Fresh gonorrhea. Symptoms, signs of gonorrhea in women and men

Gonorrhea is a sexually transmitted infection that affects the mucous membranes of the external and internal genital organs, urethra, rectum, pharynx, eyes.

The causative agents of gonorrhea are bacteria - gonococci Neisseria gonorrhoeae. A feature of gonococci is that they can live on the cell membranes of the body and in the cells themselves. There are strains of gonococci that are resistant to antibiotics and antibodies produced by the body. In this case, the treatment of the disease is significantly complicated.

The disease is transmitted sexually, therefore it is considered venereal. Infection with gonorrhea is possible with any type of sexual contact - vaginal, anal and oral. Women are more likely to contract gonorrhea. Statistics show that in women, the chance of infection with gonorrhea upon contact with an infected partner is up to 80%, and in men - up to 40%. The genitals of men are more protected from gonorrhea: the urogenital canal is narrower, and urine can flush out the gonococci when urinating.

In a household way, infection with gonorrhea occurs very rarely, since bacteria die in an aggressive environment when exposed to the sun and household chemicals. Contamination is possible through hygiene items such as a towel or a shared toilet. Women are also more likely to be infected with households than men.

Another way of infection is during childbirth. An infected mother can transmit gonococci to her baby when the baby passes through the cervix and vagina. In this case, the eyes of newborns and the genitals are affected. Genitourinary congenital gonorrhea is diagnosed mainly in girls. Boys often suffer from conjunctival gonorrhea, which can cause loss of vision.

Varieties of gonorrhea

Gonorrhea can affect different parts of the body.

According to the localization of gonorrhea, several types of the disease are distinguished:

gonorrhea of \u200b\u200bthe urethra and genitals;
gonorrhea of \u200b\u200bthe anal and rectal region;
gonorrhea of \u200b\u200bthe bone and muscular system;
gonococcal pharyngitis;
gonococcal eye infection;
gonorrheal endocarditis;
gonorrheal meningitis.

Gonorrhea of \u200b\u200bthe genitourinary organs affects the mucous membrane of the urethra, cervical canal, uterus, fallopian tubes, ovaries, periurethral glands and peritoneum. In men, the urethral region is most often affected. In rare cases, when the local immunity of the vagina is lowered, it is possible that the vaginal epithelium may be affected by gonorrhea.

Anal and rectal gonorrhea is diagnosed as gonococcal proctitis. The rectal mucosa is affected. This type of gonorrhea is more often diagnosed in homosexual men and during genital-anal contacts in traditional couples.

With gonococcal pharyngitis, there is a reddening of the throat, the formation of purulent plaque, an increase in lymph nodes. It can be transmitted through genital-oral contact. In some cases, infection occurs when using the dishes of infected people. Most often transmitted through oral contact with patients.

Gonorrhea of \u200b\u200bthe bone and muscular system is also called gonoarthritis. It affects the joints, which leads to impaired mobility, pain. It develops with untreated chronic gonorrhea.

A gonococcal eye infection is called blenorrhea, and the conjunctiva is affected. It is often diagnosed in newborns - on the second or third day after childbirth, if the mother is sick or is a carrier of gonorrhea. It is very rarely transmitted through sexual contact.

According to the duration and severity of the disease, fresh and chronic forms of gonorrhea are distinguished:

with fresh gonorrhea, infection occurred less than 2 months ago;
in chronic gonorrhea, infection occurred more than 2 months ago.

Fresh gonorrhea is additionally divided into acute (with a bright manifestation of symptoms), subacute (with less pronounced symptoms) and torpid (with minimal expression of symptoms).

In chronic gonorrhea, the symptoms of infection are less pronounced than in acute, but there is a high likelihood of complications.

In rare cases, a person can become a carrier of gonococci, but not get sick himself. It is possible to determine the carriage of gonorrhea only by laboratory means. This is a dangerous option, since a person is a source of infection for a sexual partner and the people around him. With a decrease in immunity, symptoms of gonorrhea may appear in the carrier.

How does gonorrhea manifest

Symptoms do not appear immediately after infection. The incubation period for gonorrhea can last from 1 to 14 days. The duration of the incubation period depends on the method of infection, the site of entry of the gonococci and the patient's immune status.

The clinical picture is different for men and women. Symptoms are also different for different types of gonorrhea.

Fresh gonorrhea of \u200b\u200bthe genitourinary organs in women has the following symptoms:

purulent vaginal discharge;
increased urination, accompanied by itching, burning and pain;
intermenstrual bleeding;
violation of the female cycle;
pain in the abdomen, in its lower part;
the appearance of ulcers on the mucous membranes of the genitals;
discoloration and swelling of the mucous membranes of the genitals;
temperature rise above 39 degrees;
indigestion - nausea, vomiting, diarrhea, abdominal pain.

The clinical picture of gonorrhea in women can change if other genital infections join gonorrhea.

Fresh gonorrhea of \u200b\u200bthe genitourinary organs in men has the following symptoms:

narrowing of the urethra caused by edema of the urethral mucosa;
burning and itching in the urogenital canal;
purulent discharge from the urethra;
frequent urination, accompanied by pain and burning;
fever and chills.

Chronic gonorrhea of \u200b\u200bthe genitourinary organs is manifested as follows:

in men and women adhesions appear in the small pelvis, which can cause infertility;
in men, libido decreases, there is a violation of erectile function up to impotence;
in women, the menstrual cycle is disturbed, there is a strong inflammation of the internal organs of the intimate sphere, and fertility decreases (the ability to conceive and bear a child).

Gonorrhea of \u200b\u200bthe anal and rectal region in men and women is accompanied by:

painful bowel movements;
itching, swelling and burning in the anus;
fever;
purulent discharge from the anus;
ulcers of the rectum and anus;
overgrowth of polyps in the rectum (with chronic rectal gonorrhea).

Blenorrhea has the following symptoms:

inflammation, swelling and redness of the conjunctiva;
purulent discharge from the eyes;
ulcers on the mucous membranes of the eyes;
inflammation of the cornea of \u200b\u200bthe eyes;
the appearance of a thorn (rare);
blindness (without treatment or with congenital blennorrhea).

Bilateral blenorrhea is usually diagnosed with infection during childbirth. In other cases, unilateral inflammation is possible.

Diagnostics

Various specialists are involved in the diagnosis of gonorrhea. Gonorrhea of \u200b\u200bthe genital tract in women is dealt with by a gynecologist, in men - by a urologist. Rectal gonorrhea is diagnosed by a proctologist. An otolaryngologist deals with gonococcal pharyngitis. Blenorrhea is treated by an ophthalmologist, gonorrheal meningitis - by a neurologist. An infectious disease specialist is also involved in the diagnosis and treatment of gonorrhea. It is sometimes necessary to consult an immunologist.

It is almost impossible to detect gonorrhea by visual examination, since it often proceeds without pronounced symptoms, therefore laboratory diagnosis is necessary. For analysis, they take discharge from the genitals, anus, eyes, and make a smear from the mucous membrane of the throat. Further, the biological material is examined under a microscope, bacterial culture is carried out, and PCR diagnostics are carried out.

Gonorrhea is often accompanied by other STDs, so additional screening for various infections and viruses is performed. In women, cytology of the mucous membrane of the cervical canal is performed, in men, ureteroscopy is performed.

Gonorrhea is diagnosed several times. This is necessary to track the progress of treatment. After completion of treatment, a control examination is shown with the taking of material for laboratory research.

Sexual partners of the patient should also be screened for gonorrhea, even if they have no symptoms. This is a delicate issue, but one must not hide from the partner the fact that the disease has been identified.

Treatment

The doctor should deal with the treatment of gonorrhea, otherwise complications may form. In adults, uncomplicated gonorrhea is treated at home; children are treated in a hospital under the supervision of several specialists. The prognosis for the treatment of this disease is usually positive. The difficulty in treating this disease is that often gonococci form strains that are resistant to antibiotics - this makes it difficult to select an adequate treatment. Untreated gonorrhea always becomes chronic.

During the treatment of gonorrhea, sexual activity is prohibited in order to avoid re-infection of each other. Alcohol, active sports training, hypothermia are prohibited.

Antibiotics play a critical role in the treatment of gonorrhea. They are prescribed orally, intramuscularly, in the form of vaginal or rectal suppositories, in the form of ointments, solutions and creams.

Treatment of gonorrhea is complex. Along with other therapeutic methods, physiotherapy is also used - electrophoresis, UHF, magnetotherapy. Immunotherapy speeds up treatment and helps the body fight infection.

With an acute purulent gonococcal process in the peritoneum or uterus, surgical treatment is necessary. The doctor opens the abscess area, removes purulent masses and dead tissue, and treats the tissue with antimicrobial agents.

Without adequate treatment, gonorrhea can cause numerous complications:

infertility;
impotence;
ectopic pregnancy in women;
blood poisoning with gonococci with their subsequent spread throughout all tissues.

How to prevent gonorrhea

Prevention of gonorrhea - a healthy lifestyle, hygiene and rejection of promiscuous sex. You should use only your own hygiene items - a sponge, towel, toothbrush. You should not sit on toilets in public places, after using the restroom, wash your hands with soap and water or treat them with a disinfectant solution. During sexual intercourse, it is advisable to use barrier contraception.

During pregnancy planning, be sure to be screened for gonorrhea. This will keep the baby and mother healthy. Perhaps the worst consequence of gonorrhea is the infection of babies, because this often leads to irreversible blindness.

In Russia, regular examination for gonorrhea is mandatory for workers in education, medicine, and public catering. Every year, professional examinations are carried out with the entry of the results of examinations into a personal medical book.

Sexually transmitted disease and characterized by damage to the mucous membranes of the genitals and urinary organs. Refers to sexually transmitted diseases.

Causative agent

In case of unprotected sexual intercourse, it is not recommended to carry out antibacterial prophylaxis, except in cases of contact with a partner with a high probability of infection. For the purpose of preventing gonorrhea, it is possible, although not described in any guideline [ ], the use of antibacterial drugs before or shortly after intercourse. The main condition, to some extent justifying the use of antibacterial prophylaxis, is contact with a supposedly infected partner and the impossibility, for a number of reasons, of waiting for the development / absence of infection. The main tablet preparation, the use of which is possible with gonorrhea or the risk of its development, is cefixime, preferably a dispersible tablet 400 mg once.

The systematic use of antibiotics after each unprotected contact is fraught with the development of resistance of microorganisms, which will lead, subsequently, to therapy failures and serious complications. Previously effective, azithromycin is currently not used in the treatment of gonorrhea and, naturally, for its prevention. Despite the low level of resistance compared, for example, with fluoroquinolones (ciprofloxacin, ofloxacin and others), the latter exceeds the 5% threshold recommended by WHO for socially dangerous infections. The prophylactic use of azithromycin may be justified as a prophylaxis for genital chlamydial infection, but the small number of studies cannot provide evidence of this potentially beneficial property of macrolides

Diagnostics

Microbiological diagnostics.

Bacterioscopic (microscopic) method - staining of two smears:

according to Gram;
1% aqueous solution of methylene blue and 1% alcoholic solution of eosin.

The method has a high sensitivity and specificity (90-100%) only in the study of urethral discharge in men with manifest manifestations. The microscopy method is characterized by low sensitivity (45-64%) in the study of cervical, pharyngeal and rectal samples, as well as in asymptomatic infections.

Bacteriological method: sowing on nutrient media containing native proteins of blood, serum or ascitic fluid; use non-ascite media (for example, KDS-1 medium with casein hydrolyzate, yeast autolysate and native serum); optimum growth in an atmosphere of 10-20% carbon dioxide, at pH 7.2-7.4 and a temperature of 37 ° C. Allows you to assess the sensitivity of gonococci to antimicrobial drugs.
Serological method: RSK (Bordet-Zhangu reaction) or RIGA with the patient's blood serum.
Molecular biological method - (amplification of nucleic acids using PCR). It has the highest sensitivity and specificity. Especially recommended for samples from extragenital loci.

Treatment

Treatment of gonorrhea is reduced to the use of a course of antibiotics.

With chlamydial urethritis in men, doxycycline is most effective, including when compared with azithromycin.

Notes

Disease Ontology release 2019-05-13 - 2019-05-13 - 2019.

(from the Greek term " gonorrhoia", First used by the doctor Galen in the meaning of" semen outflow ") - infectious venereal disease, usually transmitted sexually.

The disease is caused by special microorganisms - neisser's gonococci or Neisseria gonorrhoeae. Neisser discovered gonococcus in 1879. Gonorrhea is especially common among people at a young active age; more than 200 million people fall ill with gonorrhea every year in the world. The ratio of women and men with gonorrhea is, according to studies, 2: 1.5. With gonorrhea, a lesion occurs genital mucosa, less often - eyes, tonsils, rectum.

In the case of advanced gonorrhea, vital organs are affected - the heart, lungs, and the brain. May even develop gonococcal sepsis ... Such complications of gonorrhea require immediate treatment. The sources of the disease are patients with gonorrhea. Girls can also get gonorrhea through infected towels, washcloths, diapers, and dirty hands.

There are such forms of gonorrhea: freshif the disease lasts less than 2 months, which in turn happens acute , subacute , torpid , and chronic, i.e. lasting more than two months.

Infection occurs during intercourse, and the disease is transmitted and vaginal , and at anal , and at oral sex ... Women get sick in almost all cases of contact with a patient with gonorrhea, and men - not always, which is associated with the narrowness of the urethral opening. Infection occurs much less frequently by contact, for example, from a mother with a disease to a child, while the fetus passes the birth canal.

At the end of this brief description, we will debunk one of the common myths. Since gonococci live only on the mucous membrane, and outside it they most often die, therefore, although it is theoretically possible to become infected with gonorrhea in the pool, it is unlikely.

Symptoms of gonorrhea

Typically, the incubation period of the disease lasts from 2 to 5 days in men and 5-10 days in women.

The main symptoms of gonorrhea in a man are:

sharp pain and burning sensation with urinating;
yellowish discharge from the urethra, spontaneous or on pressure;
increased urge to urinate;
redness of the skin of the urethra around the external opening;
clouding of urine, "flakes" or blood are observed in it;
an erection may be painful;
sometimes rises temperature appears chills .

If untreated, the infection spreads to prostate and testicles .

Symptoms of gonorrhea in women:

pain when urinating;
frequent;
irregular, dirty yellow, thick, sometimes with an unpleasant odor;
frequent urge to urinate;
between periods;
chills, fever are possible.

Quite often, gonorrhea occurs in women without basic symptoms, and if they do appear, then the discharge is identified as, and pain during urination - how.

Diagnosis of gonorrhea

The doctor diagnoses gonorrhea on the basis of familiarization with the patient's complaints, examination and genital organs, the results of the general vaginal smear, urethra, discharge from the eyes, examination of the anus, data urinalysis... The patient's sexual activity, last sexual intercourse, the appearance of discharge from the urethra, as well as whether he had previously had sexually transmitted diseases, is determined.

If the patient did not use disinfectants, bacterioscopic analysis... In the early stages of the disease, i.e. with "fresh" gonorrhea, the method of direct immunofluorescence, allowing you to additionally identify other possible ones. Before starting the main treatment, tests are also carried out for,. In the case of chronic gonorrhea, a more accurate study is prescribed - PCR, polymerase chain reaction or seeding.

Treatment of gonorrhea

It is imperative that the treatment of the disease is carried out by a venereologist in a hospital setting. Usually the doctor prescribes a set of procedures that contribute to the patient's recovery. This includes topical treatments and methods.

Antibiotics that are used in the treatment of gonorrhea belong to the penicillin group -,. Antibiotics related to tetracyclines can also be used - sometimes azalides (,), cephalosporins and some others. it is used to increase the body's immunity and resistance to infection, in this case, vaccine therapy, autohemotherapy can be prescribed, prodigiosan ,. Physiotherapy treatments for gonorrhea include electrophoresis, , laser therapy, UHF, UFO.

Local treatment of gonorrhea is carried out by injecting a solution (0.5%) into the vagina or urethra, microclysters with chamomile tincture. With timely treatment, the disease heals quite quickly, otherwise it can turn into a chronic form. During the treatment, the patient must adhere to the recommended diet, do not consume alcohol. You can't go in for sports, you need to exclude sexual intercourse.

If the disease is combined with chlamydia or, then the treatment of gonorrhea is accompanied by the use of drugs for concomitant infections - azithromycin , doxycycline ... Because antibiotics almost always contribute to the destruction of normal intestinal microflora, then at the same time patients are prescribed lacto- and bifid-containing drugs (, Bifilong ).

It should be noted that self-treatment of gonococcal infection usually leads to chronic gonorrhea and other irreversible complications. So at the first signs of the disease or when any discomfort in the genital area appears, you need to contact a specialist as soon as possible.

In the treatment of chronic gonorrhea, the infection itself is destroyed, and drugs that strengthen the immune system are prescribed, for example, and immunomodulatory drugs .

If the disease has become chronic, then the main symptoms of gonorrhea may disappear, the pain will pass, but the "morning drop syndrome" will remain, and. discharge of cloudy fluid from the opening of the urethra. Exacerbations of the disease caused by hypothermia, menstruation are often observed.

With timely treatment, the prognosis is favorable. Gonorrhea is considered cured if the symptoms of the disease have completely disappeared, and laboratory tests showed a negative result and showed the absence of the pathogen.

The doctors

Medicines

Personal prevention of gonorrhea consists in the elimination of accidental sexual intercourse, and mandatory use. If accidental sexual intercourse has occurred, it is recommended that you contact the venereal disease clinic or the personal prevention point working with it as soon as possible to take the necessary measures to avoid the development of the disease.

Complications of gonorrhea

Among the complications of advanced gonorrhea in men is a violation spermatogenesis , and the inner layer of the foreskin, as well as damage to the testicle and its epididymis orchitis , epididymitis or, which can lead to infertility. In a woman, inflammation spreads to the uterus (), fallopian tubes, and further to the ovaries and appendages ( salpingo-oophoritis ), which can lead to infertility, as well as to various sexual disorders, frigidity , development.

If a pregnant woman contracted gonorrhea, then it is likely, and also premature birth , fetal death. Gonorrhea is especially dangerous for newborns, who may develop eye diseases leading to blindness. If the gonococci have spread to other organs, then serious diseases such as damage to the joints, heart, skin and brain are possible.

For prevention, you must follow the basic rules of personal hygiene, especially after using the toilet, regularly wash the genitals with soap and water. It should be noted that with timely treatment and adherence to all the doctor's recommendations, complications of the disease can be avoided.

Diet, nutrition for gonorrhea

List of sources

Adaskevich V.P. Sexually transmitted diseases. - Vitebsk: Publishing house of the Vitebsk Medical Institute, 1996;
Vasiliev M.M. Gonococcal infection / M.M. Vasiliev // Med. Newspaper. 2003. No. 51, 52;
Dermatovenereology / Edited by A.A. Kubanova. - M.: DEKS-PRESS, 2010.

Gonorrhea in men is the most common and diagnosed sexually transmitted disease. Signs and symptoms of gonorrhea in men are pronounced, which forces them to seek medical help in a timely manner. Symptoms are absent in 50% of cases, which leads to late seeking medical help, and the woman herself has been a distributor of infection for a long time. The widespread prevalence of drug-resistant forms of the disease makes the treatment of gonorrhea difficult.

At the end of the 19th century, the German scientist Neisser identified the causative agent of gonorrhea - Neisseria gonorrhoeae. The infection is transmitted during intercourse and during childbirth. The disease affects the mucous membrane of the urethra, cervix, rectum, pharynx and eyes. Inflammation of the uterus and appendages in gonorrhea leads to female infertility. In men, the disease is often complicated by acute epididymitis. In addition to the genitals, gonorrhea affects the joints, heart and brain membranes. During childbirth, the causative agent of gonorrhea can be transmitted to the newborn and infect the mucous membrane of the eyes, which leads to the formation of ulcers, which subsequently heal with a scar.

Figure: 1. The photo shows the main symptoms of gonorrhea in men and women. With the disease, the mucous membrane of the urethra and eyes in men and the cervix in women are most often affected.

About the causative agent of gonorrhea

Gonococci are round-shaped gram-negative bacteria. They have a slightly bumpy surface. They are often arranged in pairs. A large number of pathogens are found in leukocytes, which are captured and destroyed. The bacteria are clearly visible under a microscope when stained with Gram and methylene blue. Gonococci are not stable in the external environment. They die quickly when exposed to light rays, disinfectant solutions and heat. Certain strains of the pathogen exhibit an ability that makes them resistant to penicillin.

Figure: 2. Causative agents of gonorrhea.

Immunity in gonorrhea

Protective immunity does not develop in gonorrhea. The disease can develop in the same person many times.

How does infection occur

The main route of transmission is sexual, when pathogens are transmitted during unprotected vaginal and anal intercourse. 20 - 50% of people become infected with gonorrhea during a single and unprotected traditional intercourse. Much less - with oral intercourse.
With perverted intercourse, gonorrheal inflammation develops in the rectum, pharynx and tonsils. The disease can be transmitted through the sick person's vibrators and sex toys.
The disease is transmitted from a sick mother to the newborn during childbirth. Gonorrheal conjunctivitis of the newborn proceeds with the formation of ulcers that heal with a scar.
Very rarely, the source of infection for little girls is the personal belongings of a mother with gonorrhea.
Due to the instability of bacteria in the external environment, the disease is not transmitted through kisses, personal belongings of the patient, cutlery, toilet bowl and swimming pools.

Figure: 3. The photo shows gonorrhea in men.

Development of gonorrhea in men

Gonococci that get on the mucous membrane of the urethra linger there for up to 2 hours. During this period, they can be destroyed by applying personal hygiene methods. Reproduction of gonococci occurs rapidly. They quickly penetrate into the interepithelial space, connective tissue layer, glands and lacunae of the anterior urethra.
With the penetration of gonococci into the posterior urethra, there is a threat of infection of the seminal vesicles, prostate gland and epididymis.
With a sharp decrease in the function of the immune system, sepsis and gonococcal arthritis develop.

Figure: 4. In the photo of the gonococcus. Clusters of pathogens in leukocytes and intercellular space are visible (indicated by arrows).

Figure: 5. The photo shows gonorrhea in men. Discharge from the urethra is the main symptom of the disease.

Signs and symptoms of gonorrhea in men

The latent (incubation) period for gonorrhea is up to 5 days in men, and from 5 to 15 days in women. In more than 90% of cases, gonorrhea in men is manifested by severe symptoms, which forces them to seek medical help. Asymptomatic and malosymptomatic course leads to late seeking medical help, as a rule, during the development of complications of the disease, and the woman herself has been a distributor of infection for a long time.

Symptoms of the disease are absent in every 10th man and in almost half of women infected with gonococci

Signs and symptoms of acute gonococcal urethritis

Abundant discharge from the urethra and pain at the end of the act of urination are the main symptoms of gonorrhea in men. The lips of the external opening of the urethra are hyperemic and edematous, and the discharge is yellowish. Severe cramps and burning at the end of urination appear on the second day of the disease.

Gonorrhea in men has a subacute and torpid course, when symptoms of the disease are insignificant or completely absent. In such a situation, patients are especially dangerous in relation to the spread of infection. If the infection spreads into the posterior part of the urethra, then acute total urethritis or urethrocystitis develops. The symptoms of gonorrhea during this period are pronounced. Terminal pain (at the end of urination) intensifies, and at the end of the act of urination a drop of blood appears. Often the process is accompanied by intoxication complaints. The presence of chlamydia aggravates the disease.

Figure: 6. The photo shows acute gonococcal urethritis.

Signs and symptoms of gonococcal proctitis

In 40% of cases of gonorrhea in men, inflammation of the rectum is detected. Redness of the perianal region and the appearance of wounds, rashes, blisters and warts are the main signs of the disease. The disease is characterized by rectal discharge, itching, urging and bleeding after bowel movements. Anoscopy reveals mucosal hyperemia, punctate hemorrhages and purulent exudate.

Signs and symptoms of gonococcal pharyngitis

The disease is often asymptomatic. Redness of the pharynx with purulent exudate and an increase in regional lymph nodes is sometimes recorded.

Signs and symptoms of gonorrheal arthritis

Gonorrheal arthritis is rare in men. This is due to the rapid cure of the disease - gonorrheal urethritis. More often, the disease is recorded in homosexuals suffering from gonorrheal proctitis.

The disease often affects the knee, ankle and wrist joints. Pain, swelling and redness are the main symptoms of the disease. The main diagnostic feature is the detection of gonococci in the synovial fluid and in the blood.

Figure: 7. The photo shows gonorrheal arthritis.

Figure: 8. In the photo, the lesion of the mucous membrane of the lips with gonorrhea.

Figure: 9. The photo shows gonorrheal conjunctivitis. The disease is always manifested by profuse suppuration.

Symptoms and signs of chronic gonococcal urethritis

The chronic form of gonococcal urethritis develops 2 months after the onset of the disease. As a rule, this is a transformation of acute and subacute gonorrheal urethritis, the treatment of which was unsuccessful for a number of reasons.

With the defeat of the anterior part of the urethra, the signs and symptoms of the disease are absent or mild. Discharge from the urethra in the morning is sometimes recorded. With a slight discharge, you can only notice the sticking of the lips of the urethra after a night's sleep.

When using ureteroscopy, the following signs of the disease are detected:

changes in the epithelium of the urethra in the form of hard and soft infiltrates,
the presence of inflammation of the mucous glands of the urethra;
the presence of inflammation of the lacunae of Morgagni;
the presence of collicular inflammation.

Complications of chronic urethritis:

inflammation of the skin of the glans penis and the inner layer of the foreskin - balanoposthitis;
inflammation of the cooper gland;
inflammation of the prostate gland;
inflammation of the seminal vesicles (vesiculitis);
epipidymitis;
functional disorders of the genitourinary apparatus.

Figure: 10. The photo shows gonorrhea in men, chronic form. Slight discharge from the urethra in the morning and sticking of the lips of the urethra after a night's sleep are the main signs of the disease.

Diagnosis of gonorrhea in men

Gonorrhea is easily diagnosed in men. A sample for research can be a smear from the urethra, pharynx, rectum and, in some cases, the patient's urine.

Bacteriological diagnostics

Direct bacterioscopy is the simplest, fastest, most sensitive and specific method for detecting gonococci in the test material. Its sensitivity is 90%. Sowing biological material it is 95% sensitive to nutrient media.

Two-glass sample

If the mucous layer of the anterior urethra is damaged from 2 urine samples, changes will be detected only in the first sample. Changes in 2 samples are recorded when the anterior and posterior parts of the urethra are affected.

PCR (polymerase chain reaction) technique

It is highly sensitive and specific and is comparable to that of crops.

Testing for gonorrhea should be done as soon as possible, as the disease can lead to serious health problems.

Figure: 11. Preparation of a smear for microscopic examination.

Figure: 12. Photo of gonococcus (pus smear). Microscopic view (methylene blue stain on the left and Gram stain on the right).

Treatment of gonorrhea in men

At present, strains of the causative agent of gonorrhea that are resistant to penicillin are widespread. Strains resistant to fluoroquinolones are widespread in Asia. In the heterosexual part of the population, 1/3 of cases of gonorrhea are combined with chlamydial infection. Therefore, the treatment of gonorrhea in men is carried out with two antibiotics. In the case of an uncomplicated course of the disease, a single dose of ciprofloxacin (ciprolet) is recommended.

With adequate treatment, the patient's condition improves within a few days.

A man is considered cured of gonorrhea if:

bacterioscopy and cultures of biological material gave negative results;
no changes were found on palpation of the prostate and seminal vesicles;
in the secret of the prostate, the content of leukocytes does not exceed 5 - and in the field of view;
absence of inflammatory changes during ureteroscopy.

Do not self-medicate. Only a doctor will prescribe the correct treatment and determine the fact of a cure. Self-medication leads to the development of resistant strains of the pathogen and the transition of the disease into a chronic form.

Prevention of gonorrhea

Prevention of gonorrhea is based on the following postulates:

Full course of anti-gonorrheal treatment.
Examination and treatment of sex partners.
Promotion of monogamous relationships.
Condom use.
Abstaining from sex with illness.

Gonorrhea in men is today the most common and diagnosed sexually transmitted disease. With the disease, the mucous membrane of the urethra is most often affected. In 90% of cases of diseases, the signs and symptoms of gonorrhea in men are pronounced. Seeking medical attention early ensures that treatment is successful. The development of drug-resistant forms of the disease complicates the treatment of gonorrhea.