Urethral opening with albuginea formation

Introduction The urinary sensation caused by mycoplasma is similar to the general bacterial urinary sensation, and a white film is formed in the urethral opening in the morning. And the possibility of abnormal performance such as frequent urination.

Cause

In 1937, Drsnes et al. isolated mycoplasma from Pap septic abscess, which is the first report of mycoplasma causing disease in humans. There are 7 kinds of mycoplasma detected from the genitourinary tract, mainly M. hominis (MH) and ureaplasma urealyticum (UU). The pathogenicity of mycoplasma is generally considered to be not important in the pathogenesis of NGU. The study of UU as the etiology of NGU has the following aspects.

1. Isolation and culture: UU (with or without Chlamydia trachomatis) is isolated in nearly 50% to 60% of NGU patients. In the urethra of NGU patients who were negative for Chlamydia trachomatis, the UU detection rate was significantly higher than that of Chlamydia-positive NGU patients or NGB-free controls.

2. Antibiotic treatment test: Sulfa drugs and rifampicin are effective against Chlamydia and are ineffective against UU. While spectinomycin and streptomycin are effective against UU, they are ineffective against Chlamydia. Patients with negative chlamydia culture but positive UU culture have poor efficacy on sulfa and rifampicin. However, when treated with spectinomycin or streptomycin, the clinical symptoms are improved if UU is removed, and the clinical improvement is not improved if UU is not cleared.

3. Primate vaccination: urethritis and transient serum antibody reaction occur after UU inoculation in human urethra, and minocycline (minocycline) is effective, indicating that some mycoplasma is pathogenic under natural conditions. Inoculation of UU into non-human primate urethra can further isolate mycoplasma, and urethral swab smears see elevated neutrophils.

The urinary sensation caused by mycoplasma is similar to the general bacterial urinary sensation. May have fever, low back pain, bladder irritation and urinary sediment leukocytosis and other acute pyelonephritis; can also be manifested as symptoms of lower urinary tract infection; typical manifestations of urinary tract itching and dysuria and burning sensation, mild urethra Redness and swelling, often with serous or serous purulent urethral secretions, is less thin than that of gonorrhea urethritis secretions, or a white film is formed only in the morning when the urethra is found. Some patients may have no symptoms or signs of urinary sensation at all, and urinary sediment may also be free of leukocytosis, and only urinary mycoplasma culture is positive. Therefore, clinical diagnosis is often missed. The main infection site of female patients is the cervix, and the symptoms of urinary tract inflammation are not obvious. It is characterized by acute and chronic cervicitis and cervical erosion, increased vaginal discharge or mild dysuria and frequent urination, and it can be completely asymptomatic.

an examination

Related inspection

Urine routine urethral examination

The clinical diagnosis of this disease is difficult, and the premise of improving the diagnosis rate is the vigilance of the disease. According to the history of unclean sexual contact, the symptoms of urinary tract inflammation are milder than gonorrhea, and the gonococcal bacteria can not be found in the secretion examination. There are 10 to 15 white blood cells under high magnification (400×) and more than 5 white blood cells under oil microscope (1000×). The initial diagnosis can be made in any case of clinically suspected urinary sensation and repeated urinary bacterial culture. The diagnosis of mycoplasma urinary tract is mainly based on laboratory tests.

Differential diagnosis

Urethral adhesion: normal urethra has urethral glands, which can secrete a small amount of mucus every day to play a role in lubricating and protecting the urethra. Under normal circumstances, these mucus remain in the urethra and have a protective effect on the urethra mucosa. When the urethra or prostate is inflamed, the secretions may increase. After the urethral secretions are dried in the outer urethra, the mucosa and the skin on both sides of the urethra are slightly adhered, the urinary passage is slightly unsatisfactory, and bifurcation occurs in the initial stage of urination. The urine will stick out and the fork will disappear.

Nodular or red hemorrhagic mass in the urethra: early symptoms of paraurethral adenocarcinoma are dysuria, urethral bleeding, frequent urination, and dysuria. A nodular or red hemorrhagic mass appears in the distal urethra or urethra, and local swelling of the urethra can reach the mass. When the tumor is enlarged, it can block the urethra or expand into the vestibular vestibule and vaginal opening, and there are obvious ulcers and hemorrhagic masses, accompanied by pain and possible metastasis of the groin and pelvic lymph nodes.

There are erythema and edema in the urethra: repeated episodes of Candida balanitis appear as erythema at the glans, and there may be small pustules or small papules on the surface. It can also be expressed as local edema of the glans mucosa, mild desquamation at the edges, and the presence of papules and small pustules to expand around to form glans erosion.

Nodular or red hemorrhagic mass in the urethra: early symptoms of paraurethral adenocarcinoma are dysuria, urethral bleeding, frequent urination, and dysuria. A nodular or red hemorrhagic mass appears in the distal urethra or urethra, and local swelling of the urethra can reach the mass. When the tumor is enlarged, it can block the urethra or expand into the vestibular vestibule and vaginal opening, and there are obvious ulcers and hemorrhagic masses, accompanied by pain and possible metastasis of the groin and pelvic lymph nodes.

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