Abstract | Spolno prenosive bolesti vrlo su heterogena skupina bolesti uzrokovana različitim mikroorganizmima, a svima je zajedničko da se prenose spolnim putem – odnosno nezaštićenim spolnim odnosom, čime su pod najvećim rizikom za infekciju adolescenti i mlađi odrasli, tj. spolno aktivne osobe. Navedene bolesti mogu se očitovati širokim spektrom simptoma, od asimptomatske infekcije, blage nelagode s iscjetkom, preko pojave zdjelične upalne bolesti (PID) i tubarne neplodnosti pa sve do karcinoma reproduktivnih organa. Budući da su mahom pogođene osobe u zreloj, reproduktivnoj dobi, jedna od glavnih komplikacija s kojima se oboljeli susreću su problemi s reproduktivnom sposobnošću. Ovaj rad bavi se pregledom osam najčešćih uzročnika spolno prenosivih bolesti (bez HIV-bolesti) – to su Clamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Treponema pallidum, Humani papilomavirus (HPV), genitalne mikoplazme te Herpes simplex virus (HSV), njihovom mikrobiologijom, epidemiologijom, kliničkom slikom, dijagnostikom i liječenjem te stavlja poseban naglasak na njihov utjecaj na reprodukciju i eventualnu pojavu neplodnosti u oba spola. Kao najčešći uzročnici tubarne neplodnosti, odnosno neprohodnosti jajovoda koja ne omogućuje susret spermija i jajne stanice, te time uspješnu oplodnju, pokazali su se infekcija klamidijom i gonorejom, odnosno njihova komplikacija – PID. Trihomonas može poslužiti kao vektor za uzročnike PID-a, HPV je povezan sa razvojem muške neplodnosti, a sifilis i genitalni herpes sa lošim perinatalnim ishodom. Zbog svega navedenog, primarna prevencija ovih bolesti, koja uključuje edukaciju o odgovornom spolnom ponašanju, korištenje kontracepcije i eventualno cijepljenje, kao i što brže započeto antibiotsko ili antivirusno liječenje u slučaju infekcije, ostaju zlatni standard u sprječavanju kasnijih posljedica poput neplodnosti ili neuspješne trudnoće. |
Abstract (english) | Sexually transmitted diseases (STD) are a heterogeneous group of diseases caused by various microorganisms, but with mutual mode of transmission – through unprotected sexual intercourse, which makes adolescents and young adults, ie. all sexually active people, the population at greatest risk of infection. STDs can manifest with a large spectrum of symptoms, from asymptomatic infection, mild discomfort with discharge, through occurrence of pelvic inflammatory disease (PID) with tubal infertility and all up to malignant tumours of genital organs. Since prevalence of STDs is highest in young, healthy adults, one of the most common complications of those diseases is problems with reproduction. This thesis covers eight most common agents of STDs (without HIV-disease) – which are Clamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Treponema pallidum, Human papillomavirus (HPV), genital mycoplasmas and Herpes simplex virus (HSV), their microbiology, epidemiology, clinical presentation, diagnostics and treatment with special review of their influence on reproduction and infertility in both sexes. The most common agents of tubal factor infertility (TFI), ie. obstruction of fallopian tubes which prevents sucessful fertilization, are Clamydia trachomatis, Neisseria gonorrhoeae and genital mycoplasmas through their complication, PID. Trichomonas vaginalis can serve as a vector for agents of PID, HPV is connected with development of male infertility and syphilis and genital herpes are associated with bad perinatal outcome. Due to all presented, primary prevention of these diseases which includes education about responsible sexual behavior, contraceptive use and eventually vaccination if possible and so as fast and effective antibiotic or antiviral treatment in case of infection, remains golden standard for prevention of late complications such as infertility or unsucessful pregnancy. |