POSTCOITAL CYSTITIS AND BACTERIAL VAGINOSIS

Postcoital cystitis is a common form of urinary tract infection that occurs in women after sexual intercourse. This review article is aimed at analyzing the etiology, risk factors, diagnosis, treatment and prevention of postcoital cystitis.
The article systematizes the data of modern scientific research on the etiology of postcoital cystitis, the prevalence of the disease, modern methods of diagnosis, treatment and prevention, including the use of antibacterial therapy, probiotics and hormonal drugs. Particular attention is paid to the relationship between postcoital cystitis and bacterial vaginosis.
The main causative agents of postcoital cystitis are Escherichia coli and other bacteria that enter the urinary tract during sexual intercourse. Bacterial vaginosis significantly increases the risk of recurrent cystitis, as it disrupts the microbial balance in the vagina, weakening the natural defense mechanisms. Modern treatment methods include antibacterial therapy, hormonal therapy and the use of probiotics. Preventive measures such as urinating after intercourse, maintaining hygiene and using alternative methods of contraception reduce the frequency of relapses. Postcoital cystitis and bacterial vaginosis are closely related, which requires a comprehensive approach to treatment and prevention. Vaccination and alternative antibacterial drugs also represent promising areas for preventing relapses.

1. Koshul'ko PA, Anisin DM, Tomilina EG, et al. Bacteriophage therapy of vaginal infection during pregnancy as a way to improve its favorable outcome. Reproduktivnoe Zdorov'e Vostochnaya Evropa. 2024;14(3):357-365. doi:10.34883/PI.2024.14.3.006 (In Russ)

2. Garifullova (Faleeva) YuV, Mal'tseva LI. Bacterial vaginosis: current estimates of complications and treatment strategy. Prakticheskaya Meditsina. 2024;22(3):8-13. doi:10.32000/2072-1757-2024-3-8-13 (In Russ)

3. Dorokhova EA. Vaginal Microbiota Transplantation for the Treatment of Bacterial Vaginosis. Molodezhnyi Innovatsionnyi Vestnik. 2023;12(S2):14-16. (In Russ)

4. Klimov NA, Shamova OV. Microbiota Disturbances in Bacterial Vaginosis and Possibilities of Personalized Therapy of the Disease Using Probiotics (literature review). Rossiiskii Zhurnal Personalizirovannoi Meditsiny. 2022;2(6):78-90. doi:10.18705/2782-3806-2022-2-6-78-90 (In Russ)

5. Kuz'min IV, Slesarevskaya MN, Al'-Shukri SK. Non-antibacterial prophylaxis of postcoital cystitis in women. Rmzh Mat' I Ditya. 2021;4(3):209-217. doi:10.32364/2618-8430-2021-4-3-209-217 (In Russ)

6. Neimark AI, Razdorskaya (Ryapolova) MV, Oberemok PA. Treatment of recurrent cystitis and prevention of its exacerbations in women. Eksperimental'naya I Klinicheskaya Urologiya. 2019;(2):92-97. doi:10.29188/2222-8543-2019-11-2-92-96 (In Russ)

7. Pestrikova TYu, Kotel'nikova AV, Yurasova (Pestrikova) EA, Strel'nikova (Panfilova) NV, Yurasov IV. Personalized approach to the diagnosis and treatment of recurrent forms of bacterial vaginosis. Klinicheskii Razbor V Obshchei Meditsine. 2024;5(4):54-60. doi:10.47407/kr2024.5.4.00419 (In Russ)

8. Kulchavenya E V, Treyvish L S, Telina E V, Tsukanov A Y, Neimark A I, Neimark A B, Kholtobin D P, Razdorskaya M V. Onto-phylogenetic prerequisites for development of chronic cystitis in women. Urologiia. 2023 Dec;(6):30-37. Russian. PMID: 38156680. (In Russ)

9. Kul'chavenya EV, Treivish LS, Telina EV, Kholtobin DP, Brizhatyuk (Esaulova) EV, Shevchenko SYu. Postcoital cystitis in menopause. Urologiya. 2024;(3):21-27. doi:10.18565/urology.2024.3.21-27 (In Russ)

10. Komyakov BK, Ochelenko VA, Shevnin MV, Tarasov VA, Melikov RA. Postcoital cystitis as a cause of sexual dysfunction in women. Eksperimental'naya I Klinicheskaya Urologiya. 2023;16(2):134-139. doi:10.29188/2222-8543-2023-16-2-134-139 (In Russ)

11. Eliseev DE, Kholodova ZhL, Abakumov RS, Dobrokhotova YuE, Shaderkina VA. Postcoital cystitis: surgical treatment. Eksperimental'naya I Klinicheskaya Urologiya. 2021;14(1):130-134. doi:10.29188/2222-8543-2021-14-1-130-134 (In Russ)

12. Khasanova G.M., Khasanova A.N. The problem of healthy lifestyle of student youth. Spiritual and physical health of a person in the 21st century: traditions and innovations. 2015: 170-174. (in Russ)

13. Khashukoeva AZ, Agaeva MI, Savchenko TN, Agaeva ZA, Burdenko MV, Lobacheva YuI. Rational use of antimicrobial drugs in obstetric practice, taking into account growing antibiotic resistance. Lechashchii Vrach. 2024;27(6):52-57. doi:10.51793/OS.2024.27.6.007 (In Russ)

14. Mamedov VK, Shabanova KA, Il'yasov KhKh, Kazilov BM. Modern aspects of the etiological structure of chronic recurrent cystitis. Urologiya. 2022;(5):123-126. doi:10.18565/urology.2022.5.123-126 (In Russ)

15. Sil'chuk NA, Nechiporenko AN, Korsak VE, Knyazyuk AS. Chronic Recurrent Postcoital Cystitis: A Modern View of the Problem. Zhurnal Grodnenskogo Gosudarstvennogo Meditsinskogo Universiteta. 2022;20(4):374-379. doi:10.25298/2221-8785-2022-20-4-374-379 (In Russ)

16. Hooton TM, Fihn SD, Johnson C, Roberts PL, Stamm WE. Association between bacterial vaginosis and acute cystitis in women using diaphragms. Arch Intern Med. 1989;149(9):1932-1936. (in Engl)

17. Barea BM, Veeratterapillay R, Harding C. Nonantibiotic treatments for urinary cystitis: an update. Curr Opin Urol. 2020;30(6):845-852. (in Engl) doi:10.1097/MOU.0000000000000821

18. Nestler S, Grüne B, Schilchegger L, Suna A, Perez A, Neisius A. Efficacy of vaccination with StroVac for recurrent urinary tract infections in women: a comparative single-centre study. Int Urol Nephrol. 2021;53(11):2267-2272. (in Engl) doi:10.1007/s11255-021-02987-4

19. Yoo JJ, Song JS, Kim WB, et al. Gardnerella vaginalis in Recurrent Urinary Tract Infection Is Associated with Dysbiosis of the Bladder Microbiome. J Clin Med. 2022;11(9):2295. (in Engl) doi:10.3390/jcm11092295

20. Putonti C, Thomas-White K, Crum E, Hilt EE, Price TK, Wolfe AJ. Genome Investigation of Urinary Gardnerella Strains and Their Relationship to Isolates of the Vaginal Microbiota. mSphere. 2021;6(3):e00154-21. (in Engl) doi:10.1128/mSphere.00154-21

21. Kwok M, McGeorge S, Mayer-Coverdale J, [et al.] Guideline of guidelines: management of recurrent urinary tract infections in women. BJU Int. 2022;130 Suppl 3(Suppl 3):11-22. (in Engl) doi:10.1111/bju.1575620.

22. Kelly BN. UTI detection by PCR: Improving patient outcomes. J Mass Spectrom Adv Clin Lab. 2023;28:60-62. (in Engl)

23. McKertich K, Hanegbi U. Recurrent UTIs and cystitis symptoms in women. Aust J Gen Pract. 2021;50(4):199-205. (in Engl)

24. Mei Z, Li D. The role of probiotics in vaginal health. Front Cell Infect Microbiol. 2022;12:963868. (in Engl)

25. Dueñas-Garcia OF, Sullivan G, Hall CD, Flynn MK, OʼDell K. Pharmacological Agents to Decrease New Episodes of Recurrent Lower Urinary Tract Infections in Postmenopausal Women. A Systematic Review. Female Pelvic Med Reconstr Surg. 2016;22(2):63-69. (in Engl)

26. Pinto H, Simões M, Borges A. Prevalence and Impact of Biofilms on Bloodstream and Urinary Tract Infections: A Systematic Review and Meta-Analysis. Antibiot Basel Switz. 2021;10(7):825. (in Engl) doi:10.3390/antibiotics10070825

27. Yueh HZ, Yang MH, Huang JY, Wei JCC. Risk of Autoimmune Diseases in Patients With Interstitial Cystitis/Bladder Pain Syndrome: A Nationwide Population-Based Study in Taiwan. Front Med. 2021;8:747098. (in Engl) doi:10.3389/fmed.2021.747098

28. Ala-Jaakkola R, Laitila A, Ouwehand AC, Lehtoranta L. Role of D-mannose in urinary tract infections - a narrative review. Nutr J. 2022;21(1):18. (in Engl) doi:10.1186/s12937-022-00769-x

29. Sabharwal A, Stellrecht E, Scannapieco FA. Associations between dental caries and systemic diseases: a scoping review. BMC Oral Health. 2021;21:472. (in Engl) doi:10.1186/s12903-021-01803-w

30. Sabih A, Leslie SW. Complicated Urinary Tract Infections. In: StatPearls. StatPearls Publishing; 2024. Accessed September 22, 2024. (in Engl) http://www.ncbi.nlm.nih.gov/books/NBK436013/

31. Schaeffer AJ, Stuppy BA. Efficacy and safety of self-start therapy in women with recurrent urinary tract infections. J Urol. 1999;161(1):207-211. (in Engl)

32. Workowski KA, Bachmann LH, Chan PA, [et al.] Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep. 2021;70(4):1-187. (in Engl) doi:10.15585/mmwr.rr7004a1

33. Stapleton AE. The Vaginal Microbiota and Urinary Tract Infection. Microbiol Spectr. 2016;4(6). (in Engl)

34. Kyzlasov P, Kazhera A, Udalov Y, Zabelin M. Surgical treatments of post coital cystitis. MOJ Womens Health. 2018;Vol. 7 (Issue 1): 00157. (in Engl) doi:10.15406/mojwh.2018.07.00157

35. Luvero D, Silvagni A, Angioli AM, [et al.] The Efficacy of CO2 Vaginal Laser in the Treatment of Recurrent, Post-Coital and Interstitial Cystitis: A Multicentric Prospective Study. J Clin Med. 2024;13(12):3550. (in Engl) doi:10.3390/jcm13123550

36. Naji A, Siskin D, Woodworth MH, Lee JR, Kraft CS, Mehta N. The Role of the Gut, Urine, and Vaginal Microbiomes in the Pathogenesis of Urinary Tract Infection in Women and Consideration of Microbiome Therapeutics. Open Forum Infect Dis. 2024;11(9):ofae471. (in Engl) doi:10.1093/ofid/ofae471

37. Nalliah S, Fong JSH, Yi Thor AY, Lim OH. The use of chemotherapeutic agents as prophylaxis for recurrent urinary tract infection in healthy nonpregnant women: A network meta-analysis. Indian J Urol IJU J Urol Soc India. 2019;35(2):147-155. (in Engl)

38. Yu WR, Jiang YH, Jhang JF, Kuo HC. Use of Urinary Biomarkers in Discriminating Interstitial Cystitis/Bladder Pain Syndrome from Male Lower Urinary Tract Dysfunctions. Int J Mol Sci. 2023;24(15):12055. (in Engl) doi:10.3390/ijms241512055

39. Saraf VS, Sheikh SA, Ahmad A, Gillevet PM, Bokhari H, Javed S. Vaginal microbiome: normalcy vs dysbiosis. Arch Microbiol. 2021;203(7):3793-3802. (in Engl) doi:10.1007/s00203-021-02414-3

40. Luo H, Zhou C, Zhou L, He Y, Xie RH. The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review. Arch Gynecol Obstet. 2024 Aug;310(2):643-653. doi: 10.1007/s00404-024-07611-1.

41. Savicheva AM. Molecular Testing for the Diagnosis of Bacterial Vaginosis. Int J Mol Sci. 2023 Dec 28;25(1):449.