РОЛЬ УРОГЕНИТАЛЬНЫХ ИНФЕКЦИЙ В ПАТОГЕНЕЗЕ РАЗВИТИЯ МУЖСКОГО БЕСПЛОДИЯ

Abstract

Вопрос бесплодия на сегодняшний день остается актуальным как в Казахстане, так и во всем мире. На основании данных Всемирной Организации Здравоохранения, ежегодно число бесплодных пар составляет 4-5% от всеобщей популяции. Причин бесплодия - множество. Но одним из острых и первоочередных причин данной патологии является мужское бесплодие, частота возникновения которого составляет 48,8% от общего количества случаев. [1] По данным мировых исследований, в процентном соотношении причины мужского бесплодия составляют: бесплодие неясного генеза - 31,2%, варикоцеле - 14,7%, эндокринные нарушения - 8,45%, инфекции урогенитального тракта - 8,3%, иммунологические факторы - 4,8%, опухоли яичек - 1,17%. [2] The issue of infertility today remains relevant both in Kazakhstan and around the world. The World Health Organization accounts for 4-5% of the general population annually. There are many reasons for infertility. One of the acute and primary causes of this pathology is male infertility, the incidence of which is 48.8% of the total number of cases. According to world studies, the percentage of the causes of male infertility are: infertility of unknown origin - 31.2%, varicocele - 14.7%, endocrine disorders - 8.45%, infections of the urogenital tract - 8.3%, immunological factors - 4 , 8%, testicular tumors - 1.17%. Goal. Establishing the role of individual infections and their association of the urogenital tract in the development of male infertility. Materials and methods. The study was carried out on the basis of the GKP on the REM "City polyclinic No. 26" in Almaty. A retrospective analysis of individual cards of 538 men from 21 to 45 years old who consulted urologists with complaints of urination, pain and discomfort in the anogenital region and above the bosom from January to December 2020 was carried out. The patients were divided into two groups: the first group - 258 men suffering from infertility, and who have other causes of infertility, the second - 280 men with normal fertility. Diagnostic methods were selected: bacterial culture of urine and scraping from the urethra, PCR of urogenital infections. Result: The total dissemination of the urethra in patients of the first group is 3 times higher than in men of the second group. However, we were interested not only in the general dissemination and types of pathogens, as according to the literature [1,2] the most aggressive chlamydia trachomatis and ureoplasm. In our frequency of occurrence of chlamydial infection in both groups was 153 (59.3%) and 23 (8%); mycoplasma - 148 (57.3%) and 45 (16%); ureaplasma - 137 (53.1%) and 63 (22.5%); Candida - 98 (37.9%) and 35 (12.5%); Trichomonas - 87 (33.7%) and 48 (17.1%); gardnerella - 94 (36.4%) and 56 (20%) people, respectively. Conclusions. Urogenital tract infections are the main reason people see a doctor. Infections are one of the factors in the development of infertility in men. For infection of the urogenital tract, PCR is the most sensitive and accurate compared to urine culture and urethral scrapings. The total dissemination of urogenital infection in the group of men with infertility is 46.3%, in comparison with the group of men with a normal norm in whom the percentage of STIs is 16%, indicates a direct effect of urogenital infection on the development of the male population. Along with the revealed, as the main factor of influence of the reproductive system, chlamydia trachomatis 59.3%, mycoplasma 57.3%, ureoplasm 53.1%, which moved to the second and third place in the development of infertility in the studied men. This factor and methods of treatment will be studied in studies.