STORIES OF Disease
Tests for Mycoplasma and URINARY TRACT INFECTIONS
Think about your v – the outside part of the female genitalia – for a second.
Imagine someone twisting your arm after a sunburn, and you carry the sense of pain… down there.
That pain means you can’t have penetrative sex. And you need an STD PCR test for Mycoplasma. You’re in pain to sit down, and you can’t wear skinny jeans or use tampons.
This is the experience of women who have vulvodynia. This condition can be difficult for some doctors to identify because it has no visible symptoms.
“If you imagine the perineum, the space between the vagina and the anus. It is the piece of skin that sits just above the perineum. It is right behind the entrance to the vagina. That’s why Mycoplasma PCR Tests detect infection. And most women feel the pain,” says Claudia, 23.
Claudia started suffering from vulvodynia in adolescence. It took time to find the courage to go to the doctor for An STD Test and even longer to identify it as Mycoplasma.
She reports the symptoms as “having a cut and rubbing a chilli pepper on it.”
It’s been two years since Claudia’s engagement. The vulvodynia has heavily affected this relationship.
How it felt
“You can be relaxed, you can be totally at ease with your partner, you can want things to happen, and you just can’t,” he explains. “I remember one instance where I tried. I wanted to have sex. And this was such a bad decision that I ended up sitting in a cold bath for two hours trying to get that burning away. There was a period where I felt like, well, I can’t have sex, so I’m not a woman.” But it doesn’t just affect her sex life; STDs affect your daily life, too.
Claudia can only wear tight clothes and sit on public transport briefly.
“I tend to wear cotton granny panties because I know that if I make a mistake, things can go wrong.”
“My boyfriend sometimes asks, ‘Why don’t you ever wear nice underwear?’
“But I would feel like false advertising because I know that whatever I wear and look like, I can’t meet that expectation.
While it took her a while to find a doctor who understood her condition, she is now on a treatment regimen that has had some success with recent negative STD lab tests.
The data
There are no official stats on the number of women who have vulvodynia.
A study of nearly 5,000 people in the United States suggests that about one in six women have experienced symptoms for more than three months in their lifetime.
Less than half of the women in this study have an official diagnosis, and many have yet to seek any medical help.
The spectrum of pathogens is similar for uncomplicated UTIs of the upper and lower urinary tract, with Escherichia Coli as the bacteria responsible for 70-95% of cases and Staphylococcus saprophyticus, epidermidis and fecalis in about 10-15%. Other Enterobacteriaceae, such as Proteus Mirabilis and Klebsiella spp, are occasionally isolated. Or enterococci (especially in cultures positive for multiple microorganisms, a sign of contamination).
Predisposing factors:
There is a genetic predisposition to urinary infections in some patients due to the congenital lack or poor production of defensive chemicals
Other favourable circumstances are:
Constipation: an intestine that does not regularly empty or only in part. It is also more commonly connected with recurrent vaginitis and cystitis due to the prolonged stasis of faeces at the level of the rectal ampulla.
Intense cold causes local vasoconstriction, which can facilitate cystitis.
Connected pathologies such as diabetes, neurological pathologies, uterine or bladder prolapse, the use of contraceptive devices such as a diaphragm or spermicidal creams that alter the normal balance of the vaginal bacterial flora, the presence of bladder catheters, trauma from rubbing during sex, various conditions or therapies that reduce immune defences.
Anatomical factors due to pathologies in which there is an obstacle to the normal urinary flow (for example, due to urinary stones or, in men, prostatic hypertrophy or any stenosis of the urinary tract) with the stagnation of the urine up from the obstacle.
Vaginal factors
Receptivity to bacterial colonisation of vaginal epithelial cells is the first of the possible causes of urinary tract infections. Numerous STD studies have shown that Escherichia Coli adheres more rapidly to the vaginal cells of women with urinary tract infections rather than to the same cells of healthy volunteers.
Women with repeated UTIs appear to have more receptors for bacterial adhesion in the genitourinary mucosa and, therefore, greater points of attack for pathogens due to a reduced competitive inhibition capacity for adhesive-mediated colonisation (subjects non-secretors”.
However, the cells of “secretory” subjects produce mucopolysaccharides that tend to cover and “ask” the adhesion receptors.
Among the organic causes, in particular, the prolapse of the anterior vaginal wall (cystocele) can favour the incidence of infections as a residue of urine forms in the bladder, thus creating an environment favourable to the growth of bacteria and detectable in Mycoplasma home tests.
Urethral factors
From an anatomical point of view, the most common cause of infections is urethral stricture. Still, many authors question this pathology in females. They argue it is nothing more than an unrecognised vesico-sphincter dyssynergia (functional obstruction).
Some authors have shown that the dendritic cells responsible for antibacterial defence are in growing numbers from the proximal to the distal urethra, a defence outpost at the entrance to the urinary tract. In contrast, a switch in the position of this cell population, more often than not, relates to infections.
Prostatic factors
A subclinical infection of the prostate is connected with a higher incidence of urinary tract infection in men. In these cases, prostatic secretion would be altered. (The absence or less zinc is considered among the factors inhibiting bacterial growth, which is verifiable in an STD Panel check.)
As already mentioned, post-void residue facilitates the proliferation and growth of bacteria in cases of obstruction due to prostatic hypertrophy.
SYMPTOMS
Pollakiuria: You need to pee more times but with a reduced amount each time.
Dysuria: difficulty peeing. Stranguria: pain or burning while peeing, sometimes also with chills and cold Suprapubic pain. Bladder tenesmus: the urgent need to urinate and the feeling of an empty bladder. Possible blood in the urine. Fever: if the infection travels towards the upper urinary tract, there may be high fever and chills
DIAGNOSIS
A non-pregnant woman of childbearing age who presents with acute dysuria. They need to get an STD Profile as they usually have one of three types of infection: Acute cystitis. Acute urethritis due to Chlamydia Trachomatis, Neisseria Gonorrhoeae or Herpes simplex and Candida vaginitis or Trichomonas vaginalis
RECURRING (UNCOMPLICATED) INFECTIONS
Recurrent urinary tract infections (RUTI) are defined in the notes as three episodes of UTI in the last 12 months or two episodes in the last 6 months. Risk factors for RUTI are genetic and behavioural.
Behavioural factors connected with RUTI include sexual activity. This is especially high risk in women who use spermicides, frequency of sex, age at first UTI, and a history of UTI in the mother, which suggests the role of genetic factors and long-term environmental exposures.
To avoid excess use of antibiotics for useless Mycoplasma lab tests and treatments for those that don’t have forms, there is a sign for therapy only after two positive urine culture samples 1-2 weeks apart.
In symptomatic forms, the standard Mycoplasma treatment is using beta-lactams or nitrofurantoin for 7 days. There is always a sign for post-therapy control urine culture.
Aids and Prevention
for Urinary Tract Infections
Methods such as urine acidification, cranberry juice, bearberry extract and vaginal application of lactobacilli show different effects. They are widely used due to the low rate of side effects.