Herpetic genital infection in women

The main site of primary genital HSV infection in women is the cervix. Most often, herpetic lesions in women are localized on the labia majora and minora (68.6%), in the vulva (41.8%), clitoris (35.7%), vagina and cervix (84.4%).

HSV was isolated from the cervix at the time of primary infection in 88–90% of women with a primary HSV-2 infection who had a vesicular rash on the external genitalia, in 65% with a recurrent episode of HSV-2 infection, and in 80% of women with HSV -1. The majority (89%) of women shedding virus during the initial episode of the disease had changes in the cervix.

A feature of genital herpes (Herpes genitalis) of the female genital organs is multifocality. The pathological process often involves the lower part of the urethra, the mucous membrane of the anus and rectum. Involvement of these organs in the infectious process can occur secondarily, following the onset of herpes of the external genitalia, but it can also occur as an isolated lesion.

Recurrent herpetic infection (RGI) can manifest as vulvovaginitis and cervicitis, causing damage to the uterine mucosa, tubes and appendages. In 83.6% of cases with persistent, treatment-resistant colpitis, cervical leukoplakias, the herpes simplex virus (HSV) is isolated as one of the leading etiological factors of the disease.

According to some data, in 66% of cases in women, herpes infection (HI) occurs atypically. The presence of long-term chronic GI can be discussed based on the characteristics of the clinical course, the presence of herpetic antigen in the epithelial cells of the vulva, vagina and peripheral blood.

Screening women for genital herpes(GG) is carried out in the presence of:

a) rashes, ulcerations in the area of ​​the external genitalia;

b) itching, burning in the vagina and perineal area;

c) for chronic vulvovaginitis, colpitis;

d) with endocervicitis, sluggishly healing and recurrent erosions of the cervix;

e) chronic often recurrent salpingo-oophoritis (inflammation fallopian tubes and ovaries) and endometritis that does not respond to standard antibiotic therapy;

f) in the presence of chronic urethritis, cystitis;

g) condylomas;

h) if there is a history of miscarriages and stillbirths;

i) any cases of suspected genital herpes infection.

1–2% of women presenting to a gynecology clinic, regardless of the underlying disease, have cytological evidence of HSV infection.

Herpes of the external genitalia in women

For recurrent herpes (HR) external genitalia in women, the lesion is located in the external genitalia and perianal area. Herpetic rashes in women occur on the labia majora and minora, pubic area and perineum.

The typical form of RG of the external genitalia is characterized by pronounced symptoms of the disease, the classic development of the lesion (erythema, formation of vesicles, development of erosive-ulcerative elements, epithelialization) and subjective sensations (itching, burning sensation, soreness, malaise). manifests itself as recurring blistering rashes. Pronounced symptoms allow doctors to visually diagnose RGG, prescribe treatment in a timely manner and inform the patient about infectious nature diseases and dangers of infecting a sexual partner.

Herpes of the lower urogenital tract, anal area and rectal ampulla

Damage to the mucous membranes of the vaginal opening, vagina, vaginal part of the cervix, cervical canal, urethra, bladder, anal area and rectal ampulla manifests itself in two clinical forms:

• focal, characterized by the appearance of vesicular-erosive elements typical of herpes simplex mucous membranes,
• diffuse, in which the pathological process occurs as a nonspecific inflammation.

Herpes of the upper genital tract (damage to the uterus, fallopian tubes).

The typical clinical picture of herpetic lesions of the upper genitourinary tract is manifested by symptoms of nonspecific inflammation. Nonspecific herpetic lesions of the internal genital organs are manifested by endocervicitis, cervical erosion, and vaginitis. A number of authors also classify cervicitis without external ulcers as atypical manifestations of GG.

Clinical manifestations of herpetic lesions of the internal genital organs do not have specific features compared to inflammatory processes of non-viral etiology. Typically, patients complain of vaginal discharge, periodic pain in the pelvis, area of ​​the uterus, and ovaries.

Herpetic lesions of the cervix

Herpetic lesions of the cervix can be typical or atypical. IN typical version genital herpes is always clearly visible multiple, rather small, rounded erosions with clear boundaries; the eruptive elements quickly pass the vesicular stage, in which, by the way, these elements are poorly distinguishable without the use of colposcopy. The problem of HSV involvement in development atypical herpetic changes in the cervical mucosa are currently under research.

During colposcopy in the acute period of herpetic infection of the cervix, an ulceration with uneven edges with ichor in the fundus is determined. The evolution of this lesion goes from ulceration with a red bottom to simple erosion until complete disappearance within 3 weeks. Previous changes include small bullous formations, then rounded microerosions, followed by the formation of simple red spots that are similar to local spotted colpitis.

Studies have shown that the release of HSV DNA from the surface of cervical erosion in 60% of cases is accompanied by the replicative phase of GI (replication and assembly of viral particles in infected cells). With erosion and dysplasia of the cervix, HSV-2 is detected in 27.2% of cases directly in scrapings from the mucous membrane of the cervical canal and is accompanied by an increase in the titer of specific immunoglobulins in the blood to diagnostic levels.

The effect of herpetic infection on the condition of the cervical epithelium is of particular importance in women taking oral hormonal contraceptives for a long time. It is known that long-term use of combined steroids to one degree or another enhances the processes of squamous metaplasia, and can also cause the effect of endocervical hyperplasia, and this effect, if it develops, is observed both in the epithelium of the cervical canal and in areas of pseudo-erosion against the background of ectropion, in polyps mucous membrane of the cervical canal. In this regard, taking oral combined contraceptives may be a cofactor in the development of cervical cancer, especially in combination with herpes infection.

Herpetic cervicitis

Currently under the term exocervicitis(ectocervicitis) refers to inflammation of the vaginal part of the cervix. Endocervicitis- inflammation of the mucous membrane of the cervical canal (cervical canal). Concept "cervicitis" combines these two terms.

Herpetic cervicitis is an inflammatory process caused by HSV. The clinical manifestations of herpetic cervicitis are characterized by a variety of manifestations - from mild hyperemia with a small amount of erosion to severe necrotic lesions (cervical erosion is understood as a defect in the epithelium as a result of inflammation). Cervicitis is diagnosed in 70-90% of women with herpetic lesions of the genital organs. The cervix with herpetic endocervicitis is swollen, often has erosions, and bleeds easily during manipulation.

Herpetic endometritis

Endometritis is an inflammation of the inner (mucous) lining of the uterus (endometrium) affecting both the functional and basal layers. Endometritis caused by the herpes simplex virus is a consequence of the long-term persistence (existence) of the virus in the endometrium. Herpetic endometritis, as a rule, occurs with an atypical or asymptomatic course of HS; the typical form is rarely observed (~20% of cases). Clinical symptoms of viral infection of the endometrium are most often absent or appear atypically, which leads to errors in diagnosis and late initiation of treatment.

With herpetic tissue damage, the factors of local and general immunity and the integrity of the epithelial surface are disrupted, which leads to the creation of favorable conditions for the development of other infectious processes.

Clinically, herpetic endometritis most often manifests itself in the second phase menstrual cycle or during pregnancy, which may be due to an increase in the level of prostaglandins during this period or suppression of the T-cell component of immunity, which contributes to the reactivation of HSV that persists in the endometrium. Subclinical latent intrauterine herpetic infection is an important factor in miscarriage. Endometritis of HSV etiology is rare, but these diseases are very dangerous and can cause the death of the woman and the fetus.

The most significant clinical signs of endometritis are:

Perimenstrual bleeding (54.9%);

Uterine bleeding (29.6%);

Chronic pain in the vulva - vulvodynia (42.2%);

Recurrent miscarriage (33.8%).

Herpes of the urethra and bladder (herpetic urethritis)

Herpetic urethritis in women it is subjectively manifested by pain and stinging at the beginning of urination, frequent urge to urinate. 4.8% of women experience very painful urination or urinary retention as a result of infection of the urethra and bladder lining. Normalization of bladder function in patients with urinary retention usually occurs within 6–10 days.

On examination, hyperemia of the external urethral opening and the presence of scanty mucous discharge are observed; With urethroscopy in the anterior part of the urethra, it is sometimes possible to detect small superficial erosions and catarrhal inflammation.

Herpetic cystitis

The leading symptoms of herpetic cystitis are cystalgia, the appearance of pain at the end of urination, and dysuric phenomena. With herpetic cystitis, hematuria (blood in the urine), pain at the end of urination, and pain in the bladder area appear. In a woman, this may be the first and only sign of HSV infection of the genitourinary area. It often occurs in the first 1-3 months after the onset of sexual activity or after a change of sexual partner.

Herpes of the anal area and rectum

The lesion in the anal area usually represents a recurrent fissure, which is often a cause for diagnostic errors. Such patients with an erroneous diagnosis of “anal fissure” end up with surgeons. The itchy form of herpes anus and herpetic lesions of hemorrhoids are also difficult to diagnose.

Damage to the anal area can occur primarily as an independent disease or secondary - as a result of leakage of vaginal discharge and maceration of the anal mucosa if the patient has herpetic colpitis, accompanied by heavy exudation.

When the sphincter and mucous membrane of the rectal ampulla are damaged (herpetic proctitis), patients are bothered by itching, burning sensation and pain in the affected area, small erosions occur in the form of superficial cracks with a fixed localization, bleeding during defecation. Rectoscopy reveals catarrhal inflammation and sometimes erosion.

Herpes of the internal genitalia - subclinical and asymptomatic forms.

For subclinical form herpes of the internal genitalia (vagina, uterus, ovaries, etc.) the patient typically has no complaints, sometimes there are indications of periodically appearing light mucous discharge from the vagina. During a gynecological examination, symptoms of inflammation are not detected. During a dynamic laboratory study of smears of the discharge canal of the cervix, vagina and urethra, an increased number of leukocytes is periodically detected (up to 200–250 or more in the field of view), indicating the presence of an inflammatory process. During a virological examination of smears, the HSV antigen is determined in leukocytes using the immunofluorescence method.

Asymptomatic form herpes of the internal genitalia is characterized by the absence in patients of any complaints about the genital area, objective clinical data confirming inflammation. During a laboratory examination of the discharge of the urogenital tract, HSV is isolated, while in smears there are no signs of inflammation (leukocytosis). The asymptomatic form of herpes of the internal genitalia is detected in 20–40% of women suffering from RH of the buttocks and thighs. This important circumstance must be taken into account when planning pregnancy in women with this form of RGG due to the existing likelihood of developing complications of HSV infection during pregnancy.

According to the literature, in 83.6% of women suffering from treatment-resistant colpitis and cervical leukoplakia, HSV is one of the factors of the disease. It has been proven that HSV can cause the development of endometritis and salpingoophoritis.

Herpetic vulvovaginitis

Women often have herpetic vulvovaginitis, a feature of the course of which is the frequent addition of edema of the affected area. The herpes virus can infect the vulva and vagina in isolation. Infection occurs from patients. Herpetic vulvovaginitis manifests itself as small blisters on the hyperemic vulva. The blisters contain clear, and when a secondary infection occurs, purulent fluid. After 5-7 days, the blisters open with the formation of erosions and ulcers, which are covered with a scab. At the onset of the disease, burning, pain and itching in the vulva area are expressed. Common symptoms include headache, chills, and fever.

In women, the diagnosis of “atypical form of genital herpes” is made by gynecologists to designate a chronic inflammatory process of the vulva in the presence of a laboratory-confirmed herpetic nature of the disease, in contrast to the typical picture of the disease, in which there are lesions with vesicular-erosive elements on the mucous membrane of these organs.

Genital herpes during pregnancy

HSV disease in women during pregnancy can cause fetal death, stillbirth, and premature birth. Herpes viruses cause up to 30% of spontaneous abortions in early stages pregnancy and over 50% of late miscarriages, occupy second place after the rubella virus in terms of teratogenicity (development of fetal deformities).

Treatment of herpetic urethritis is an extremely difficult task, since the disease can be latent. Principles of treatment of genital herpes:

• treatment of the first clinical episode of herpes;
• treatment of relapses;
• long-term suppressive therapy.

• acyclovir 400 mg orally 3 times a day for 7-10 days or 200 mg orally 5 times a day for 7-10 days;
• or famciclovir 250 mg orally 5 times a day for 7-10 days;
• or valacyclovir 1 g orally 2 times a day for 7-10 days.

Treatment of herpetic urethritis should begin as early as possible, immediately after the first symptoms of the disease appear.

If treatment is insufficiently effective after a 10-day course, further use of the drug is possible.

Acyclovir is the drug of choice and usually provides fairly successful treatment. Clinical observations have confirmed the effectiveness of this drug: when used in patients with primary lesions of the genital tract, both the spread of the virus and the severity of clinical symptoms are reduced. The drug is used orally, intravenously, locally (3-5% acyclovir ointment).

Existing methods of treating herpetic urethritis can only stop relapses of the disease, but not eliminate relapses of the disease. Most patients with a first clinical episode of herpes simplex virus type 2 infection then experience relapses of the disease. This occurs less frequently in patients initially infected with herpes simplex virus type 1. Antiherpetic therapy for relapses is prescribed occasionally during clinical manifestations of genital herpes to improve the condition of patients and reduce the duration of relapse. It is prescribed long-term as suppressive therapy, which reduces the number of relapses in patients with frequent exacerbations of the disease (more than 6 times a year) by 70-80%. With this treatment, many patients note the absence of clinical episodes. There is data on the effectiveness and safety of taking acyclovir for more than 6 years and the drugs valacyclovir and famciclovir for more than a year.

Episodic treatment of recurrent genital herpes should begin on the first day of clinical manifestations or during the prodromal period.

• acyclovir 400 mg 3 times a day for 5 days, or 800 mg 2 times a day for 5 days, or 800 mg 3 times a day for 2 days; .
• or famciclovir 125 mg 3 times a day for 5 days or 100" m 2 times a day for 1 day;
• or valacyclovir 1 g 2 times a day for 5 days or 500 mg 2 times a day for 3 days.

In order to prevent recurrence of herpetic infection, suppressive therapy regimens have been developed:

• acyclovir 400 mg 2 times a day;
• or famciclovir 250 mg 2 times a day;
• or valacyclovir 500 mg once daily or 1 g once daily.

Valaciclovir 500 mg once daily may be less effective than other dosing regimens, as well as acyclovir in patients with very frequent disease relapses (more than 10 times a year). This dictates the need to search for more effective methods chemotherapy and specific prevention of this infection.

Etiotropic treatment of herpetic urethritis may also include bromuridine, ribovirin, bonofton, epigen, gossypol, megasil.

In case of recurrent forms of herpes infection, antiviral therapy is supplemented with the administration of immunomodulators (interleukins, cycloferon, roferon, interferon inducers).

For complete remission, vaccination with herpes vaccine and antioxidant protection are required.

It should be noted that when treating children, elderly and senile people suffering from herpetic urethritis, patients with chronic renal and liver failure, including those on hemodialysis, an appropriate adjustment of the dose of drugs is necessary.

Most often it worsens after or before menstruation.

In men - after sexual intercourse.

Secondary herpes is characterized by the same symptoms as primary herpes. The same organs (urethra) are affected, and a rash appears in the same places.

But the symptoms are usually less severe. This is due to the fact that the immune system is already “aware” of the danger and responds adequately to the pathological process.

The self-healing period for secondary herpetic urethritis is reduced to 5-7 days. The period of contagion is also reduced.

The infection often occurs without general symptoms of intoxication or with a slight increase in body temperature. The pathology occurs significantly more severely and longer against the background of immunodeficiency, in older and weakened patients.

Severity of herpetic urethritis

Manifesting herpetic urethritis, depending on the frequency of relapses and the severity of clinical symptoms, has four degrees of severity:

• mild - no more than 4 relapses per year, no fever, no pain, only isolated elements of the rash appear;
• average – 5 or more relapses per year, pain is mild, there are single elements of the rash, there is no pronounced intoxication, a slight increase in body temperature is possible;
• severe - up to 5 relapses per year, severe pain in the urethra, thick rash, increased body temperature to 38 degrees or higher, severe intoxication;
• extremely severe - more than 5 relapses per year, occurs in two stages (first intoxication, then rashes and pain in the urethra), accompanied by high temperature body (up to 39 degrees and above), with damage to several organs of the urogenital tract.

Based on the dynamics of the clinical course and the frequency of exacerbations, the following forms of herpetic urethritis are distinguished:

• arrhythmic – exacerbations occur chaotically;
• monotonous – relapses occur at regular intervals;
• fading - exacerbations occur at gradually increasing intervals (the duration of the remission period increases).

Diagnosis of herpetic urethritis

Laboratory tests are required to diagnose genital herpes.

Virus identification is usually done in one of two ways:

Enzyme immunoassay is the determination of antibodies in the blood.

Antibodies are factors of the immune system that are produced in response to the penetration of a pathogen into the body. Their presence confirms the presence of the herpes virus in the body.

Using the PCR method, the pathogen can be determined in the following clinical material:

• scraping from the urethra (the most informative if herpetic urethritis is suspected);
• blood.

The essence of the study is to determine the DNA of herpes virus types 1 or 2.

Herpetic urethritis: treatment

So far, no treatment has been developed that would completely get rid of the herpes simplex virus. However, there are treatments that improve the patient’s quality of life.

At one time G.B. Elion, the pharmacologist who discovered acyclovir in 1988, received the Nobel Prize. This drug, as well as its analogues (famciclovir, valacyclovir) are still used in the treatment of herpetic urethritis.

They have the same clinical effectiveness. But they differ in the frequency of administration - some drugs are more convenient for the patient.

Purposes of their use:

• reduction of symptoms;
• prevention of the spread of infection in the population;
• reduction in the frequency of exacerbations.

Many treatment regimens for herpetic urethritis have been developed.

The choice of dosage and duration of treatment depends on a number of factors:

• form of herpetic urethritis (primary or secondary);
• its severity;
• presence of concomitant pathology;
• the patient’s condition (somatic diseases, immunodeficiency, age, pregnancy, etc.);
• previous treatment experience;
• laboratory test data;
• the prevalence of herpes (the number of organs that are affected by the pathological process).

If you experience symptoms of urogenital herpes, contact our clinic. We can provide tests to confirm the infection. After receiving their results, an experienced venereologist will prescribe quality treatment.

If you suspect herpetic urethritis, contact the author of this article - a urologist, venereologist in Moscow with 15 years of experience.

The antigen enters a healthy body most often during sexual intercourse, less often - from the toilets of public toilets, from towels and due to poor personal hygiene. It is insidious in that it may not manifest itself for some time. The virus settles in nerve cells and falls asleep for the time being.

Herpetic prostatitis in men is such a rare disease that it has been little studied and is difficult to diagnose. People aged 26 to 56 years are most often susceptible to infection.

Manifestations of the disease

Herpetic prostatitis, although it occurs very rarely, does occur. It never goes unnoticed. The only thing is that the infection may simply be misdiagnosed. And men themselves, for the most part, are in no hurry to seek medical help. The incubation period of the virus lasts about five days, but in a very weakened body it can appear within a few hours.

Many people mistake the symptoms for a common cold and are treated only for it. Herpetic prostatitis can be recognized by the following signs:

• nasal discharge, runny nose;
• possible cough;
• weakness throughout the body;
• apathy, loss of appetite;
• high temperature;
• headache is very bad;
• burning sensation in the perineum;
• severe pain in the pelvic and sometimes in the lumbar region;
• bowel movements may be disrupted (constipation, diarrhea);
• severe pain when urinating;
• temporary sexual dysfunction;
• loss of libido.

Judging by the latest symptoms of herpetic prostatitis, men generally think that age-related changes are beginning, for which they have already prepared in advance and tuned in to them, and many take the first manifestations for ARVI and treat them accordingly.

This is how the infection starts, and in severe cases complications appear. Still, the main reason for the appearance of the disease is a very weak immune system, which is unable to resist the invasion of enemy antigens.

There are two forms of infection:

1. Chronic. These are periodic problems that cause a lot of problems. Not only does treatment for herpetic prostatitis last about a month, but the infection can reoccur up to five times. If recurrences of the disease occur six or more times a year, urgent assistance from a general practitioner and an immunologist is necessary. The symptoms of the chronic form of the disease are mild, but entail irreversible disturbances in the functioning of the prostate: a constant burning sensation, severe discomfort when urinating, noticeable pain in the perineum and lower back during movement and sexual intercourse, and severe sexual dysfunction. Unfortunately, if left untreated, protracted forms of herpetic prostatitis, which can last for years, lead to infertility and impotence.
2. Acute. It goes away with a pronounced clinical picture with burning, itching, temperature, retention and pain of urination, weakness and apathy. If treatment is not started during this period, there is a very high risk that the infection will become chronic. The effect of the virus must be suppressed, although it cannot be destroyed or expelled from the body. - an incurable disease.

The main prevention and an important assistant to treatment is strengthening the immune system.

Viral urethritis in women and men

Herpetic urethritis is also caused by the herpes simplex virus type 2. Infection of a healthy person occurs through sexual intercourse, less often through the toilet and a shared towel, and possibly through dirty hands. Symptoms during primary infection are very acute:

1. The appearance of a rash in men on the penis, in the glans area, in the urethra, on inside foreskin.
2. In women, the rash is localized near the urethra or inside.
3. Unbearable burning sensation when urinating.
4. High temperature.
5. A sharp deterioration in health.
6. General decline in mood, apathy.
7. Periodic unbearable pain in the urethral area.
8. Constant urge to urinate.
9. Persistent feeling of always full bladder.

Herpetic urethritis is diagnosed using urethroscopy; it looks like a cluster of small erosive formations.

Another distinctive phenomenon with herpurethritis is mucous discharge from the urinary canal, especially in the morning. When the infection is advanced, bacteria attach, and then the discharge becomes purulent in nature.

Forms of infection

Depending on the symptoms, the course of the infection is divided into four main categories:

1. Lightweight. When the number of recurrent infections does not exceed four, the rash is minor and there are no other symptoms.
2. Moderate severity. The number of relapses does not exceed four per year, the rashes are profuse, and there are general ailments.
3. Heavy. Characterizes itself as repeating the infection more than five times a year, with a lot of rash and discharge.
4. Extremely severe form very dangerous. This is more than five relapses per year with severe symptoms of intoxication, malaise, pain, and acute inflammation.

Where is the immunity?

During periods of infection, many wonder why the immune system cannot cope with the disease. And the reasons for the lack of immunity in the person himself:

• lack of sleep;
• overwork;
• alcohol and smoking;
• frequent hypothermia;
• overheating;
• traveling to a country with a dramatically different climate;
• avitaminosis.

It is very important to know that the herpes virus is so dangerous and omnipotent that it is not only capable of penetrating the nuclei of human cells, changing their structure and living there permanently, the herpes virus suppresses human immunity during periods of its activation.

Diagnosis of both diseases

Since these are diseases of the genitourinary system, their diagnosis can differ only in the type of biomaterial collected and a number of devices.

Both women and men must undergo a not very pleasant procedure - urethroscopy, in which a specialist accurately determines the presence of a rash, its prevalence and localization.

In addition to these procedures, biomaterial is collected for laboratory research:

• scrapings from the urethra of women and men;
• urine;
• blood from a vein;
• sperm;
• mucus discharge from the urethra;
• purulent discharge.

The main methods for determining the virus in laboratory conditions are as follows:

1. - this is a method in which blood is taken from a vein for analysis in the morning on an empty stomach, then by diluting its serum, the concentration of immunoglobulins is measured, the results are measured in titers.
2. PCR– polymerase chain reaction method; here the biomaterial can be all of the above, with the help chemical reactions determine the presence of the virus.
3. Antigen illumination method– the blood is treated with a special solution, and then illuminated, viral formations are highlighted in a different color.

Effective therapy

Like any other disease, herpetic urethritis and prostatitis are treated depending on the form of the infection. In this case, only a doctor can make a diagnosis, so self-medication is strictly prohibited here.

Treatment for primary infection

If the infection first entered the body and immediately manifested itself, proceed as follows:

1. Prescribed three times a day, course seven days; or five to six times a day for 10 days; or Valaciclovir twice daily for 10 days. These are similar drugs, only the excipients are different.
2. Viferon suppositories with a dosage of 1,000,000 IU are prescribed twice a day rectally. This is an excellent one that not only stimulates the immune system, but also blocks the reproduction of the virus.
3. Acyclovir and Zovirax ointments are prescribed if the rash is external. Apply six times a day in a thin layer on a dry surface.

Treatment of relapses

Mild and moderate relapses are also treated with complex therapy.

1. Acyclovir and Famciclovir are prescribed three times a day for five days in a row, and twice a day for five days.
2. Suppositories Viferon and twice a day.
3. Zovirax ointment, Acyclovir 6-7 times a day.

Suppressive therapy

In this way, protracted, severe herpetic urethritis and prostatitis are treated. It takes a whole year to suppress the virus. In this case, write:

1. Acyclovir 200 mg four times a day for a year.
2. Famciclovir 250 mg twice daily for a year.

Treatment of such diseases begins immediately, no matter the severity of the disease. In advanced cases, the infection can go from a mild stage to a severe one and bring with it bacterial complications.

You should know that antibiotic therapy for herpetic urethritis and prostatitis is prescribed only in severe cases complicated by an associated bacterial infection.

What will help in treatment?

First of all, you need not to lose heart, but to get ready for good treatment.

• get enough sleep;
• rest more;
• lead healthy image life;
• adjust your diet;
• avoid stress.

Consequences of insidious diseases

Unfortunately, it is impossible to say that these are safe infections. They entail a series of unpleasant moments. If effective and correct therapy is not started in time, diseases are fraught with:

1. Male and female infertility.
2. Loss of libido.
3. Inhibition of sperm activity.
4. Sexual dysfunction.
5. Constant problems with urination.