Trichomoniasis is a very common sexually transmitted disease, more prevalent in women as compared to men. The causative organism is a protozoan parasite, known as, Trichomonas vaginalis which is transferred from an infected person to a healthy person during sex.
In men, it infects the urethra which is present inside the penis resulting in mild to severe inflammation and considerable discomfort. It is important to diagnose the disease and start treatment as the infection can persist in the body for many years and increase your risk of contracting other sexually transmitted diseases as well.
Trichomoniasis usually remains asymptomatic in men, however, when it does cause symptoms to appear, you may feel a burning sensation while urination or ejaculation which is accompanied with irritation and itchiness inside the penis.
At times, you may also experience a discharge from the penis and pain and swelling in the scrotum. The semen may also become smelly with a foul and fishy odour.
Your physician will take into consideration the symptoms and medical history to suggest the tests for trichomoniasis.
The swab sample collected from the urethra and the first-void urine sample is used for bacterial culture. The standard culture is the most reliable test for diagnosing trichomoniasis in men as the tests using wet preparation are mostly negative. Almost 98% people can be diagnosed accurately through a bacterial culture. Semen cultures can also be used for more accurate diagnosis.
Nucleic Acid Amplification Test
The DNA of the protozoan parasite can be amplified using PCR technology which can then be easily detected using gel electrophoresis. This test is highly accurate though less commonly used.
The presence of trichomonads can be detected using a Pap smear. However, this test is not highly accurate and therefore not reliable for a complete diagnosis. Microscopy provides 60-70% sensitivity and it does not exclude the possibility of trichomoniasis even if the trichomonads are not detected.
The swab sample taken from the urethra can be used to precipitate the antigen. Immunometric assays are then used to detect the protozoan antigens in the sample. This test is highly accurate and used in home based testing kits.
Test Using DNA Probe
The DNA probe which is bound to a conjugate dye has complementary nucleotide sequences which can bind with the protozoan DNA when incubated together under specific conditions. The hybrid DNA thus formed can be picked up from the sample and is easy to detect due to the properties of the conjugate dye which can either impart a specific colour or chemiluminescence.
Antibiotic treatment can effectively cure trichomoniasis. Since trichomoniasis infects multiple sites, it is important to follow systemic treatment. Oral metronidazole is the most common medication prescribed for patients suffering from this disease.
It is highly effective with rare chances of treatment failures. However, in the rare cases where the symptoms do not improve with medication, the doctors suggest a repeat test. In case, the standard treatment fails, the doctors simply increase the antibiotic dose or switch to another nitroimidazole drug.
At times, rectal applications of metronidazole are also advised to increase the antibiotic concentration in the blood for effective therapy.
Though repeat testing for trichomoniasis is not a common practice among medical practitioners, it is advisable to repeat the tests after 5-7 and 30 days to prevent the recurrence of infection.