Natural History of Trichomonal Infection in Males

Weston, Tony; Nicol, C. S.

doi:10.1136/sti.39.4.251

Cited by 32 publications

(21 citation statements)

References 15 publications

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“…We further hypothesized that once/if T. vaginalis reaches the prostate, its frequent lack of symptoms may also allow it to persist within the prostate, where it may establish a chronic focus of infection [95]. This hypothesis is supported by findings from early, pre-antibiotic era studies of trichomonosis in which investigators frequently found evidence of T. vaginalis in prostate specimens from asymptomatic male partners of women with trichomonal vaginitis [97][98][99][100][101][102], some of whom were chronically infected [101].…”

Section: Another Sti Gaining Recent Attention Is Trichomonas Vaginalisupporting

confidence: 57%

Sexually Transmitted Infections and Risk of Prostate Cancer: Review of Historical and Emerging Hypotheses

Sutcliffe

2010

Future Oncol.

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ABSTRACT/SUMMARYSince the early 1950s when sexually transmitted infections (STIs) were first proposed as a possible risk factor for prostate cancer, numerous epidemiologic studies have been conducted.Initially, these studies were primarily small case-control studies with retrospective, self-reported assessment of a narrow range of STIs, typically either any STIs, or gonorrhea and syphilis.However, as new STIs have been discovered/recognized, new and better tests to detect histories of STIs have been developed, and new resources for prostate cancer research have been created, epidemiologic studies have expanded to include a wider range of STIs, and have moved towards more rigorous, prospective study designs and serologic assessment of STI histories. The results of these studies are reviewed and discussed, as well as possible new avenues of research, such asTrichomonas vaginalis infection and infections not typically considered to be sexually transmitted. 3 EARLY HYPOTHESES FOR SEXUALLY TRANSMITTED INFECTIONS AND PROSTATE CANCEREarly hypotheses related to a sexually transmitted etiology of prostate cancer were initially motivated by contemporary, epidemiologic patterns of prostate cancer occurrence. In the early 1950s, Ravich and Ravich [1, 2] noted a higher prostate cancer prevalence among mainly uncircumcised non-Jewish than circumcised Jewish men, similar to patterns for penile cancer and cervical cancer among female partners of these men, leading them to propose that observed patterns might be explained by sexual transmission of a virus or other carcinogenic agent contained within the smegma of uncircumcised males. Subsequent investigators [3][4][5] further proposed additional hypotheses related to infection, sexual behavior, and sexual frustration to explain other contemporary patterns of prostate cancer occurrence by marital, paternal, and racial status. Together, these observations and hypotheses led to a series of investigations beginning in the early 1970s to examine possible associations between STIs and sexual behavior in relation to prostate cancer. Selection of STIs STI markers:Most early investigations of STIs and prostate cancer assessed either a history of any STIs or individual histories of gonorrhea and syphilis as markers or possibly vectors of the potentially causative STI or sexual behavior [6][7][8][9]. These STIs were likely selected because they were the most common, well-known, and symptomatic STIs at the time, making them also more readily assessed by self-report, medical record abstraction, or registry query. Prostate inflammation:Other early studies focused specifically on gonorrhea because it frequently led to 4 secondary gonococcal prostatitis in the pre-and early-antibiotic era, and because prostate inflammation had previously been hypothesized as a cause of atrophy and subsequent prostate cancer ([9-11] and references therein). This inflammation-atrophy-prostate cancer hypothesis has since gained further support with the observation of morphological and epigenetic transitions betwe...

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Section: Another Sti Gaining Recent Attention Is Trichomonas Vaginalisupporting

confidence: 57%

Sexually Transmitted Infections and Risk of Prostate Cancer: Review of Historical and Emerging Hypotheses

Sutcliffe

2010

Future Oncol.

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“…101 The organism has been found to coexist with a number of other infections, including gonococcal infection and bacterial vaginosis. 11,103 Concurrent bacterial vaginosis and trichomoniasis were found in 22% of pregnant adolescents in one study. 104 Trichomonads generate hydrogen, which combines with oxygen, removing oxygen from the vaginal ecosystem.…”

Section: Trichomonas Vaginitis Pathologymentioning

confidence: 99%

Evaluation and management of vaginitis

1998

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V aginitis is a common medical problem in women that is associated with substantial discomfort and frequent medical visits. Roughly 5 to 10 million office visits per year are attributed to vaginitis. 1 Research in recent years has increased our understanding of the disease process and its potential sequelae and resulted in improved diagnostic and treatment modalities. 2-6 Nevertheless, adequate diagnosis and treatment of vaginitis in the office setting often is problematic for practitioners. 2,5,7-9 Moreover, the availability of over-the-counter medications for fungal vaginitis has increased the likelihood that women will come to medical attention with partially or inadequately treated infections. 10 We will focus on the common infectious causes of vaginal discharge-yeast infection, bacterial vaginosis, and trichomonas infection, emphasizing new developments in diagnosis, associated complications, and treatment of these infections.The initial evaluation of vaginal discharge requires an understanding of physiologic vaginal discharge and what differentiates it from abnormal, pathologic discharge. Substances from the vulvar, sebaceous, sweat, Bartholin's and Skene's glands, as well as exfoliated cells, cervical mucus, and secretions of the endometrial cavity and fallopian tubes constitute the normal physiologic secretions of the vagina. These secretions pool in the posterior fornix and do not adhere to the vaginal walls. 11 The pH of normal vaginal secretions in women of childbearing age is between 3.8 and 4.5. The presence of sperm, blood, amniotic fluid, or cervical mucus raises the vaginal pH. 11 The amount and fluidity of the discharge can vary over the menstrual cycle. Cervical mucus becomes more fluid around ovulation, and women frequently mistake this change in consistency for an abnormal discharge. Stress increases the rate of vaginal desquamation and thus the amount of discharge, which patients can also mistake for a pathologic discharge. 12 Women generally do not have other symptoms if their discharge is physiologic.In contrast, a pathologic discharge adheres to the vaginal walls and is often accompanied by irritation, pruritus, odor, or urinary symptoms such as dysuria or frequency. 6 The discharge can be thick to watery and frothy, and white to yellow, gray, or green. 11 Causes of an abnormal discharge include infectious causes of vaginitis such as yeast infection, bacterial vaginosis, and trichomonas infection, as well as cervicitis and sexually transmitted diseases such as gonorrhea and chlamydia infection. Noninfectious etiologies include chemical irritants such

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“…In the past, TV was linked to urethral strictures in men with chronic urethral infection [32,33], and some small studies implicated TV as a cause of chronic prostatitis [34]. Recently, a study was conducted evaluating 388 men with symptoms and signs of chronic prostatitis.…”

Section: Clinical Manifestations and Morbiditymentioning

confidence: 99%

Trichomoniasis: What’s new?

Wendel

2003

Curr Infect Dis Rep

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Trichomonas vaginalis is the most common nonviral sexually transmitted disease in the world. Recent research has elucidated several virulence factors that allow T. vaginalis to adhere to extracellular host proteins and evade the host immune system. Further investigation is needed to determine the mechanisms responsible for the perinatal morbidity associated with trichomoniasis and to evaluate the interactions between trichomoniasis and HIV infection. An effort to decrease T. vaginalis associated with perinatal morbidity by metronidazole treatment in pregnancy was unsuccessful. However, more sensitive tools for diagnosis such as polymerase chain reaction may further facilitate future understanding of the epidemiology and risk factors of disease and improve approaches to control this widespread infection. Treatment has remained highly efficacious with single-dose metronidazole, although concern regarding drug resistance has led to more systematic evaluations of the prevalence of metronidazole resistance and alternatives to metronidazole treatment.

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Natural History of Trichomonal Infection in Males

Cited by 32 publications

References 15 publications

Sexually Transmitted Infections and Risk of Prostate Cancer: Review of Historical and Emerging Hypotheses

Sexually Transmitted Infections and Risk of Prostate Cancer: Review of Historical and Emerging Hypotheses

Evaluation and management of vaginitis

Trichomoniasis: What’s new?

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