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    Current methods for evaluation of the vaginal microbiocenosis See Details



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    User Username Password Remember me Forgot password? Notifications View Subscribe. Article Норма Print this article. Indexing metadata. Cite item. Email this article Login required. Email the author Login required. Request permissions. Keywords bacterial vaginosis cesarean section chronic endometritis endometriosis endometrium genital endometriosis gestational diabetes mellitus in vitro fertilization infertility laparoscopy macrosomia maternal mortality miscarriage obesity oxytocin мазков organ prolapse placenta polycystic ovary syndrome preeclampsia pregnancy risk factors.

    Current methods for evaluation of the vaginal microbiocenosis. Authors: Rybina E. Abstract Full Text Влагалища the authors References Statistics Влагалища The article reviews literature data мазков the history of research into the microflora of the genital tract, as well as current views about the vaginal microbiota. Definitions of the vaginal microflora in норма and diseases, such as bacterial vaginosis and vaginitis are presented. Data on main methods of laboratory diagnostics used for the investigation of the vaginal влагалища are summarized.

    It was concluded that there is a need in further optimization and standardization of the current methods for evaluation of the vaginal biotope. Keywords vaginal microfloramicrobiocenosismicrobiotalaboratory diagnosticsмазков methods.

    Spiegel at al. Nugent R. Amsel R. Helsingfors; Amsel R. Nonspecific vaginitis: diagnostic criteria and microbial and epidemiologic associations. The American Journal of Medicine. Female genital-tract HIV load correlates inversely with Lactobacillus species but positively with bacterial vaginosis and Mycoplasma hominis. Journal of Infectious Diseases. Evaluation of the bacterial vaginal flora of 20 postmenopausal women by direct Nugent score and molecular polymerase chain reaction and denaturing gradient gel electrophoresis techniques.

    The biology of the vagina in the human subject. Leipzig: E. Besold; Donders G. Definition and classification of abnormal vaginal flora. Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. Variability in diagnosis of clue cells, lactobacillary grading and white blood cells in vaginal wet smears with conventional bright light and phase contrast microscopy. Microscopy of the bacterial flora on fresh vaginal smears. Infectious Diseases влагалища Obstetrics and Gynecology.

    Application and use of various mass spectrometry methods in clinical microbiology. Clinical Microbiology and Infection. Molecular identification of bacteria associated with bacterial vaginosis. New England Journal of Medicine. Koenig S. Мазков, Fu L. Temporal dynamics of the human vaginal microbiota. Science Translational Medicine. Haemophilus vaginalis vaginitis: a newly defined specific infection previously classified non-specific мазков.

    American Journal of Obstetrics and Gynecology. Treatment of sexually transmitted infections for HIV prevention: влагалища of the road or new beginning?

    Regan J. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. Sexually Transmitted Diseases.

    Validation of a simplified grading of Gram stained vaginal smears for use in genitourinary medicine clinics. Sexually Transmitted Infections. Quantification of bacterial species of the vaginal microbiome in different groups of women, using nucleic acid amplification tests. BMC Microbiology. Neue Klassifikation der Vaginalbiocoenose auf sechs Grundbilder. Gynecologic and Obstetric Investigation. Heterogeneity of vaginal microbial communities within individuals.

    Journal of Clinical Microbiology. Comparison of methods for diagnosing bacterial vaginosis among pregnant women. Bacterial vaginosis-a disturbed bacterial flora and treatment enigma. Enumeration of clue cells in rehydrated air-dried vaginal wet smears for the diagnosis of bacterial vaginosis. Importance of vaginal microbes in мазков health. Reproductive Sciences. Relationship of specific vaginal bacteria and bacterial vaginosis treatment failure in women who have sex with women.

    Annals of Internal Medicine. The microbiota of the human genitourinary tract: trying to see the forest through the trees. Transactions of the American Clinical and Climatological Association. A new method for sequencing DNA. Proceedings влагалища the National Academy мазков Sciences. Норма accuracy of quantitative real-time PCR assay versus clinical and Gram stain identification of влагалища vaginosis.

    Molecular quantification of Gardnerella vaginalis and Atopobium vaginae loads to predict bacterial vaginosis. Clinical Infectious Diseases. Sequencing technologies - the next generation. Nature Reviews Genetics. Detection of fastidious vaginal bacteria in women with HIV infection and bacterial vaginosis.

    Reliability влагалища diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. Vaginal microbiome of reproductive-age women. Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for мазков of sickle cell anemia.

    Journal норма Molecular Biology. Zur Pathogenese und Klinik des vaginalen Fluors. Влагалища One. Prognosis норма treatment of desquamative inflammatory vaginitis. Prevalence of bacterial vaginosis in a community setting and role of the pap smear in its detection. Acta Cytologica. Diagnosis норма bacterial vaginosis by влагалища gram stain of vaginal fluid.

    Bacterial communities норма women with bacterial vaginosis: high resolution phylogenetic analyses reveal relationships of microbiota to clinical criteria.

    PloS one. The human vaginal норма biota and bacterial норма. Interdisciplinary Perspectives on Infectious Diseases. Adherent biofilms мазков bacterial vaginosis. Gardnerella biofilm involves females and males and is transmitted sexually. Does bacterial норма cause pelvic мазков disease? Proline aminopeptidase activity as a rapid diagnostic test to confirm bacterial vaginosis.

    The Sequence of the Human Genome. Prevention of perinatal group B streptococcal disease: revised guidelines from CDC, Cloning of норма rRNA genes amplified from normal and disturbed vaginal microflora suggests a strong association мазков Atopobium vaginae, Gardnerella vaginalis and bacterial влагалища. Group A streptococcal vaginitis: an unrecognized cause of vaginal symptoms in adult women. Archives of Gynecology and Obstetrics. Longitudinal analysis of the vaginal microflora in pregnancy suggests that L.

    The biofilm in bacterial vaginosis: implications for epidemiology, diagnosis and treatment. Current Opinion in Infectious Diseases.

    Мазок из шейки матки. .. Нахождение такой флоры во влагалище говорит о возможном соединении с просветом прямой Норма или не норма? Aim. To estimate and compare the features and efficacy of different surgical methods of pelvic organ prolapse correction. Methods. patients with stage 4 of. FIELD: medicine. SUBSTANCE: substance of the diagnostic technique for nonspecific vulvovaginitis in girls involves bacterioscopic examination of a vaginal.

    Surgical treatment for pelvic organs prolapse

    Clinical and microbiologic evaluation of current treatments for bacterial vaginosis
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    Associated professor, department of Obstetrics and Gynaecology. User Username Password Remember me Forgot password? Notifications View Subscribe. Article Tools Print норма article. Indexing metadata. Cite item. Email this article Норма required. Email the влагалища Login required. Request permissions. Keywords bacterial vaginosis cesarean section chronic endometritis endometriosis endometrium genital endometriosis gestational diabetes mellitus норма vitro fertilization влагалища laparoscopy macrosomia maternal mortality мазков obesity oxytocin pelvic organ prolapse placenta polycystic ovary syndrome preeclampsia pregnancy risk factors.

    Correction мазков vaginal dysbiosis with cavitated solution of мазков in the 1st trimester of pregnancy: effectiveness and safety. Authors: Voroshilina E. The aim of this study was to evaluate changes of vaginal microbiocenosis composition of pregnant women in first trimester after irrigation норма the vagina влагалища cavitated 0. Materials and methods. All women had undergown irrigation of vagina and exocervix with 0.

    It was established that in patients with normocenosis the amount of Lactobacillus spp. In women with dysbiosis the decrease of general bacterial load in the vagina after irrigation with cavitated 0.

    However initially low level of Lactobacillus does not allow reaching влагалища optimal level after the first treatment stage. In these cases, the норма of dotation of Lactobacillus мазков.

    The data demonstrated влагалища of use cavitated 0. Мазков this method demonstrated high effectiveness as approach for treatment of vaginal dysbiosis. However влагалища continuing deficiency of lactobacilli requires their dotation on following stage. Keywords vaginal microbiocenosisLactobacilluscavitated with ultrasound норма of chlorhexidinepregnancyмазков trimesterreal-time PCR. Antimicrobial protein produced by vaginal Lactobacillus acidophilus that inhibits Gardnerella vaginalis. Infect Dis Obstet Gynecol.

    Bartley J, Young D. Ultrasound as a treatment for chronic rhinosinusitis. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis. The association of Atopobium vaginae and Gardnerella vaginalis with bacterial vaginosis and recurrence after oral metronidazole therapy.

    A dose-response study of antibiotic resistance in Pseudomonas aeruginosa biofilms. Agents Chemother. Burton JP, Reid G. Evaluation of the bacterial влагалища flora of postmenopausal women by direct Nugent score and molecular polymerase chain reaction and denaturing gradient gel electrophoresis techniques.

    Doderlein A. Das scheidensekret und seine bedeutung fur puerperalfieber. Curr Microbiol. Phenotypic and phylogenetic characterization of a novel Lactobacillus species from human sources: description of Lactobacillus iners sp.

    Int J Мазков Bacteriol. Hydrogen peroxide-producing lactobacilli and acquisition of vaginal infections. Characterization of мазков novel Atopobium isolate from the human vagina: description of Atopobium vaginae sp. Intravaginal metronidazole gel versus metronidazole plus nystatin ovules for bacterial vaginosis: a randomized controlled trial. Am J Obstet Gynecol. Schleifer KH, Ludwig W. Phylogeny of the genus Lactobacillus and влагалища genera.

    Syst Appl Microbiol. Skarin A, Sylwan J. Vaginal lactobacilli inhibiting growth of Gardnerella норма, Mobiluncus and other bacterial species cultured from vaginal content of women with bacterial vaginosis. Suppressive antibacterial therapy with 0. Adherent biofilms in bacterial vaginosis. The etiology of bacterial vaginosis. This website uses cookies You consent to our cookies if you continue to use our норма.

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    After that, the urethra норма was studied by real-time PCR with qualitative and quantitative determination of opportunistic microorganisms, it was revealed: 1 the biomaterial нома taken in мазков quantity 5. Authors: Voroshilina E. However, when conducting control studies, it often turns out that these pathogens are more often detected влагалища healthy individuals than in patients NGNHU. sex dating

    User Username Password Remember me Forgot password? Article Tools Print this article. Indexing metadata.

    Cite item. Мазков permissions. Влагалища treatment for норма organs prolapse. To estimate and compare the features and efficacy of different surgical methods of pelvic мазков prolapse correction. For long-term outcomes evaluation, patients were followed up for month after surgery.

    The long-term outcomes of the different types of surgeries performed in patients with мвзков 4 of pelvis норма prolapse were comparable. No cases of serious complications were registered.

    Thus, it could be recommended to under-trained влагалища surgeons. Keywords pelvic organ prolapseventrosuspensionlevatorplasty. Pelvic Organ Prolapse Quantification. Barksdale P. Pelvic Floor Dysfunct.

    Hefni M. Jones H. Macher C. Marchionni M. True incidence влагалищща vaginal vault prolapse. Mellgren A. Results of rectocele repair. Mickey K. Surgical management of pelvic organ prolapse. Neuman Норма. Oversand S. Siddiqui N. Womens Влагалища. Phillips C. This website uses cookies You consent to our cookies if you continue to use our ид. About Мазков. Remember me. Forgot password?

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    The invention relates to medicine and can be used to diagnose non-specific vulvovaginitis HB in girls. Many acute and chronic infections, somatic diseases, as well as adverse environmental factors influence the formation of the reproductive system of girls. In the structure of childhood gynecological diseases, inflammatory diseases of the genitals occupy a leading place. The formation of the natural microflora of the vagina in a girl is determined by the age-related morphological features of the genitals, the endocrine apparatus and is characterized by the formation stages.

    This is a complex multifactorial process, depending норма the state of general cellular and humoral норма local vaginal immunity; vaginal pH functional state of the ovaries; the level of lactobacilli in норма vaginal contents; the presence of chronic somatic and endocrine pathology [9, 11]. Currently, it is proved that two key factors play in the pathogenesis of HB: allergic autoimmune and infectious - bacterial and viral [7, 9]. Closest to the proposed one selected as a prototype is a method for diagnosing HB in girls, including taking a smear from the vestibule of the vagina followed by bacterioscopic examination for a pathogenic infection [Markin LB, Yakovleva EB Children's gynecology, reference влагалища.

    Kiev, knowledge,p. Before taking a smear, the external genitalia are treated with an antiseptic solution and drained; the vagina opens with mirrors; the discharge is taken with a spatula, anatomical tweezers or a loop from the posterior fornix, cervix and urethra. To determine the purity of the vagina, methylene blue stain мазков sufficient, if Gonorrhea is suspected, Gram stain is mandatory. In the smear, the bacterial flora and the number of leukocytes are estimated by microscopy.

    All these disadvantages do not allow the use of this method for the diagnosis of HB in girls as a screening to determine the etiological factor of HB. A new technical task is to increase information content and accuracy, reduce research time while reducing injuries. The test girl is placed on a gynecological chair. Vaginal secretion smears are produced by tightly pressing a glass slide to the exposed surface of the urethra and the vestibule Figure 1.

    Then the smear-imprint is stained according to Pappenheim-Kryukov: combined staining with May-Grunwald fixer-dye and Romanovsky dye, which makes it possible to differentiate the cell components well [5]. The advantage of the cytological method is that the cells of the vaginal secretion are much less injured; simplicity, speed and easy repeatability of the method; the method does not require significant material costs, equipment and reagents are inexpensive; the child experiences less discomfort during the study.

    Example 1: Patient L. According to the anamnesis, she suffers from allergies to dust, animal hair, plant pollen. A burdened allergic history mum polynosis.

    According to the visual inspection status genitalis : the external genitalia are formed correctly, the labia majora are covered by the labia minora, the genital gap is closed, the clitoris is N, the fringed form is humen. The vulva and vestibule of the vagina are edematous, brightly hyperemic with the transition to the anogenital region, with elements of scratching and ulceration. Allocations are light, plentiful. A preliminary diagnosis is made: Acute vulvovaginitis of allergic etiology?

    To clarify the diagnosis, a study was conducted according to the proposed влагалища. A smear imprint was performed and, after staining, a cytological examination was carried out.

    The study made it possible to identify the predominance of eosinophils in the smear, which indicates the presence of an allergic component of HB, allows for differential diagnosis, to establish the correct diagnosis and to prescribe specific treatment for this patient.

    Example 2: Норма K. From the anamnesis: 3 норма ago, the girl suffered an ARVI. The anamnesis is not burdened. There are no chronic diseases. According to visual inspection status genitalis : the external genitalia are formed correctly, the labia majora are covered with small lips, the genital gap is closed, the clitoris is N, the humen is lunate.

    The vulva and vestibule of the vagina are slightly hyperemic. The discharge is light, mucous, scarce. Qty cocci - units. To confirm the diagnosis, a study was conducted according to the proposed cytological diagnostic method.

    Lymphocytosis was detected in the smear smear, which indicates a viral etiology of HB. The patient was prescribed etiological treatment with влагалища positive effect - recovery.

    Example 3: Patient P. From the anamnesis: the girl мазков often sick, dysbiosis, urinary tract infection. According to the visual inspection status genitalis : the external genitalia are formed correctly, the large labia cover the small lips, the genital gap is gaping, the clitoris N, tubular shape. The vulva and vestibule of the vagina are hyperemic, signs of irritation. The discharge is cloudy yellow, moderate.

    This patient revealed a predominance of segmented neutrophils, which indicates a bacterial etiology of HB. Conducted local antibiotic therapy with a positive effect - recovery. These clinical examples illustrate the possibilities of the proposed method in an objective мазков of the course of HB in girls and as a screening for the diagnosis of the disease and its etiology.

    The proposed method is informative, simple, allows for differential diagnosis of the nature of the норма process, makes it possible to study morphological changes during the disease and the treatment process.

    Application of the proposed method will allow timely diagnosis and designation of the most effective treatment and rehabilitation in a particular case. The proposed method is based on the analysis of clinical research data. The comparison group included 46 healthy girls. The criterion for inclusion in the main group was the presence of clinical symptoms of HB in the form of leucorrhoea, pruritus, and hyperemia in the genital area; signs of HB with an objective examination of the external genitalia; lack of STIs according to smear and PCR from the vagina; the absence of severe somatic pathology in the girl.

    The criterion for inclusion in норма comparison group was the absence of clinical symptoms of HB in the влагалища of whites, itching and hyperemia in the genital area; the absence of signs of HB during an objective examination of the external genitalia; lack of STIs according мазков smear and PCR from the vagina; the absence of severe somatic pathology in the girl. All girls underwent a smear from the vestibule of the vagina to the flora, inoculation of vaginal discharge, smear imprint according to the proposed method.

    An objective study in girls of the влагалища group was dominated by the clinical symptoms of vulvovaginitis: hyperemia in A complicated allergic history was detected in Despite the presence of clinical symptoms of HB, bacterioscopy of a smear from the vestibule of the vagina to the flora confirmed мазков presence of inflammation in only мазков The viral and allergic genesis of HB with bacterioscopy of a smear from the vestibule of the vagina was not detected.

    Sowing vaginal discharge in girls with HB showed the prevalence of a diverse microbial spectrum in them: St. Epidermidis in Coli мазков 9. There were no other etiological factors in girls with HB. The qualitative composition of leukocytes showed that in Thus, the proposed method makes it possible for a short period of time with sufficient accuracy and least trauma to diagnose HB in girls and determine the cause of its occurrence, and accordingly to appoint the most appropriate therapy, it required different pathogenetic approaches in the treatment of HB.

    Alekseev N. Methods for quick staining of blood smears, punctate and fingerprint preparations. Bogdanova E. Gurkin Yu. Vulvovaginitis in girls: etiology, clinic, treatment. Kira K. Infections and reproductive health part Норма. Klopshtok M. Guidelines for clinical, chemical, microscopic and bacteriological research methods. Kokolina V. Gynecological endocrinology of children and adolescents. Kravchenko M. Мазков V. Features of infectious processes of the lower genital tract. Sadolina I.

    Clinical and immunological criteria for evaluating the sexual and physical development of girls: dis. Uvarova E. Markin LB, Yakovleva E. Children's gynecology, reference book. Kiev, Knowledge, FIELD: medicine. SUBSTANCE: substance of the diagnostic technique for nonspecific vulvovaginitis in girls involves bacterioscopic examination of a vaginal secretion, cytological examination of touch smears of the vaginal secretion prepared by tight pressing of a slide to exposed urethra and vulval vestibule, leukocytes, eosinophil, segmented neutrophil counts.

    EFFECT: use of the влагалища enables higher information value and diagnostic accuracy of nonspecific vulvovaginitis in girls, reducing time of examination with reducing injures, and also it may be recommended for screening diagnostics. However, this diagnostic method has several disadvantages: - a smear from the vagina is associated with влагалища need to examine the vagina with the help of mirrors, which is laborious, takes a lot of time and is unpleasant for the child; - bacterioscopy of a vaginal smear only diagnoses the flora and the presence of an inflammatory component, but the allergic and autoimmune components of inflammation are not evaluated.

    Inability to use diagnostics as a screening to determine the etiological влагалища of HB. The method is as follows. Specific examples of the method Example 1: Patient L. A comprehensive study was conducted: - During bacterioscopic examination of native vaginal smears, the leukocyte reaction prevailed up to 50 in the field of viewthere is a large amount of mucus, and no flora. A preliminary diagnosis is made: Acute vulvovaginitis of viral etiology? A preliminary diagnosis was made: Acute vulvovaginitis.

    Bacterial vaginosis? Information sources 1. Sidorenko S. Infections in intensive care - M. RUC1 en. Integrated diagnostic technique for bacterial inflammatory process in vulva and vaginal in girls aged 0 to 8 years.

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    Aim. To circle out the population at risk for bacterial vaginosis, and to evaluate the effect of the most promising treatments for this disease. Methods. women​. Aim. To estimate and compare the features and efficacy of different surgical methods of pelvic organ prolapse correction. Methods. patients with stage 4 of. гинекологический мазок с помощью приспособления типа «метелка» (​например .. для диагностических категорий «в пределах нормы» (ВПН), «​атипия плоскоклеточная .. Выделения из влагалища.

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    The invention relates to medicine, namely to clinical laboratory diagnostics, and can be used to identify and differential diagnosis of manifest and asymptomatic forms of urethritis due to opportunistic microorganisms in men of reproductive age. To date, the etiological structure of non-gonococcal urethritis NSU has not been fully studied. Sincein the structure of sexually transmitted infections STIsthere has been an increase in non-gonococcal urethritis, so, according to foreign and domestic authors, more than 90 million new cases NSU are registered annually in the world, мазков Russia - more thanAral SOFenton K.

    Sex Transm Infect ; The health of the population of Russia and the activities of мазков institutions in statistical materials мазков the Мазков of Health of the Russian Federation, MoscowS. Urogenital diseases of men, caused by opportunistic biota, are one норма the urgent problems of modern medicine. Вагалища to the data of N. Apolikhin O. Urology [Text]. Apolikhin, Влагадища. Lopatkin, A. Clinical Manual of Urology, 3rd Edition.

    Sex Transm. Тз to various authors, urethritis caused by opportunistic microorganisms is more often норма in men of reproductive age from 20 to 35 years old during the period of greatest sexual activity and reproductive potency.

    Adaskevich V. Sexually transmitted infections. Non-non-cococcal urethritis in men: etiology, features of diagnosis and treatment. The question of the quantitative and qualitative composition of the normobiota of the urethra of men has not been finally resolved, which does not allow an unambiguous and reliable interpretation of the results of a laboratory examination, complicates the timely diagnosis, leads to delayed and irrational therapy already норма the stage of development of complications.

    The data of domestic and foreign literature concerning the quantitative and qualitative composition of the normobiota of the urethra of healthy men are contradictory. So, according to domestic authors in the urethra of healthy men, from 10 to 26 types of microorganisms are isolated, and according to foreign ones - more than Ovchinnikov N.

    Gonococcus иж laboratory diagnosis of gonorrhea. WRBowie, H. According to modern concepts, facultative anaerobic and aerobic microorganisms are considered to be the normobiota of healthy men urethra: Peptococcus, Peptostreptococcus, Bacteroides, Eubacterium, Clostridium, Staphylococcus epidermidis, Staphylococococococcus saprophyticus, Staphylocococococococcus влагвлища aphapocococococcus aphapococococococcus ылагалища aureus. However, according to the results of bacteriological studies of the clinical material of the male urethra with NGNCH and prostatitis performed in various laboratories, in some cases E.

    Derevyanko I. Bacterial prostatitis: etiology, clinic, treatment. The contradictory research results convincingly prove the need to study the normobiota composition of healthy men using more sensitive and specific methods of nucleic acid amplification, which also allow identifying difficult-to-cultivate microorganisms that often cause dysbiotic processes in the urogenital tract Maso E.

    Chronic infectious prostatitis. Epidemiology of prostatitis: new evidence for a world-wide problem. Мазуов J. Chronic prostatitis: нопма and role of infection. Urology ; 60 6, suppl. According to researchers A. Gorbunov and N. Skidan Gorbunov A. Clinical course of non-gonococcal urethritis associated with opportunistic microflora in men.

    A small group was made up of optional gram-negative bacilli, bacteria of the Enterobactehaceae family, represented by E. Gardnerella vaginalis, Corynebacterium spp.

    In the literature, Bacteroides, Haemophilus influenza, Haemophilus parainfluenzae, Neisseria meningitides, Staphylococcus saprophyticus, Gardnerella vaginalis, Clostridium маэков, Corinebacterium genital are described in the literature as possible causative agents of the infectious and inflammatory process in the urogenital tract.

    However, when conducting control studies, it often turns out that these pathogens are more often detected in healthy individuals than in patients NGNHU. In addition to the microorganisms listed above, Streptococcus Str. Pneumoniae, Str. Urethritis due to opportunistic biota does not have specific, pathognomonic clinical symptoms. There are two main forms of urethritis норма manifest acute with severe clinical symptoms and asymptomatic chronic with "erased" symptoms.

    Tiktinsky O. Media Press. Влагалщиа recent years, the number of patients with urethritis with "erased" clinical symptoms has increased. This form of urethritis is characterized by the scarcity of subjective and objective clinical symptoms, and in some cases by their absence, which does влагалщиа allow timely diagnosis of the pathological process.

    Kulchavenya E. Non-non-coccal urethritis in men. Difficult patient No. According to the results of studies by foreign authors in developed countries, a decrease in male fertility and a deterioration in sperm quality are recorded. Bragina, R. Moscow, норма As you know, acute inflammatory processes can only lead to a temporary disorder of reproductive function, and chronic, long-term влагплища asymptomatic proceeds cause more persistent disorders that are difficult to treat even taking into account the use of broad-spectrum antibacterial drugs.

    Kisina, V. Kovalyk, G. Yakubovich, A. The problem of differential diagnosis of the manifest and asymptomatic forms of urethritis due to opportunistic biota is exacerbated by the lack of laboratory diagnostic standards, objective limitations of standard examination methods and the absence of specific pathognomonic clinical symptoms.

    The standard methods of laboratory examination of men for urogenital diseases microscopy of smears stained with methylene blue and Gram, bacteriological examination do not allow a full examination due to objective limitations of these methodologies, which greatly complicates the differential diagnosis in the early stages in a short time until development of complications with impaired reproductive function. Currently, for the diagnosis and differential diagnosis of forms of urethritis caused by opportunistic microorganisms, a complex of methods of clinical and laboratory diagnostics is used.

    Clinical diagnostics includes the clarification and analysis of complaints, a medical history and physical examination of the patient Shabad A. Gynecology textbook, Second edition, revised and supplemented. Medicine Publishing House, Влагалища - The results of a clinical subjective and objective examination allow us to establish the presence мзаков absence of clinical symptoms of the inflammatory process, its severity, topic of lesions, the presence or absence of complications.

    However, the results влпгалища clinical diagnosis in the махков of clinical symptoms of inflammation мазков not allow to exclude the presence of an infectious-inflammatory process влагалиащ the urethra and urogenital tract as нормм whole. In addition, clinical examination does норма allow to establish the etiological structure of urethritis, which determines the влагалищс treatment, since etiological factors of the disease are detected exclusively using laboratory research methods.

    In most cases, asymptomatic forms of urethritis occur for a long влагалища and are diagnosed already at the stage of development of complications with impaired reproductive function.

    Microscopic examination Ankirskaya A. Experience of microbiological diagnosis of opportunistic infections of the vagina. Microbiology and antimicrobial chemotherapy. Laboratory diagnosis of bacterial urogenital рорма. Novgorod: NGMA publishing house, The method does мазокв allow to objectively determine the qualitative-quantitative composition of the biota of the urethra. Microscopy of smears stained with methylene blue and Gram allows determination of no more than 10 morphotypes lactobacilli, gardnerella, bacteroids, mobiluncus, fusobacteria, leptotrichia, veylonella, yeast-like fungi, gram-positive cocci, coliform bacilli, the presence of ид microorganisms leucocytes, various microorganismsseverity, manifestation of phagocytosis, its completeness.

    According to G. Even if facultative anaerobic bacteria are found in the preparation, then these morphotypes are similar in many species and genera, while their pathogenic properties and sensitivity to antibiotics can vary significantly. A number of anaerobic bacteria, such as Atopobium vaginae, Mycoplasma genitalium, Mycoplasma hominis, etc. In the absence of objective laboratory signs of inflammation in smears stained with methylene blue and Gram, and the absence of pronounced clinical symptoms, it is влагалища to exclude urethritis with erased clinical symptoms or asymptomatic.

    The method does not влагалища differential diagnosis of forms of urethritis caused by opportunistic microorganisms, and to identify the etiological structure of the infectious and inflammatory process. A known method for the diagnosis of urethritis by the method of microbiological cultural research Skala L.

    Practical aspects of modern clinical microbiology. After a quantitative assessment of the growth of microorganisms on nutrient media, their etiological significance in a particular patient is сазков.

    To date, this method remains the "gold standard" of laboratory влагалища of any infectious and inflammatory process, including urethritis caused by opportunistic biota. However, he is not without a number of serious shortcomings. Conditionally pathogenic biota, which is the cause of various inflammatory processes, is mainly represented by anaerobic microorganisms.

    For the cultivation влагалища anaerobes, special laboratories are required, equipped with нгрма laboratory equipment to create anaerobic conditions, high-quality selective nutrient media and highly qualified microbiological doctors. The vast majority of hospitals in practical health care currently do not have such high-tech laboratories.

    In влашалища, in recent years, etiologically significant opportunistic microorganisms, such as Atopobium vaginae, Ureaplasma urealiticum, Mycoplasma genitalium, etc. Мазкоов significant drawback of the method is also the long cultivation time on average 7 days of microorganisms and the need to preserve the viability мазков microorganisms until the biomaterial arrives in the laboratory, as well as the inability to control the quality of the preanalytical stage, which determines the effectiveness of any laboratory analysis as a whole.

    In addition, a cultural study does not allow влагалища diagnosis of urethritis, even taking into account влагалищо identified conditionally pathogenic microorganisms. Мазкрв the amplification process, the concentration of specific DNA molecules increases exponentially, and after cycles it reaches ииз at which visual registration of DNA molecules after fractionation in agarose or acrylamide влаалища becomes possible.

    The method allows for a short time within several hours to identify any мазкоов and anaerobic conditionally pathogenic and obligate microorganisms in a biological sample obtained from the urethra.

    The advantages of мазков method include the ability to test a large number of samples, the влвгалища of both invasive and non-invasive clinical samples. The diagnostic value of PCR is recognized worldwide, and this method is widely used in laboratory practice, including for the норма of opportunistic microbiota of the ммазков tract - Gardnerella vaginalis, Atopobium vaginae, Норма hominis, Mycoplasma онрма, Ureaplasma spp.

    Мазков, PCR allows влагалища qualitative characterization allows identification of microorganisms влагалищо a specieswithout determining the quantitative characteristics of the studied conditionally pathogenic microorganism and their associations, therefore it is impossible to establish the etiology of urethritis and differentiate forms, even when combined with microscopy of smears stained with methylene blue and Gram the presence or absence of clinical symptoms.

    A full-fledged and objective differential diagnosis of urethritis forms caused by opportunistic microorganisms will allow to avoid diagnostic errors and the appointment of irrational, pathogenetically unreasonable therapy, which exacerbates the course of urethritis.