Sexual infections in women. Treatment of sexually transmitted diseases (STDs)

The concept of “sexually transmitted infections” (or “sexually transmitted diseases”, STDs) includes not only sexually transmitted diseases, but also urinary tract infections.

A feature of many STDs is the absence of clearly defined symptoms (the so-called “hidden infections”). A woman may not even be aware that she is infected for a long time. Without timely treatment, STDs lead to chronic inflammatory diseases of the pelvic organs, which, in turn, can cause infertility or spontaneous abortion and other serious consequences (see complications of pregnancy). Don't let the situation go that far! MedicCity diagnoses and treats all major sexually transmitted infections in women.

What microorganisms are “guilty” of causing STDs?

STDs are transmitted by various microorganisms, including:

fungal infections (candidiasis);
protozoa (trichomoniasis);
viral (genital warts, HIV, genital herpes);
bacterial (chlamydia, gonorrhea, syphilis).

This group also includes infections caused by opportunistic microorganisms (such as gardnerella, mycoplasma and ureaplasma). In small quantities, these microorganisms live even in completely healthy people, but in large concentrations they lead to urogenital diseases.

1 Surgitron

2 Diagnosis and treatment of sexually transmitted infections

3 Laboratory diagnostics

Possible symptoms that the patient takes as a sign of illness

Doctors have established the norm for an adult man leading a regular sex life. It is 1-2 emissions in 7 days, and the involuntary eruption of sperm should occur mainly at night.

Sometimes after a wet dream there is a feeling of weakness

When the number of wet dreams is less than or equal to the specified number, then the man does not receive any harm from the described phenomenon. There is a category of males who, after a wet dream (day or night), experience a feeling of weakness that spreads throughout the body. Such a patient begins to worry, and attributes the malaise to some illness.

But before going to the doctor, a person should carefully monitor the number of wet dreams. To relieve anxiety, you can use some self-medication methods. If the number of involuntary ejaculations does not decrease, then you need to undergo an examination.

Often, during a wet dream, various secretions appear along with sperm. Most often these are blood stains. If the patient has detected the presence of blood in the semen, then self-medication is strictly prohibited, since this symptom may indicate a serious disease that needs to be treated under medical supervision.

How do women get STDs?

There are no male or female sexually transmitted diseases. There are features of the course of the disease in men and women. The routes of infection are the same: sexual intercourse, infection through blood, close contact with an infected person at home. It is also possible to transmit the infection from mother to fetus during intrauterine development or to a child during childbirth and through milk during breastfeeding.

Diseases can intensify due to such unfavorable factors as:

reduced immunity;
stress;
poor nutrition;
environmental factor, etc.

It should be remembered that sexually transmitted diseases are very contagious, immunity to them is not developed, that is, re-infection is possible.

Causes of involuntary ejaculation

As scientists have found, there may be several reasons as a result of which nocturnal emissions develop:

Involuntary ejaculation occurs not only at night during dreams. This phenomenon can also be recorded during the daytime, for example, with strong sexual arousal. Hot hugs, close contact with a female representative, and passionate kisses lead to the involuntary release of sperm.

Such ejaculations are not a symptom of any disease or abnormality. A man should urgently consult a doctor only if involuntary ejaculation occurs several times a day.

General symptoms of sexually transmitted infections

Since many sexually transmitted infections do not manifest themselves in the early stages, a woman only begins to experience certain symptoms during an exacerbation of the disease and consults a doctor late. Therefore, it is important to know the main primary signs of sexually transmitted infections , which include:

When do boys have wet dreams?

Many parents are interested in the question at what age do teenagers normally begin to have wet dreams. There is no clear and specific answer here. Some people mature earlier, others a little later. However, doctors have determined the average age of puberty for a boy, at which nocturnal emissions occur. Most often this is the age of 11-14 years. There is also an approximate age range in which various age-related changes occur in a boy’s body. They look like this:

11 years - visible increase in the size of the scrotum;
12 years - appearance of pubic hair;
13 years - growth of the penis and formation of folds on the scrotum, pigmentation of the genital organs;
14 years - nocturnal ejaculation in a teenager;
13.5-15 years - physiological growth of the prostate;
16 years – stoppage of penis growth;
17-18 years old - growth of testes stops.

It is believed that during puberty at the age of 11-15 years, an increase in the hormone testosterone occurs in a boy’s body. The teenager pays attention to girls and becomes acquainted with the feeling of the first sexual desire, as a result of which nocturnal voluntary ejaculations occur. The process is considered completely normal from a physiological point of view. And so that the boy does not feel inferior, defective, etc., it is necessary to prepare the son for the process of puberty and tactfully tell him what time wet dreams begin in adolescents. This can be done by a tactful father or a competent psychologist. As a last resort, if parents are embarrassed to talk about this with their son, you can offer the boy special teenage literature on the topic of puberty.

How do various sexually transmitted infections manifest themselves?

Sexually transmitted diseases occur in both men and women. You can read about the peculiarities of sexually transmitted infections in men here, and in this article we will talk about how sexually transmitted infections manifest and are treated in women.

Chlamydia

The causative agent of this disease is chlamydia. The disease is characterized by scanty symptoms - absence or a small amount of mucous discharge with pus, possibly painful urination, accompanied by itching and/or burning in the vagina. The infection poses a great danger for women planning pregnancy, as it can lead to adhesions and obstruction of the fallopian tubes, and, consequently, to infertility or miscarriage, and fetal pathology.

Mycoplasmosis

The disease is caused by a microorganism such as mycoplasma. It manifests itself as transparent discharge and causes discomfort during urination and intimate contact. Can lead to inflammation of the vagina, uterus and appendages, and urethra. If infected during pregnancy, it can cause polyhydramnios, pathology of placental development and miscarriage.

1 Diagnosis and treatment of sexually transmitted infections

2 Diagnosis and treatment of sexually transmitted infections

3 Diagnosis and treatment of sexually transmitted infections

Candidiasis

Candidiasis or “thrush” is caused by yeast fungi of the Candida class. They affect the vaginal mucosa and cause severe itching and cheesy discharge. You can read more about candidiasis here.

Trichomoniasis

One of the most common sexually transmitted infections is caused by Trichomonas vaginalis. This disease is characterized by slightly foamy vaginal discharge with an unpleasant odor and pain during intercourse. In its acute form, the infection is extremely dangerous for pregnant women.

Genital herpes

It is considered an incurable disease. When the herpes virus (and its relative, cytomegalovirus) enters the body, it integrates into human nerve cells and remains there for life.

In addition to itching and burning in the genitals, it is characterized by the appearance of a blistering rash, high fever, muscle pain and headaches. Subsequently, it can lead to such unpleasant diseases as conjunctivitis, encephalitis, meningitis, keratitis and damage to the central nervous system.

Human papillomavirus

HPV (and in particular, flat condyloma of the cervix) can be recognized by the following signs: the appearance of warts and genital warts on the genitals and mucous membranes, the occurrence of cervical erosion.

The danger of infection is that the virus cannot be treated. The current approach is to test all women with cervical cytology during mandatory annual screening. It is important to carry out typing of the virus for oncogenic variants and, if detected, take the patient under observation, and not engage in mythical treatment of the human papillomavirus. However, if anatomical changes are detected in the form of condyloma or cervical papilloma, surgical excision is indicated. It must be remembered that oncogenic types of human papillomavirus are associated with cervical cancer.

Staphylococcus

A whole group of diseases caused by pathogenic staphylococci. Often, staphylococcus, together with pathogenic microbes such as gonococcus, chlamydia, and trichomonas, enters the genital tract during sexual intercourse and after a while causes itching, pain and burning.

1 Diagnosis of sexually transmitted infections

2 Diagnosis of sexually transmitted infections

3 Diagnosis of sexually transmitted infections

Causes of wet dreams in teenagers and boys

Having figured out when boys begin to have wet dreams, it is worth understanding the reasons for this physiological process. These are:

Diagnosis of sexually transmitted infections

To diagnose sexually transmitted infections, you may be prescribed the following STD tests:

general smear (a smear scraping from the genital organs is taken for examination);
ELISA (i.e. enzyme immunoassay) - the patient’s biological material is examined. The immunological reaction to certain pathogens is checked;
PCR (polymer chain reaction, analysis shows the pathogen). DIGENE test - quantitative analysis for HPV allows you to determine the concentration of the virus in the material.
bacteriological culture (helps to identify the sensitivity of the infection to antibacterial drugs);
RIF (immunofluorescence reaction) is carried out by staining biological material using various reagents;
urine test for infections.

At the MedicCity clinic, you can undergo a gynecological examination at a time convenient for you and get tested for any sexually transmitted infections in women. You can find out the cost of testing for HPV, testing for cytomegalovirus infections and other STDs by phone.

Quite often, worried patients search the Internet for answers to their questions (for example, what to do if the blood test for ureaplasma is negative, but the smear test is negative?). However, it is better not to rely on all sorts of Internet forums, but to receive information first-hand during a consultation with a professional gynecologist.

Prostate diseases in children and adolescents

17.07.2019

9046

Tarusin Dmitry Igorevich

Doctor of Medical Sciences, Professor, City Center for Reproductive Health of Children and Adolescents, Morozov Children's City Clinical Hospital, Moscow

Urologists know quite a lot about prostate diseases in adults - this is a favorite topic at all urological events. The situation is completely different with the peculiarities of semiotics and ultrasound diagnosis of prostate diseases in children and adolescents. A lecture for specialists on the tactics of managing patients under 18 years of age with prostate diseases was presented by Doctor of Medical Sciences, Professor Dmitry Igorevich Tarusin from the City Center for the Reproductive Health of Children and Adolescents of the Morozov Children's City Clinical Hospital in Moscow.

Anatomy of the prostate gland in children

At the beginning of his lecture, Dmitry Igorevich drew attention to a number of structural features of the prostate in children and adolescents. In particular, in newborns, glandular structures develop during the period of false puberty, after which they “freeze” in development. Up to 9 years of age, the prostate gland has a spherical shape due to insufficiency of the muscle layer, and after 10 years it takes the shape of a truncated trapezoid. Only by the age of 12 does the prostate take on its final shape of a truncated pyramid. The lobes of the gland in children, due to the poor development of interacinar septa, are poorly differentiated on ultrasound. At the age of 11, the first accumulations of secretion (mucus plugs) can be detected; at 12, the prostate has a clear three-lobe structure; by 13, it is already clearly palpable.

The role of masturbation in the development of the prostate gland

Intercinar septa develop along with the onset of muscle fiber activity. In turn, the muscular structure of the gland develops under the influence of masturbation and wet dreams. The formation of muscle structures is completed within 6 months from the start of masturbatory activity, and the level of secretory activity of the gland also depends on the degree of masturbation.

Features of prostate ultrasound in children

With an ultrasound scan of the prostate you can see changes:

sizes (relative and absolute increase/decrease);
structures (hyper-, hypo-, mesoechogenicity, diffuse and focal changes: hyperechoic inclusions, hypoechoic cysts, dilation of the prostatic urethra/prostatic uterus, dilatation of the efferent ducts, swelling of the seminal tubercle);
capsules (emphasis, thickening, layering);
ducts (dilation, ectopia);
surrounding the gland (dilation of paraprostatic veins, increase in size/formation of seminal vesicle cysts). In children of the younger age group, the gland capsule is practically not visualized, there is no zonal differentiation, and there is no visibility of the seminal vesicles

Features of diagnostic search

Dmitry Igorevich drew attention to the fact that the prostate is an organ actively associated with external (extensive) sexual manifestations. In particular, with a sudden cessation of masturbatory activity in adolescents, signs of congestive prostate gland may appear: an ovoid form of the prostate, mesoechogenic (edematous) parenchyma, a clearly visualized thickened capsule, an overstretched seminal vesicle and an expansion of the paraprostatic plexus.

An increase in the size of the gland is usually accompanied by perifocal swelling of the capsule. Characterized by a rounded shape of the prostate, its enlargement, contouring and overstretching of the seminal vesicle, as well as the presence of a “spermatogenic plug”. The formation of a mucus plug in the lumen of the ejaculatory duct can occur without enlargement of the prostate. In such cases, the seminal vesicle is double-lumen, and the gland capsule is not changed.

If we talk about the signs of severe spermatic stasis in the efferent system of the reproductive tract, these include the round shape of the gland in older adolescents, diffuse echoheterogeneity of the prostate tissue, pronounced dilation of the seminal vesicles and their ovoid shape. Often the condition is accompanied by dilation of the paraprostatic veins.

As Dmitry Igorevich emphasized, the most common mistake among those who are just starting to practice ultrasound diagnostics is to confuse the prostate with the ampullary part of the rectum. Therefore, if the size of the prostate gland significantly exceeds the volume of half the sum of the testicles, measurements should be repeated.

During puberty, the prostate gland can develop asynchronously in relation to the adolescent’s body as a whole. Regularly in practice there is an increase in the middle lobe of the prostate gland with a change in echogenicity. Most often, this situation is associated with the patient’s masturbatory activity and can resolve independently.

Dmitry Igorevich also noted that swelling of the periprostatic tissues can occur regardless of the size of the gland, but the prostate with an undeveloped acinar apparatus does not swell. However, often periprostatic tissues end up in the area of edema due to changes in the rectum.

The process of formation of prostate cysts is quite long and takes about three years. Most often, cysts are asymptomatic. However, sometimes uroflowmetry can be used to identify bladder outlet obstruction.

During an ultrasound examination, it is necessary to measure both seminal vesicles of the patient, keeping in mind that their sizes are not constant. Changes in the seminal vesicles depend on sexual activity. Seminal vesicle cysts develop gradually during puberty; their predictor can be considered a “bulb-shaped” expansion of the vesicle at the start of spermatogenesis. Inflammatory cysts of the seminal vesicles are always accompanied by a multiple enlargement of the prostate. This condition is described as “signs of prostatovesiculitis.”

A complex condition that requires special examination is dilatation of the prostatic urethra. In this case, the task of the first-line specialist, as the lecturer noted, is only to state the fact and refer the patient to an andrologist. He, in turn, can resort to the capabilities of ultrasound tomography and three-dimensional reconstruction of the area of interest.

Sometimes transperineal access can help in the differential diagnosis of various conditions. It is possible not only in young children, but also in adolescents.

During puberty, the appearance of pelvic venous disorders and the formation of prostate cysts are often observed.

As mentioned above, a clear sign of edema is the sphericity of the prostate in older patients. Three-dimensional modeling here, as a rule, reveals pronounced swelling of the ostium urethrae interna. Three-dimensional modeling may also be useful in identifying thickening and layering of the bladder wall, changes in the seminal vesicles and ejector duct, and focal hyperechogenicity.

Rigidity of the prostate gland due to swelling leads to dilatation of the urethra. Transrectal ultrasound of the prostate is easy to perform and quite informative in adolescents and older children, but in younger patients its applicability is limited by the morbidity of the procedure and ethical considerations.

Prostate stones look exactly the same as mucus plugs on an ultrasound, but they have a serious difference: they always “glow” during Doppler ultrasound.

One of the most common causes of retrograde ejaculation with the reflux of seminal fluid into the bladder is dystopia of the ductal structures of the prostatic uterus. With sufficient magnification and good resolution of the ultrasound machine, you can see the dilated vas deferens, almost flowing into the bladder. This situation can negatively affect the patient’s reproductive health and requires the attention of a specialist.

Every pediatric urologist-andrologist should know the features of diagnosing prostate diseases, because there are significant differences from those in adult patients. A urologist-andrologist who sees children and adolescents must undoubtedly have tact and comply with all ethical and legal requirements.

Material prepared by Yu.G. Boldyreva, special. corr. Urology Digest

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Treatment of sexually transmitted infections in women

Treatment of sexually transmitted infections in women, as well as in men, includes taking antibacterial drugs, antiviral, antifungal agents, and immunomodulators. If it is necessary to remove papillomas and condylomas, radio wave methods are used.

When treating sexually transmitted infections, women often rely on advice from friends or advertising. In most cases, this not only does not help get rid of a sexually transmitted disease, but also causes serious damage to the female body! Be sure to consult with a gynecologist who will conduct the necessary tests for STDs and individually select the medications you need.

Even if you follow STD prevention measures, do not forget to visit a female doctor every six months! In our clinic, specialists work on Voluson 10 expert-class ultrasound equipment, which allows them to detect the slightest alarming changes in the female body. Remember: any illness is easier to cure at an early stage!

Nocturnal emissions - what are they?

Nocturnal emissions are involuntary ejaculation that occurs during sleep.
They are observed in almost all boys, young men and adults of the stronger sex. Nocturnal emissions most often occur in men aged 18-30 years, although doctors have recorded this phenomenon in people whose age exceeds 50-60 years. The described phenomenon is typical for 28-32% of men who are over 30 years old, so this age group most often turns to doctors for help. Some doctors also use the term wet dream to refer to nocturnal sexual discharge in women, which is observed during prolonged abstinence from sex.