptoms of gonorrhea in men

The first signs of gonorrhea in men do not appear immediately. This is preceded by an absolutely asymptomatic period, although at this stage the pathogen hardens on the surface of the urethra at its mouth, penetrates into the cells of the mucous membrane and actively multiplies. Signs of the disease appear after the development of active inflammation against the background of a progressive increase in the number of bacteria. The incubation period usually lasts 3-5 days, but in some cases it lengthens up to 2 weeks.

The first symptoms are discomfort along the urethra, quickly replaced by itching and burning in this area. Soon mucous membranes appear, and then purulent yellowish-white discharge from the opening of the urethra. The lips of the urethra on the head of the penis turn red and swell, painful nocturnal emissions are possible. At first, suppuration is intermittent and is associated with pressure on the penis and the onset of urination, then it becomes almost continuous. With the rapid development of the disease, the body temperature may rise with the appearance of nonspecific signs of general intoxication.

Symptoms of gonorrhea in men usually increase rapidly during the first week after the first manifestations, after which they often dull and lose their severity. Self-treatment also contributes to the atypical course. Antibiotics, often taken haphazardly, without a doctor's prescription and in an insufficient dose, lead to a decrease in the activity of gonococci, but do not destroy them. As a result, the signs of the disease become erased, the man can consider himself cured, and the process becomes chronic. In this case, the suppuration is scanty, like a "morning drop", changes on the glans penis are poorly expressed.

In the first 2 months after infection, they speak of acute or fresh gonorrhea. If the disease is more than 8 weeks old, the chronic form is diagnosed. With a low-symptom course of the acute process, gonorrhea is called torpid.

Possible complications

Over the course of several weeks, inflammation can spread along the walls of the urethra to the bladder, prostate, and vas deferens. This causes complications of gonorrhea in the form of cystitis and prostatitis. The symptoms are joined by frequent painful urination, pulling pain in the perineum with sexual arousal and ejaculation, and discomfort in the testicles. Prostatitis can lead to impotence and a decrease in the fertility of sperm.

Gonorrheal epididymitis appears when the epididymis is involved in a specific inflammatory process. It is usually sharp and violent. In this case, there is a fever, redness and swelling of the scrotum, a sharp pain in it on the side of the lesion. Epididymitis is unilateral or affects both testicles to varying degrees. The development of epididymitis threatens the subsequent cicatricial narrowing of the lumen of the vas deferens with the development of infertility.

Long-term urethritis, leading to deep lesions of the urethral wall, can be complicated by urethral stricture. The obstruction of the outflow of urine at the same time contributes to stagnation in the bladder, reflux of urine into the ureters and an ascending infection of the excretory system.

Massive penetration of the pathogen into the bloodstream leads to the generalization of gonorrhea. In this case, sepsis develops, foci of inflammation appear in other organs, and heart valves are often affected.

Factors contributing to the development of complicated gonorrhea in men:

1. the presence of concomitant acute or chronic diseases of the genitourinary system (cystitis, urolithiasis, prostatitis, prostate adenoma);
2. being infected with other STDs;
3. weakened local immunity, re-infection with gonorrhea (reinfection);
4. eating spicy foods;
5. frequent sexual arousal;
6. the use of interrupted intercourse as a method of contraception;
7. excessive physical activity;
8. alcoholism.

Often, a man suffering from gonorrhea turns to a doctor not with the initial symptoms of anterior gonorrheal urethritis, but after the development of complications. In this case, even after intensive complex therapy, the consequences of gonorrhea often develop in the form of narrowing of the urethra, infertility and chronic prostatitis.

Diagnostics

In the classical course of the disease, the doctor may suspect the presence of gonorrhea already during the initial treatment of a sick man, based on the existing symptoms of anterior urethritis with suppuration. The diagnosis must be confirmed by microbiological examination of a smear from the urethra and a portion of urine. Serologic diagnosis of gonorrhea is rare.

To start treatment, it is sufficient to detect paired bean bacteria by microscopy of urethral secretions. But even in this case, inoculation is carried out on nutrient media, which allows confirming the diagnosis and revealing the sensitivity of the isolated pathogen to the main antibiotics. Gonococci grow best on nutrient media with ascitic fluid and blood plasma, forming transparent, rounded colonies with smooth edges.

An analysis for gonorrhea in men is taken not only in the presence of obvious clinical signs. It is performed when other STDs are detected, in the presence of chronic prostatitis and urethritis of unknown etiology. In addition, the examination is carried out according to epidemiological indications, when tests are taken from all sexual partners of a sick woman. And on the initiative of a man, a smear for gonorrhea is taken after unprotected intercourse with an unfamiliar woman. This takes into account how much gonorrhea appears and how much is necessary for gonococci to penetrate into the mucous membrane of the urethra and start reproduction. Therefore, the analysis is carried out a few days after questionable sexual intercourse.

To increase the reliability of the result, it is important to obtain the right material for research. Before taking a smear from the urethra, a man should not urinate for 4-5 hours, do not use topical antiseptics and do not take antibiotics. A smear is taken with a Volkmann spoon or a bacteriological loop. With scanty secretions and signs of prostatitis, a preliminary prostate massage is performed.

Chronic gonorrhea often causes difficulties in laboratory diagnostics, a false-negative examination result in this case is mainly due to the intracellular position of the pathogen. Therefore, before taking smears, provocation is necessary - stimulation of the release of gonococci with artificially induced exacerbation of chronic urethritis. To do this, apply:

1. instillation of silver nitrate solution;
2. bougienage of the urethra, urethrography;
3. warming up the inflamed area with inductothermy;
4. eating food with a lot of spices;
5. intramuscular administration of gonovaccine.

The provocative method followed by taking a smear is also used to control the treatment.

Treatment

Treatment of gonorrhea in men consists of etiotropic antibiotic therapy, symptomatic measures to reduce the severity of symptoms, compliance with sexual rest and diet. Avoid physical activity, cycling, drink plenty of fluids and avoid the use of spices.

Antibiotics for gonorrhea are prescribed by a course, the duration of therapy depends on the nature and duration of the course of the disease and is determined by the doctor. You cannot stop taking medications after the condition improves, which usually happens after 2-3 days of antibiotic therapy. This can form the resistance of gonococci to the agent used, it will contribute to the preservation of the pathogen in the body intracellularly or in the L-form.

For the treatment of gonorrhea, preference is given to antibiotics of the penicillin series and 3 generation cephalosporins. In case of insufficient sensitivity of the pathogen to them or the presence of contraindications, drugs of other groups are used, focusing on the data of bacteriological research.

Systemic antibiotic therapy is complemented by urethral debridement. For this, rinsing and instillation are carried out with various solutions with antimicrobial and anti-inflammatory effects. When acute inflammation subsides, physiotherapy is prescribed: UHF, phonophoresis and electrophoresis, laser and magnetic therapy, inductothermy, exposure to ultraviolet light. With a chronic, recurrent and torpid course, immunotherapy is indicated, which can be specific (with the help of a gonovaccine) and nonspecific.

After 7-10 days and then immediately after the completion of the course of treatment, a control bacteriological examination is carried out, which is repeated after a month.

Since it is necessary to treat gonorrhea in men together with a sexual partner, an epidemiological study is being carried out. All women in contact with the sick are referred to a gynecologist and dermatovenerologist; if gonorrhea is detected, they also undergo specific therapy. In case of refusal of treatment, non-compliance with recommendations and the presence of a generalized infection, hospitalization is recommended.