Genital mycoplasma infection is a sexually transmitted disease. Mycoplasma can exist in healthy carriers, with higher detection rates among individuals with multiple sexual partners, homosexuals, sex workers, and gonorrhea patients. Reports from China indicate that the carrier rates in healthy individuals across seven regions were 10.59% for Ureaplasma urealyticum (UU) and 5.34% for Mycoplasma hominis (MH). Among individuals with multiple sexual partners, the detection rates were 71.7% for UU and 19.57% for MH. Studies show that the more sexual partners one has and the higher the sexual activity index, the greater the infection rates of UU and MH.

bubble_chart Etiology

Disease cause:
In adults, it is primarily transmitted through sexual contact, while newborns are infected during childbirth through the mother's birth canal. In adult males, the infection site is the urethral mucosa, and in females, it is the cervix. In newborns, it mainly causes conjunctivitis and pneumonia.

Mycoplasma can only adhere to receptors on the surface of epithelial cells in the respiratory or urogenital tract and does not enter tissues or blood. The reasons mycoplasma causes cell damage are: mycoplasma adhering to the surface of host cells absorbs nutrients from the cells, obtains lipids and cholesterol from the cell membrane, leading to cell injury; toxic metabolites produced by mycoplasma, such as neurotoxic substances produced by neurotropic mycoplasma, cause cell membrane injury; ureaplasma contains urease, which hydrolyzes urea to produce large amounts of ammonia, which is toxic to cells. In addition to adhering to cells and macrophage surfaces, mycoplasma can also adhere to sperm surfaces, thereby inhibiting sperm motility. The neuraminidase-like substances it produces can interfere with the binding of sperm and eggs. This is one of the reasons why mycoplasma infection leads to infertility.

Symptoms

The incubation period is 1-3 weeks, and the typical acute-phase symptoms are similar to other non-gonococcal genitourinary infections, manifesting as urethral stabbing pain, varying degrees of urgency and frequency of urination, and stabbing pain during urination, especially when the urine is more concentrated. The urethral opening shows grade I redness and swelling, with thin and scant secretions that are serous or purulent. Often, secretions only overflow when the urethra is forcefully squeezed. In the morning, there may be a small amount of sticky secretions or only a crust membrane sealing the urethral opening, or the underwear may appear soiled.

The subacute phase is often complicated by prostate infection, with patients frequently experiencing perineal distending pain, lower back soreness, discomfort in the inner thighs, or a stabbing pain radiating from the perineum to the inner thighs during anal lifting movements.
Female patients often exhibit reproductive system inflammation centered around the cervix. Most show no obvious subjective symptoms, but a few severe cases may experience a vaginal heaviness. When the infection spreads to the urethra, urinary frequency and urgency are the main symptoms that draw the patient’s attention. If the infection is confined to the cervix, it presents as increased and turbid leucorrhea, cervical edema, congestion, or surface erosion. If the infection spreads to the urethra, it manifests as redness and congestion of the urethral opening, with a small amount of secretions upon squeezing the urethra, but tenderness is rarely present.

Common complications of mycoplasma infection include salpingitis, and a few patients may develop endometritis and pelvic inflammation.

The treatment is essentially the same as for chlamydia. Doxycycline 100mg orally, twice daily for 7-14 days, or azithromycin 1g as a single oral dose, with a half-life of up to 60 hours, maintaining effective concentrations for 5 days after a single dose; ofloxacin 0.2g orally, twice daily for 7-14 days.