Ureaplasma

[chfquestion]

Hello Doctors,

I am a 31yr old male, married and living in Switzerland. Last week I went to the hospital to have an STD test from which I got the results today. I had an exam based on blood and urine and all the results came back negative, however the doctor told me that there was a bacteria found in my urine called Ureaplasma and that needed to be treated to avoid a future infection. I was a bit surprised to hear this, as I had never heard this STD before. In addition, I was surprised when the doctor when about to prescribe the antibiotics for the treatment. She said that she needed to find out what would be the right one to prescribe as sometime the bacteria is resistant to the treatment, and that she would do a couple of tests before giving me the prescription. I am wxpecting her to come back to me in a couple of days to give me the prescription. My questions are the following:
1. Is this an STD and should I be concern about a possible infection/complication?
2. The doctor this mention that infections happened less often in women as this bacteria might be part of the flora. Should my wife be teested for Ureaplasma? Could I have passed to her? This is of course my greatest fear. Should we start using condoms until she gets tested?
3. I do not have any symptoms today and have never had. Should you recommend to follow the antibiotic treatment or would this be an over reaction?
4. If I don't do the treatment should I be on the alert for the future incase there are symptoms or this should not be a concern?
5. Is there any scientific reason why these are tested for in EU and not in the US?

Thank you

[amy_au]

A related discussion, Ureaplasma Urealyticum was started.

[Edward W Hook, MD]

Anyone who wants to take antibiotics can.  I doubt thatthey will have any benefit for you or, should she take them, your wife.  EWH

[chfquestion]

Thank you again. If I take the antibiotics, can my wife take them wtih me? or are these antibiotics suitable only for me? Thanks

[Edward W Hook, MD]

No, stomach queasiness in not described as a symptoms or ureaplasma.  My honest opinion is that you are overthinking this and personally I would not worry.  EWH

[chfquestion]

Thank you for your note. I have an additional question to make. Since yesterday I have been feeling kind of like a heaviness in my stomach not sure if it is my stomach or my blader. It's not pain but it is kind of a bothering feeling almost like a burning feeling as if I had not eaten. Could this be realted to Ureaplasma?
I do not have a ny other symptom and it does not bother me when I urinate, everything else is normal. But I just find it weird that I get this strange feeling now and therefore makes me think that might be related to Ureaplasma.
I would appreciate if you can tell me what you think about this and provide some clarity if at all this might related to Ureaplasma or not. Thank you.
  

[Edward W Hook, MD]

thanks for the clarification. With that as background, I would say that there is a strong possibility that your positive test does not reflect something that you acquired from your casual partner and that it is not causing disease.  I have my doubts as to what benefit you might derive from treatment.  In answer to your specific fllow-up questions:

1.  Se above.  i do not see a need for immediate treatment.
2.  Yes, there is a strong possibility that the Ureaplasma detected is part of your body's normal bacterial flora.
3.  Yes, it is possible and even likely that you had Ureaplasma before the encounter you describe.

I hope my comments help.  I would not treat you based on what you have told me.  On the other hand, I am sure there are others who would be willing to do so. Should you choose that course, there is also a substantial chance that the Ureaplasma would not be eliminated by therapy.  EWH

[chfquestion]

Doctor,
Thank you for your answers. The background for me do a STD test was because I made the mistake of having unprotected sex with a friend (female) of mine. Therefore the need to go and have a check on STDs. Even though this is someone I know fairly well I decided to get checked to be sure. This mistake happenned only once. Furthermore, the Dr. I went to see is not a regular doctor as I just went to the local hospital for the STDs tests. The Dr.  did not provide further information, except for mentioning that I was negative for al the STDs from blood and urine samples, and that there was only a bacteria found in my urine and that it would be good to eliminate it with antibiotics.

But I wanted to add that I am left with mixed opinions/feelings about this. On one hand from reading articles in this website and others, I understand that this is not a disease nor something one should worry about. In fact, I have read in a few articles that this bacteria is part of our body and therefore in some clinics/hospitals is not checked for neither treated.
On the other hand, I get the impression that this IS a disease and that should be treated, even if the treatment might not eliminate Ureaplasma completely or forever (?). Therefore I am having troubles as to how to take this. (1) Is this something I should be concerned and stressed about it? Something I should treat inmediately?

I guess with all this I am just trying to clarify how should think about this. As I mentioned in my previous note, I am healthy and I do not have any symptoms (if I understand them correctly, for Ureaplasma they would be: irritation when urinating, discharge and pelvic pain) and have been for the most part monogamus and careful about sex when I was single. My second question would be (2) Can I just assume that Ureaplasma is part of my body and carry on as normal without any treatment? Is this valid?
(3) Is it possible that I had this Ureaplasma before this mistake I made and I did not know it? My wife and I have never had a common test for STDs.

Thank you for your anwers and advice.

[Edward W Hook, MD]

Good questions.  The role of Ureaplasmas as STDs is controversial.  Over 30 years ago studies showed that following the initiation of sexual intercourse Ureaplasmas begin to be found in the genital tract.  Whether or not they cause disease is controversial with some feeling that they do, others feeling that they don't and still another group of experts feeling that while low concentrations of Ureaplasmas may be normal for the genitourinary system in low concentrations. Larger concentrations are not and can be associated with symptoms.  All of this is further complicated by the fact that there are several different types (species) of Ureaplasma and some investigators have suggested that some species cause disease while others do not.  Yet one other complication is that Ureaplasmas may be difficult to culture and even when cultures are done, telling which species is present is even more difficult.  As a result of this profound lack of information, since most U.S heath care providers do not know how to use the information if they got a positive culture for Ureaplasma, the approach has been to make this a research topic and to not use Ureaplasma culture data to guide therapeutic decision making and to leave the topic to researchers (who have not given a clear answer on this to date, despite many studies.)  In contrast, some European experts choose to look for the organism and treat based on its presence.  Personally, I am interested in the ongoing research but also feel that if the organisms clearly caused disease, the research might have already proven this.  With that as background, let's go to your questions and then I will provide a few more words of advice.

1.  See above.  It is not surprising to me that you have positive tests for Ureaplasma,.  whether or not it is causing disease is less clear.  You do not mention whether or not you have reason to be concerned about STD, giving me little context in which to comment on your positive tests.
2.   I appreciate your concern for your wife.  My advice would be that if you and your doctor start therapy, it may be best for also to be treated at the same time, irrespective of what tests might show for her.  Thus, personally, I see no reason for her to be tested.
3.  the issue of whether or not you should be treated is something that you and your doctor should discuss.  I do not know what lead to the STD testing but I can tell you that STDs can certainly be present without symptoms.  It would be improper for me to give you an opinion on this over the internet.  On the other hand, I have no objection with your discussing this with your doctor and, if fact, would encourage it.
4.  See no. # above.  If you are at risk and have the onset of symptoms you should discuss them with your doctor.
5.  See my initial paragraph.

I hope my comments on this confusing topic are helpful to you.  The bottom line however is that I recommend that you discuss this situation with your own doctor for the purpose of clarification.  EWH