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Gonorrhea is a common infectious sexually transmitted disease. The ancient Roman physician Galen mistakenly called gonorrhea any disease, the symptom of which was discharge from the urethra (from the ancient Greek gonos – “seed” and rhoe – “outflow”). Often the same disease is called “clapper” (from German tropfen – to drip).
Only in 1879, the German physician and scientist Albert Neisser discovered the causative agent of gonorrhea. He examined under a microscope the discharge of the patient from the urethra, as well as the conjunctiva of the eye, and found unknown bacteria both there and there. They looked like coffee beans. Albert Neisser described their morphological features, typical location, division. Since then, this type of bacteria has been named after the scientist – Neisser’s gonococcus.
What is gonorrhea
– Gonorrhea is a sexually transmitted infection (STI), and in terms of prevalence it ranks third after trichomoniasis and chlamydia, – says Head of the Department of Dermatovenereology and Cosmetology, SSMU named after V.I. Razumovsky Andrey Bakulev. – Most often, infection occurs during sexual intercourse, when the mucous membranes of the urinary tract are affected. The entrance gate in men is the urethra. Although occasionally gonococci cause inflammation on the tonsils, skin, joints, conjunctiva, and anal area.
Gonococci are dangerous because they can form the so-called L-forms, as a result of which they are able to remain in the body for a long time. They lose sensitivity to antibiotics, the infectious process becomes chronic. It is important to identify gonorrhea in men at the initial stage and, at the end of treatment, make sure that the pathogen is destroyed, otherwise the disease may return again, and the patient will transmit the disease further on the planet.
According to the latest data, more than 60 million people are infected with gonorrhea every year around the globe.
Causes of gonorrhea in men
Since gonorrhea is an STI, the main reason for its occurrence in men is promiscuity, or communication with an untested partner for infections. Gonorrhea can also be carried by hands, on which there is a secret of the patient’s mucous membranes.
Occasionally, the infection can be transmitted with wet underwear or towels, where there may be fresh secretions. In any case, the cause of gonorrhea in men is non-compliance with the rules of personal hygiene and ignoring the rules of contraception.
Symptoms of gonorrhea in men
In men, the first signs of the disease usually appear 2 to 5 days after infection. It can be:
- mucopurulent or purulent discharge from the urethra;
- itching / burning in the urethra;
- pain when urinating (dysuria);
- frequent urination and urgent urge to urinate;
- pain during sexual intercourse (dyspareunia);
- pain in the perineum radiating to the rectum.
Gonorrhea in men manifests itself in fresh and chronic forms. The disease, lasting more than 2 months, becomes chronic. Fresh gonorrhea is characterized by inflammation of the urethra – fresh gonorrheal urethritis. Acute urethritis is manifested by cutting pains during urination, redness and swelling of the mucous membrane of the external opening of the urethra, abundant purulent discharge. The subacute form suggests all the same, but the symptoms are less pronounced. In the torpid course of gonorrhea in men, clinical symptoms are sometimes absent or limited to meager mucopurulent or mucous secretions, itching or tickling during urination.
With primary inflammation of the anus, complaints of discomfort in the anus, purulent discharge, and defecation disorders are characteristic. The skin in the anus is swollen and irritated.
Inflammation of the mucous membrane of the mouth, tonsils, pharynx may develop after orogenital contacts. The mucous membrane of the pharynx and tonsils is bright red, painful, swollen, with a purulent coating.
Inflammation of the mucous membrane of the eyes begins rapidly with swelling of the eyelids, conjunctival hyperemia, hemorrhages and purulent discharge. A characteristic symptom is blepharospasm. Visual disturbances are possible.
Treatment of gonorrhea in men
If the process is fresh (acute, subacute) and uncomplicated, it is enough to carry out only etiotropic therapy, i.e. antibacterial. Spectinomycin (Trobicin) is considered one of the effective drugs for the treatment of gonorrhea. However, there is a drawback: often inflammation of the mucous membranes in men is caused not only by gonococci, but by mixed microflora. In this case, the use of the drug will not work. Therefore, only a doctor prescribes treatment!
The following groups of antibiotics may be recommended for the treatment of gonorrhea in men:
- cephalosporins;
- fluoroquinolones;
- macrolides;
- tetracyclines;
- aminoglycosides;
- penicillins;
- sulfonamides (with intolerance to antibiotics).
It is now known that certain strains of gonococci produce substances that provide resistance to penicillin and its derivatives. Therefore, antibiotic susceptibility testing may be necessary to prescribe treatment.
And remember: simultaneous treatment of sexual partners is a must!
Diagnostics
In men, the diagnosis of gonorrhea is based on a characteristic clinical picture, anamnesis, and is confirmed by laboratory tests. It is used as a discharge of the urethra, paraurethral ducts, and the secret of the seminal vesicles, the prostate gland. The indication for treatment is the presence of gonococci in the test contents.
In order to establish the localization of the inflammatory process in the urethra, a two-glass urine sample is sometimes prescribed.
Differential diagnosis of gonorrhea in men should be carried out with other urogenital infections.
Modern treatments
Modern methods of treating gonorrhea in men are mainly associated with the emergence of new groups of antibiotics. At the same time, in the study of chronic inflammation or in suspicious cases, when the tests do not confirm the presence of gonococci, and the clinical picture is obvious, it is important to conduct provocative tests. This will help to conduct repeated laboratory studies with the greatest efficiency.
If a chronic process or the so-called torpid (low-symptomatic) form of gonorrhea is detected, in addition to antibiotics, immunotherapy (strengthening the immune system) and local treatment (anti-inflammatory ointments, solutions) are prescribed.
Prevention of gonorrhea in men at home
- limiting multiple and / or promiscuous sexual relationships, it is desirable to have one sexual partner;
- condom use;
- examination by a dermatovenereologist every 6 months (preferably together with a partner);
- compliance with the rules of personal hygiene;
- exclusion of contact with wet surfaces of the skin of the body in the pool, baths, saunas, etc.
- Wash hands thoroughly with soap and water after visiting the restroom.
Popular questions and answers
We asked about gonorrhea in men Head of the Department of Dermatovenereology and Cosmetology, SSMU named after IN AND. Razumovsky, professor, MD, dermatovenereologist Andrey Bakulev.