In contrast to gonococci, affecting mainly cylindrical epithelium, Trichomonas damage only squamous epithelium (WHO, Geneva, 1984). Men Trichomonas spread urethral mucosa, penetrate into her breast and the gaps. Because of the frequency of invasion of prostate trichomonads Crowiey (1964) proposed to call them Tr. prostatialis, but trichomonads do not usually cause clinical symptoms of prostatitis. Such asymptomatic carriers of trichomonas in the prostate gland GA Resurrection (1969) found in 27.8% of the examinees, D. Tsvetkov, PLN. Peycheva (1981) - in 29,6%. However, in men the main habitat of trichomonads is the urethra, and for women - the vagina, where the most frequently detected parasites [Turanova EN et al, 1971]. A. Tsvetkov, H. Christ (1985) emphasize that none of the women they surveyed did not have an isolated lesion trichomonads urethra, which indicates that its secondary infection from the vagina. Occasionally Trichomonas in women being introduced into the bladder, uterus. From the cervical canal trichomonads isolated no more than 13% of cases [Rein, Muller, 1984]. The bottom-up process developed in 14-19% of patients with trichomoniasis women [Resurrection GA Naftoleva YO, 1974].In some cases, trichomonads were inoculated from remote fallopian tubes and piosalpinksa [Jirovec et al., 1958; Sebek, 1972].
The pathogenesis of trichomonads cell damage is unclear, but found that it occurs only in direct contact with the parasite host cell. Toxin trichomonads do not form. Killed cultures of trichomonads do not cause an inflammatory reaction at the inoculation into the urethra [Lanceley, McEntegart, 1953].
In the urogenital trichomonads that are more or less pronounced inflammation, but often their presence is not accompanied by any symptoms (asymptomatic infection). Sometimes the parasites in the genitals, especially in men, killed immediately or after a short time (transient carriage). The reasons for a carrier is not installed. Possibly play a role here are some random things: mechanical removal of the urine had not managed to be fixed to the epithelial cells of trichomonads, the presence of chemicals or metabolites that inhibit parasites, etc. It is not excluded and the immune immunity in individuals.
The patients had been ill and trichomoniasis formation of various serum and secretory antibodies, but they are not able to provide the immune system and prevent re-infection. "Low levels of immune response typical of this disease, most likely due to the nature of the interaction of the parasite with the host, as in this case there is no invasion of tissue or release of toxic or antigenic products" (WHO, Geneva, 1984).
The clinical picture of trichomoniasis depends on the virulence of the pathogen, and the reactivity of the human body. As with gonorrhea, distinguish recent disease with acute, subacute and torpid (oligosymptomatic) over, chronic trichomoniasis (with disease duration more than 2 months) and asymptomatic trichomoniasis.
The latent period for infection of men with pure cultures of Trichomonas in the urethra was 6-9 days [Lanceley, McEntegart, 1953]. According to clinical observations, the duration of incubation in both men and women ranging from 3 days to 3-4 weeks, averaging 10-14 days [Baksheev NS, Padchenko IK, 1971, Semenov PP, Semenov . VP, 1972, Ilyin I., 1983]. Sometimes reported an unusually long incubation period. Apparently, in such cases it is more of an aggravation malosimptomno process influenced by various endogenous and exogenous factors. For example, it is known that menstruation and pregnancy often cause severe outbreak of trichomoniasis.Aggravation torpid urethritis in men may be due to sexual excesses or irritating effects of alcohol.
