I am pregnant, and when tested for urogenital infections, one laboratory discovered gonococcus. Of course, I was shocked - my husband and I do not have any manifestations of gonorrhea, we have been married for 1.5 years. When tested in another laboratory, gonococcus was not detected. I had to retake the control test again at the 1st laboratory. They put a stamp “gonococcus not detected”, but on the smear in the columns “gonococcus” they wrote “yeast cells”. The doctor convinces me that I am a carrier of a hidden infection, and the 2nd laboratory simply could not detect it. My question is the following: aren’t they trying to “powder” my brains, trying to hide the first mistake, because of which they convince me of hidden gonorrhea? There is no discharge and there hasn’t been any, except for an odorless leucorrhoea, everything is definitely fine with my husband. The child is developing normally. My husband suffered from gonorrhea in 1999, treated it and cured it. Can there be such a hidden infection as gonococcus, how long will it be hidden (for now, it turns out, more than 3 years for my husband, 1.5 years for me), how can it harm? Thank you very much.

There are many myths surrounding gonorrhea. Some believe that the mode of transmission of the disease is exclusively sexual, others are sure of the opposite. But the number of patients with signs of gonococcal infection continues to increase. Therefore, it is important to know the true causes of infection.

Causes of gonococcal infection

Doctors divide the ways of transmission of gonorrhea into three categories:

1. unprotected sex;
2. household transmission;
3. birth canal

Unprotected sex. In the case of contact with a sick partner, the likelihood of infection varies between men and women. If a woman has sex with a sick person, she will almost certainly become infected with a gonococcal infection. The vagina creates simply ideal conditions for her.

A man is more protected in this regard. It's all about the narrowness of the urethra, which does not allow the pathogen to quickly penetrate the channel. The risk of infection increases significantly with repeated contacts and in relationships with a menstruating partner. During menstruation, the infection “descends” along with the discharge, rushing towards the vagina, which allows the gonococcus to easily reach the male genitals.

Household transmission route. People often ask, is it possible to become infected with gonorrhea at home? In some cases, this route of infection has been recorded. The culprit may be:

• underwear;
• towel;
• bed dress;
• washcloth.
• toilet.

It is noteworthy that gonorrhea infection occurs through personal hygiene items most often in women. A particular risk group includes girls who have not yet developed an immune system capable of suppressing infection.

For healthy people to become infected at home, several factors must coincide:

• a large number of gonococcal pathogens;
• weakened immune system;
• elderly or children's age.

Gonococcus can be localized in the oral cavity, so care for toothbrushes must be careful.

Infection through the birth canal. During childbirth, a child can become infected from a mother suffering from an infection. In this case, the mucous membrane of the eye suffers. Complete blindness may develop. In newborn girls, the genitals are also affected.

Due to the vulnerability of the baby, infection can also occur after birth through saliva if a person with gonorrhea kisses the baby or touches it with untreated hands.

Infection by kissing

Many believe that oral sex is preferable and the chances of getting sick are significantly reduced. Gonorrhea is transmitted from the genital tract to the oral cavity and also vice versa. Therefore, unprotected oral contact with a sick partner can cause illness.

To the frequent question whether gonorrhea is transmitted through a kiss, doctors do not give a definite answer. But the likelihood of infection increases significantly if you kiss after oral sex.

The risk category includes people with damage to the oral cavity and with reduced immunity. Young girls, recent illnesses, older people, and those who are promiscuous are more at risk of contracting clap through kissing.

Symptoms of the disease

The incubation period of gonorrhea is quite short and lasts from 2 days to 2 weeks. All this time the person poses a sexual danger. The first signs of gonorrhea appear on the 5-6th day. Given these deadlines, you can find out the source of infection.

Doctors distinguish between acute gonococcal infection and the chronic course of the disease. In the acute course of the disease, the following signs can be observed in men:

• yellowish-white discharge from the urethra;
• burning and stinging during urination;
• frequent urge to go small.

Women may also experience spotting.

The main danger of gonorrhea is that it can occur for a long time without any symptoms. During this time, a man can be sexually active and expose his partners to the risk of infection.

When infected with several types of sexually transmitted diseases, the treatment of gonorrhoea becomes more complicated. Gonococcal microorganisms successfully develop in the environment of other pathogenic bacteria.

Of particular danger is the simultaneous contraction of Trichomonas and gonorrhea. Gonococci integrate into pathogenic cells and remain resistant to antibiotic treatment.

Other concomitant diseases also become frequent companions of gonorrhea. Therefore, when it is detected, tests are prescribed for:

• ureaplasma;
• chlamydia;
• candidiasis;
• herpes;
• trichomoniasis;
• syphilis.

The danger of gonococcal infection is the weakening of the body's local defenses, which increases the likelihood of picking up other viral and bacterial infections.

Types of gonococcal infection

Classic signs of gonorrhea infection appear mainly in the genitourinary organs. But gonococcal infection can affect the lymph nodes, causing pharyngitis and proctitis.

Gonococcal proctitis. It manifests itself as pain during bowel movements and discharge from the rectum. Infection occurs through the practice of anal sex.

Gonococcal pharyngitis. Characterized by a sore throat and swollen salivary glands. You can become infected through oral contact.

The infection is insidious in that it quickly spreads throughout the body. Without proper treatment, microorganisms quickly rise to the bladder and kidneys and infect them.

In men, the infection penetrates into the testicles, in women into the fallopian tubes.

The main problem of gonorrhea is its possible asymptomatic course. At this time, a man can infect his partners.

Treatment of gonorrhea

Having learned how you can become infected with gonorrhea, you need to know how to get rid of it. Under no circumstances should you self-medicate. In society, sexually transmitted diseases are considered shameful. Therefore, treatment can be carried out anonymously.

Having discovered the first signs of gonorrhea in men, it is necessary to notify your sexual partner and seek help from a venereologist.

During treatment, it is necessary to strictly follow the rules of behavior to prevent infection of others. You should not visit public baths, saunas and swimming pools. Be sure to wash your hands after using the toilet. A man is prohibited from squeezing discharge from the urethra. This leads to the spread of infection.

Treatment of gonorrhea involves mandatory treatment with antibiotics. Treatment should not be stopped as soon as improvement appears. Be sure to follow all the doctor’s recommendations to the end.

Untreated infection leads to a chronic course of the disease. After a full course of treatment, regular visits to a venereologist are recommended to prevent relapses.

Preventive actions

The best protector against any sexually transmitted disease is a condom. Having sex with a regular partner reduces the risk of contracting gonorrhea. In case of casual relationships, you should use an antiseptic and thoroughly wash the genitals.

However, it is necessary to take into account that the gonorrhea is insidious and the measures taken may not be effective. Only compliance with the rules of personal hygiene, relationships with a regular partner and the use of a condom during casual relationships will protect against gonorrhea and other sexually transmitted problems.

Gonorrhea in men: symptoms

Symptoms of gonorrhea in men develop around the third day after infection. Appears:

• pain during urination;
• frequent urge to urinate;
• burning sensation along the urethra;
• purulent discharge from the urethra;
• redness and swelling around the opening of the urethra.

Since the disease manifests itself rapidly, with pronounced symptoms, and the signs of the disease significantly affect the quality of life, most men consult a doctor in a timely manner.

If during the acute period treatment is not carried out or is carried out incorrectly, the disease becomes chronic. The chronic form is characterized by subsidence of vivid symptoms, however, it is much more dangerous than the acute form.

With chronic gonorrhea, concern:

• mild burning sensation during urination;
• slight discharge from the urethra in the morning.

Chronic gonorrhea can develop:

• prostatitis;
• orchitis;
• epididymitis;
• urethral stenosis.

These conditions are fraught with infertility, so you should not neglect the disease. Timely seeking qualified help helps prevent the development of complications.

Gonococcal pharyngitis and proctitis are most often asymptomatic. Such lesions rarely appear in men and are associated with unconventional methods of sexual intercourse.

In people with immunodeficiency, dissemination of gonococci throughout the body may occur, affecting all internal organs. In this case, the development of infectious-toxic shock and multiple organ failure is possible.

Often, gonorrhea occurs atypically, with uncharacteristic symptoms or with blurred clinical symptoms. The reason for this is considered to be a mixed infection, that is, a combination of gonococcal infection with other diseases, for example, chlamydia or trichomoniasis.

In such cases, it is unrealistic to make a diagnosis based only on symptoms, so all kinds of laboratory research methods are used. Only after accurately identifying the pathogen can treatment begin.

Drugs for the treatment of gonorrhea in men

Since gonorrhea is caused by microorganisms, the main drugs for its treatment are antibiotics. Several groups of antibiotics can be used to treat gonorrhea:

• cephalosporins;
• fluoroquinolones;
• macrolides.

From the group of penicillins, the most commonly used are benzylpenicillin, amoxicillin and oxacillin. If they are ineffective, cephalosporins (cefataxime, ceftriaxone) are used.

If individual intolerance to penicillins is observed, cephalosporins are not prescribed, since they are similar in their mechanism of action and can cause cross-allergic reactions.

Macrolides(azithromycin, clarithromycin) and fluoroquinolones (ciprofloxacin, ofloxacin) are also highly effective against gonococci. These drugs are widely used when gonorrhea is combined with other sexually transmitted infections. Most often, gonorrhea occurs together with chlamydia.

In some cases, combination drugs consisting of sulfonamides and trimethoprim are used, for example, Biseptol, Septin, Bactrim.

In addition to antibacterial agents, general strengthening agents and immunomodulators are used.

Treatment course for gonorrhea in men

During treatment, sexual intercourse should be avoided. This is due to both the possibility of infecting a partner and the likelihood of re-infection with gonorrhea or another sexually transmitted disease, which significantly complicates the treatment process.

It is also important to examine the sexual partner of a person with gonorrhea. If he also develops a disease, it is worth treating together. This way you can protect yourself from reinfection and significantly increase the likelihood of a complete recovery from the disease.

During therapy, diet is an important condition. It is necessary to exclude the intake of alcoholic beverages and hot, smoked, spicy foods. This is done to reduce irritation of the urethra, which in itself reduces the clinical manifestations of urethritis in gonorrhea. In addition, taking antibacterial drugs increases the load on the liver, so diet is also a means to prevent liver damage.

• For acute uncomplicated gonorrhea, benzylpenicillin is prescribed intramuscularly every 4 hours or every 6 hours, first dissolved in 0.5 novocaine. Novocaine is used to dilute the dry drug and for pain relief.
• Possible use of bicillin. This is also a penicillin antibiotic, but with a prolonged effect. It is administered intramuscularly once.
• Fluoroquinolones and macrolides are prescribed in tablets either once, or the course dose is divided into 3-5 days.
• If gonorrhea is combined with another infection, antibiotics are prescribed that are effective against all identified microorganisms. For example, in the presence of gonorrhea and chlamydia, doxycycline is used; for gonorrhea and trichomoniasis, macrolides are used in combination with metronidazole.
• For chronic uncomplicated gonorrhea, courses of immunomodulatory therapy and local treatment are used along with antibacterial drugs.
• If antibacterial drugs do not give the desired effect, an antibiotic is selected taking into account the sensitivity of the pathogen. To do this, a bacteriological study of urethral discharge is carried out with further determination of sensitivity.
• As a local treatment, the urethra is washed with weak solutions of boric acid or potassium permanganate. It is advisable to do this after urination.

After the acute process subsides, physical therapy can be performed. For the treatment of gonorrheal urethritis, the following is used:

• ultrasound;
• electrophoresis and phonophoresis using drugs;
• inductothermy;
• laser therapy.

The criteria for the effectiveness of treatment are the absence of clinical symptoms of the disease and negative laboratory results.

A week after the end of the course of treatment, a control study is carried out. This is necessary to ensure a complete cure. If laboratory tests show a negative result, provocative tests are performed.

They are:

• instillation of lapis solution into the urethra;
• intramuscular administration of gonovaccine;
• drinking 0.5–1 liter of beer.

After this, 3 control studies are carried out over 3 days. If after this the results are negative, the last study is carried out a month later.

Gonorrhea is a disease that is highly treatable. However, there is one condition - you should not delay contacting a doctor and under no circumstances self-medicate.

It is always better to engage in prevention rather than treatment. To prevent infection with gonorrhea, it is necessary to avoid casual sexual contact and use barrier methods of contraception.

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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 is a gram-negative diplococcus, has a bean-shaped shape and is located in pairs. He does not have the ability to move independently.

The small villi (pili) present 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, which can change during the development of the disease and under the influence of factors unfavorable for the bacterium.

Gonococcus has the ability to transform into a protective L-form. This allows it to survive engulfment by phagocytes and insufficiently intensive antibiotic therapy. But the L-form does not protect against the action of antiseptics and environmental factors; outside the body, the gonococcus is quickly destroyed when the secretions dry out. Therefore, the household route of infection is rare; it is possible only when objects are heavily contaminated and there is a short period of time between the release of bacteria and their contact with another person.

Pathogenesis

Gonorrhea in men most often occurs during sexual contact with a partner with gonorrhea, who may not have obvious external pathological signs. The causative agent is contained in vaginal discharge and urethral secretion. During oral intercourse, the presence of gonococcal lesions of the nasopharynx is important, and during anal intercourse, gonorrheal prostatitis is important.

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 sperm and sometimes enter the terminal portions of the vas deferens.
• With concomitant infection with trichomoniasis, gonococci can penetrate into trichomonas, in which case antibacterial drugs are not dangerous for them.

A characteristic feature of gonococci is the ability to multiply inside 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, gonococci exist for quite 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, spreading them 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 observed.

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 strengthens on the surface of the urethra at its mouth, penetrates 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 extends to 2 weeks.

• The first symptoms are discomfort along the urethra, quickly followed by itching and burning in this area.
• Soon, mucous and then purulent yellowish-white discharge appears from the opening of the urethra.
• The urethral sponges on the head of the penis become red and swollen, and painful nocturnal emissions are possible.
• At first, suppuration is intermittent and is associated with pressure on the penis and the beginning of urination, then it becomes almost continuous.
• With the rapid development of the disease, body temperature may increase 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 become dull and lose their severity. Self-treatment also contributes to an atypical course. Antibiotics, often taken haphazardly, without a doctor’s prescription and in insufficient doses, 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 head of the 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 an asymptomatic course of the acute process, gonorrhea is called torpid.

Possible complications

Over several weeks, inflammation can spread along the walls of the urethra to the bladder, prostate and seminiferous tubules. This causes complications of gonorrhea in the form of cystitis and prostatitis. Symptoms include frequent painful urination, nagging pain in the perineum during sexual arousal and ejaculation, and discomfort in the testicles. Prostatitis can lead to impotence and a decrease in the fertilizing ability of sperm.

• Gonorrheal epididymitis appears when the epididymis is involved in a specific inflammatory process.
• It is usually acute and proceeds violently.
• This causes fever, redness and swelling of the scrotum, and sharp pain on the affected side.
• Epididymitis can be unilateral or affect both testicles to varying degrees.
• The development of epididymitis threatens subsequent cicatricial narrowing of the lumen of the vas deferens with the development of infertility.

Long-term urethritis, leading to deep lesions of the wall of the urethra, can be complicated by urethral stricture. Difficulty in the outflow of urine contributes to congestion in the bladder, reflux of urine into the ureters and 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 the 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,);
2. infection with other STDs;
3. weakened local immunity, repeated infection with gonorrhea (reinfection);
4. eating spicy food;
5. frequent sexual arousal;
6. use of coitus interruptus as a method of contraception;
7. excessive physical activity;
8. alcoholism.

Often, a man suffering from gonorrhea consults 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, etc.

Diagnostics

In the classic course of the disease, the doctor may suspect the presence of gonorrhea already at the initial visit 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. Serological diagnosis of gonorrhea is rarely performed.

To begin treatment, it is sufficient to detect paired bean-shaped bacteria by microscopy of urethral discharge. But even in this case, culture is carried out on nutrient media, which makes it possible to confirm the diagnosis and determine the sensitivity of the isolated pathogen to the main antibiotics. Gonococci grow best on nutrient media with ascitic fluid and blood plasma, forming transparent round colonies with smooth edges.

• A test for gonorrhea in men is taken not only in the presence of obvious clinical signs.
• It is carried out 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 the sick woman.
• And on the initiative of the man, a smear is taken for gonorrhea after unprotected sexual intercourse with an unfamiliar woman.
• This takes into account how long it takes for gonorrhea to manifest itself and how long it takes for gonococci to penetrate the urethral mucosa and begin to reproduce.
• Therefore, the analysis is carried out a few days after questionable sexual intercourse.

To increase the reliability of the result, it is important to correctly obtain the material for the study. Before taking a smear from the urethra, a man must not urinate for 4-5 hours, not use topical antiseptics or take antibiotics. A smear is taken with a Volkmann spoon or a bacteriological loop. If the discharge is scanty, a preliminary massage of the prostate is performed.

Chronic gonorrhea often causes difficulties in laboratory diagnosis; a false-negative examination result in this case is mainly due to the intracellular location of the pathogen. Therefore, before taking smears, a provocation is necessary - stimulation of the release of gonococci during an artificially induced exacerbation of chronic urethritis. For this purpose:

1. instillation of silver nitrate solution;
2. bougienage of the urethra, urethrography;
3. heating the inflamed area using 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 monitor the treatment.

How to get rid of the disease

Treatment of gonorrhea in men consists of etiotropic antibacterial therapy, symptomatic measures to reduce the severity of symptoms, sexual rest and diet. It is necessary to avoid physical activity, cycling, drink plenty of fluids and avoid the use of spices.

• Antibiotics for gonorrhea are prescribed in a course; the duration of therapy depends on the nature and duration of the disease and is determined by the doctor.
• You should not stop taking medications after the condition improves, which usually happens after 2-3 days of antibiotic therapy.
• This can create resistance of gonococci to the drug used and 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 penicillin antibiotics and 3rd generation cephalosporins. If the pathogen is insufficiently sensitive to them or there are contraindications, drugs from other groups are used, based on the data of bacteriological research.

Systemic antibiotic therapy is supplemented with sanitation of the urethra. To do this, rinsing and instillation with various solutions with antimicrobial and anti-inflammatory effects are carried out. When acute inflammation subsides, physiotherapy is prescribed: UHF, phonophoresis and electrophoresis, laser and magnetic therapy, inductothermy, ultraviolet exposure. In case of chronic, recurrent and torpid course, immunotherapy is indicated, which can be specific (using gonovaccine) and nonspecific.

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

Since it is necessary to treat gonorrhea in men together with the sexual partner, an epidemiological study is being conducted. All women who have been in contact with the sick person are sent to a gynecologist and dermatovenerologist; if they are diagnosed with gonorrhea, 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.

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First symptoms

The first symptoms of gonorrhea in men may appear as early as the second day after contact with a carrier of the infection. It is then that unpleasant sensations appear in the urethra. However, usually the first signs of gonorrhea in men appear after 3-5 days. Then purulent discharge from the penis appears - both voluntary and flowing out when pressing on the head, as well as itching in the man’s groin.

Opinions about what the first sign of gonorrhea in men is vary from patient to patient. Often, men infected with gonococci experience painful nocturnal erections; less often, there is a general deterioration in the body’s condition and an increase in body temperature.

Discharge

The main symptoms of the disease include discharge from gonorrhea in men. First of all, leucorrhoea begins to secrete profusely, leaving purulent yellow spots on the linen that have a foul odor. The peak of discharge, accompanied by painful sensations during urination, occurs in the first or second week after infection.

Subsequent development of symptoms

How does gonorrhea manifest in men? Inflammation of the urethra (urethritis) begins. The inflammation is painful, and the urge to urinate occurs more and more often. The color of the urine changes and it becomes cloudy. The urethra takes on a painful and dense appearance, with pronounced redness visible near the opening of the urethra.

Gonorrhea in a man can cause a complication such as prostatitis. It is often accompanied by inflammation of the seminal vesicle (vesiculitis).

Asymptomatic gonorrhea in men

According to statistics, gonorrhea without symptoms in men is quite rare - only in 20% of cases. Such patients do not have to rejoice, because in such cases the disease manifests itself later, but in a much more severe form. Lack of timely treatment leads to the fact that asymptomatic gonorrhea in men becomes chronic, and over time the symptoms become much stronger than with acute gonorrhea.

Incubation period

The incubation period of gonorrhea in men is short - from 2 to 5 days. The first symptoms may appear within the first week after infection. In case of decreased immunity or antibiotic therapy with irrational dosage, the incubation period may increase to 3 weeks.

Often this period increases in those patients who self-medicated with folk remedies for gonorrhea. That is why it is so important to contact specialists in a timely manner - a venereologist or andrologist.

Forms of gonorrhea

Acute gonorrhea

Acute gonorrhea in men is characterized by pain on palpation, swelling and redness of the penis. Involuntary yellow-green purulent discharge from the urethra appears, and erosion on the head of the penis may also develop.

If treatment is not carried out, and the amount of discharge gradually decreases, and the signs of the disease disappear, then this indicates the transition of the disease to a chronic form.

Hidden gonorrhea

The greatest danger is latent gonorrhea in men, which occurs in an asymptomatic form. It is extremely difficult to diagnose it yourself, therefore, as a rule, after 2 months the disease becomes chronic.

Also, a latent form of gonorrhea can be caused by self-administered treatment, when the infection is not completely destroyed and becomes less noticeable and more difficult to cure. That is why it is so important to contact an experienced doctor in time, who can recognize the disease and prescribe the correct treatment.

Is gonorrhea curable?

Today, the answer to the question of whether gonorrhea can be treated in men can be answered in the affirmative. The early stages of the disease are highly treatable and often proceed without complications. In any case, it is strictly not recommended to self-medicate; this can provoke the disease to become chronic, threatening various complications.

How long to treat

It is impossible to say exactly how long gonorrhea in men is treated - this value is individual for each case. Treatment should begin only after a visit to a venereologist. Based on the results of tests for gonorrhea, the doctor prescribes appropriate treatment. The timing of treatment mainly depends on how quickly the patient sought help, as well as on the form of the disease.

Detection and initiation of treatment for gonorrhea immediately after the incubation period ensures a rapid cure - within 5-7 days. Treatment of asymptomatic gonorrhea can take a longer time, up to several months.

Scheme and course of treatment for gonorrhea

Treatment of gonorrhea in men is carried out after examination and examination by a venereologist (dermatologist). Only a qualified doctor can prescribe the correct course of treatment. The main direction is the fight against gonococci and the complete destruction of the infectious agent in the body.

Treatment regimens for gonorrhea in men vary depending on the severity of the disease. As a rule, doctors prescribe antibiotics in the form of tablets, supplementing treatment with ointments for topical use. When treated with antibiotics, the positive effect of therapy is achieved quite quickly. In addition, sexual intercourse is prohibited during the entire therapy.

Medicines for gonorrhea in men

Almost any remedy for gonorrhea for men, as well as for women, belongs to antibiotics of one group or another. An important condition for treatment is abstinence from sexual relations.

It is worth noting that there are no specific drugs to treat gonorrhea in men. In addition, any patient who has a regular sexual partner is strongly recommended to be tested and undergo treatment with him.

Treatment regimens prescribed by a doctor are identical for patients of both sexes. Minor differences apply only to specific drugs. Thus, medications for gonorrhea in men that complement the main treatment are solutions or ointments for application directly to the genital organ. For women with gonorrhea, additional medications include vaginal suppositories and creams.

In some cases, medicine for gonorrhea in men may be prescribed in the form of intramuscular injections. Antibiotic injections included in the treatment regimen for gonorrhea are given for at least 5 days, 3-4 times a day.

Gonorrhea pills for men

According to most doctors, the most convenient dosage form is gonorrhea tablets for men and women. The most reliable drugs that have proven themselves over many years of therapeutic use are penicillin tablets. These include oxacillin, ampicillin, chloramphenicol, ampiox and carfecillin.

If the disease occurs with complications or has already become chronic, then doctors prescribe tetracycline antibiotics: doxycycline, metacycline, tetracycline, rondomycin.

Most often, treatment of gonorrhea in men with tablets is prescribed when the infection is detected immediately and is fresh. In this case, experts prescribe azalides, the most modern drugs that can fight many strains of gonococcal infection. This group includes azithromycin (Main article: “ Azithromycin for gonorrhea"), josamycin and roxithromycin.

Macrolides, which include macropen, erythromycin, oletethrin and erycycline, have the fewest possible side effects. Often they are prescribed even to pregnant women who have been diagnosed with gonococci.

Antibiotics

Whatever the stage of the disease, the most appropriate treatment is considered to be antibiotics for gonorrhea in men and women.

• As a rule, 95% of cases of gonorrhea of ​​any stage are successfully treated with antibacterial tablets.
• The remaining 5% occurs in the chronic form of the disease and in those cases when, after completing a course of antibiotics, a smear still shows the presence of gonococci in the body.
• Then doctors can use sulfonamide tablets.

Antibiotics can be taken in a weekly course or once. One way or another, the doctor prescribes the dosage and treatment regimen.

Consequences

The consequences of gonorrhea in men can manifest themselves in various forms of complications. This is an inflammation of the glans penis and the inner layer of the foreskin (and balanitis); inflammation of the urinary tract and paraurethral canals

• In addition to those listed, complications can be more serious: vesiculitis (inflammation of the seminal vesicles), epididymitis (inflammation of the epididymis).
• Epididymitis develops particularly quickly, which is accompanied by fever and severe pain in the testicle - to the point that the patient can no longer move.
• If gonorrhea affects both testicles, this can lead to infertility. Another complication is prostatitis. Its chronic form threatens impotence.

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1) Acute gonorrheal epididymitis - inflammation of the epididymis

The infection spreads from the urethra along the vas deferens. It begins with swelling of the testicle and such sharp pain in the scrotum that the man actually cannot move. Then pain appears in the lower back, moving to the side of the abdomen and to the groin area. The pain is stronger on the side where the inflammation is more intense. As swelling increases, the epididymis increases 2-4 times in just a couple of hours; At the same time, pain during urination increases, and blood appears in the urine.

The temperature is understood, the person feels a strong chill, the pulse quickens. The main complications of epididymitis are the formation of an epididymal abscess and the spread of infection to the testicle (orchitis). The normal functions of the epididymis are limited to transporting, storing and maturing sperm. When the ducts become inflamed, they narrow or are completely blocked by adhesions, resulting in infertility. With unilateral epididymitis - in 35% of cases, with bilateral - in 87%.

2) Gonorrheal prostatitis

Gonococci enter the prostate through the ducts connecting the gland to the urethra. Acute inflammation is characterized by pain in the lower back and lower abdomen, radiating to the scrotum and groin areas. The prostate gland swells and can compress the urethra, making it difficult to urinate; mucus and blood appear in the urine. Chronic forms develop unnoticed, but ultimately lead to adhesions inside the ducts, acute forms lead to purulent inflammation with the formation of an abscess. In both cases it is possible

3) Gonorrheal inflammation of the periurethral canals and glands, foreskin, head of the penis

They can be complicated by narrowing of the urethra and its opening, fusion of the internal layers of the foreskin, and erosions on the skin of the genital organs.

Gonorrheal epididymitis and prostatitis are diagnosed by a smear from the urethra, and appropriate antibiotics and restoratives are prescribed. Purulent complications are treated in a hospital, chronic and subacute forms are treated on an outpatient basis, also with the use of antibiotics and then physiotherapy. To reduce pain, it is suggested to put a suspensor on the testicles; if urinary retention occurs, drink a decoction of parsley and make local baths with chamomile or sage.

• Limitation of activity with temporary cessation of sexual activity.
• Also from cycling and horse riding.
• Diet with limited fats and spices, without alcoholic beverages.

Detection of the disease

The first point of the diagnostic algorithm is patient interview. The doctor finds out what exactly is bothering you at the moment, when the problems started and what they may be associated with, whether such symptoms existed before.

• Then proceeds to inspection, urological or gynecological, if necessary, evaluates the condition of the genital organs by palpation (palpation).
• In women with an acute form of gonorrhea, hyperemia of the cervical canal is visible, and liquid yellowish-milky pus is released from it.
• In men, the discharge is in the form of a drop, the color is the same, there may be an admixture of blood.
• Chronic gonorrhea gives a more modest picture: there is little discharge, they appear after pressing on the opening of the urethra.

Gonorrhea smear taken with a sterile loop or swab.

If gonorrheal inflammation outside the genital organs is suspected, material is obtained from the mucous membrane of the mouth and throat, from the anus, and from the corners of the eyes.

With standard localization of gonorrhea: in women - from the urethra, cervical canal, vagina and the mouth of the Bartholin glands, in men - from the urethra.

If necessary, a sample of discharge from the prostate gland is additionally examined. To do this, the doctor massages the prostate through the rectum, and the patient holds the test tube near the opening of the urethra. The procedure is unpleasant, but goes quickly. With normal inflammation, the prostatic secretion contains only leukocytes and columnar epithelium, with gonorrhea - leukocytes, epithelium and gonococci, and Neisseria are located inside the cells.

Culture method

This involves inoculating material from the area of ​​inflammation on nutrient media, isolating gonococcal colonies and determining their sensitivity to antibiotics. Used as a definitive diagnosis of gonorrhea to prescribe specific treatment.

Antibiotic sensitivity test: gonococci isolated from colonies are mixed with a nutrient medium, which is placed in a special container (Petri dish). Pieces of paper, similar to confetti, soaked in solutions of various antibiotics are placed on the surface in a circle. After the growth of gonococci in it, the medium becomes cloudy, and only round transparent areas are visible around the “confetti” with certain antibiotics. They are measured, with a diameter of 1-1.5 cm, the sensitivity of a given microflora to an antibiotic is considered average, a diameter of 2 cm or more indicates high sensitivity. It is this medicine that can successfully cope with the infection.

The disadvantage of the method is the long execution time; it takes 7 to 10 days for colonies to grow successively on two media. Plus – detection of gonorrhea in 95% of cases.

Smear microscopy

The material to be studied is placed on a glass slide, the preparation is stained and examined under a microscope. The causative agents of gonorrhea are found in the form of bluish-violet diplococci, located mainly inside other cells. The technique is not complicated, but depends on the qualifications of the laboratory doctor, so its accuracy is only 30-70%. Microscopy is used to make a preliminary diagnosis.

Analyzes

Blood for general clinical research, for PCR and ELISA tests.

1. General clinical analysis reveals signs of inflammation: leukocytosis, increased lymphocyte count, ESR, and possibly increased platelets.
2. PCR, polymerase chain reaction. The method is highly sensitive and is based on the determination of gonococcal DNA. Used for preliminary diagnosis, it is often false positive. For confirmation it is supplemented by a cultural method.
3. ELISA test (enzyme-linked immunosorbent assay). The results may be distorted by concomitant autoimmune diseases. In general, the method has a confidence level of 70%, is inexpensive and can be done quickly.

Hardware methods are used after treatment to assess the severity of the consequences of gonorrhea for the internal genital and other organs. In women, sclerosis (replacement of active tissue with scar tissue) of the ovaries and fallopian tubes is possible, in men – of the seminal ducts and urethra. In both cases, infertility occurs.

Treatment with antibiotics

The main principle: be sure to treat sexual partners, in whom gonococci were detected using the culture method. Acute and chronic gonorrhea require an etiotropic approach, that is, an impact on the cause of the disease.

Sexual contact and alcohol are prohibited for the entire treatment period!

Therapy with antibiotics taken orally is always carried out against the background hepatoprotectors(karsil) and probiotics(Linex, yogurt). Local remedies with eubiotics (intravaginal) - acylact, lacto- and bifidumbacterin. It would also be useful to prescribe antifungal drugs (fluconazole).

It is better to stop the temptation to heal yourself immediately, since the antibiotic may not work and gonorrhea will become chronic, and medications are increasingly causing allergies and its complication - anaphylactic shock - develops at lightning speed. And most importantly: only a doctor can reliably diagnose gonorrhea, based on objective data.

Acute uncomplicated gonorrhea of ​​the lower genitourinary system is treated literally according to instructions compiled on the basis of official recommendations. Preferably one of the following antibiotics is prescribed:

• tablets for gonorrhea, single dose - azithromycin (2 g), cefixime (0.4 g), ciprofloxacin (0.5 g);
• intramuscularly, once - ceftriaxone (0.25 g), spectinomycin (2 g).

Exist alternative schemes, in which ofloxacin (0.4 g) or cefozidime (0.5 g), kanamycin (2.0 g) intramuscularly, once are used (once, orally). After treatment, it is necessary to monitor the sensitivity of gonococci to antibiotics.

Acute complicated gonorrhea of ​​the lower and upper parts of the genitourinary system requires long-term treatment.

The antibiotic is changed after a maximum of 7 days, or the drugs are prescribed in long courses - until the symptoms disappear, plus another 48 hours.

1. Ceftriaxone 1.0 IM (intramuscular) or IV (intravenous), x 1 per day, 7 days.
2. Spectinomycin 2.0 IM, x 2 per day, 7 days.
3. Cefotaxime 1.0 IV, x 3 per day or Ciprofloxacin 0.5 IV, x 2 per day - until symptoms disappear + 48 hours.

After the acute manifestations of gonorrheal inflammation have been relieved (the temperature should return to normal, discharge is scanty or undetectable, there is no acute pain, local swelling has decreased), antibiotics continue to be used. Twice a day - ciprofloxacin 0.5 or ofloxacin 0.4 g.

In the presence of a mixed infection of gonorrhea and chlamydia, the regimen is expanded by adding azithromycin tablets (1.0 g once) or doxycycline (0.1 x 2, 7 days). Trichomoniasis can be treated with metronidazole, ornidazole, or tinidazole. Syphilis accompanying gonorrhea is treated with penicillins or tetracyclines. If you are allergic to these groups of drugs, erythromycin or oleandomycin is prescribed, which are also active against mycoplasmosis and chlamydia.

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