Outcomes of surgical correction of the urethra in the management of postcoital cystitis: A systematic review and meta-analysis

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  • Authors: Loran O.B.1,2, Vorobev V.A.3,4, Kosova I.V.2,5, Kasyan G.R.1,6, Sharakshinov B.K.7, Kostyuchenko D.O.8
  • Affiliations:
    1. State Budgetary Healthcare Institution of the city of Moscow «Moscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin» of the Department of Health of the City of Moscow
    2. Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Сontinuing Professional Education» of the Ministry of Health of the Russian Federation
    3. Bashkir State Medical University
    4. Irkutsk State Medical University
    5. State Budgetary Healthcare Institution of the city of Moscow City «Clinical Hospital named after V. P. Demikhov» of the Department of Health of the City of Moscow
    6. Russian University of Medicine
    7. Expert Clinic LLC
    8. MEDICLINIC Clinical and Diagnostic Center LLC
  • Issue: No 5 (2025)
  • Pages: 183-197
  • Section: Systematic rewiev
  • Published: 18.11.2025
  • URL: https://journals.eco-vector.com/1728-2985/article/view/696554
  • DOI: https://doi.org/10.18565/urology.2025.5.183-197
  • ID: 696554

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Abstract

Objective. To evaluate the efficacy and safety of surgical approaches for recurrent postcoital cystitis (PCC) in women.

Materials and methods. A systematic search (PubMed, Scopus, Web of Science, eLibrary) was conducted following PRISMA 2020 guidelines. Nine studies (n=1850) were included, assessing surgical treatment of PCC in women ≥18 years. Interventions included extravaginal urethral transposition, distal transposition, hymenoplasty, urethro-vaginal adhesiolysis with bulking injection, and urethroplasty. Outcomes: recurrence rates, treatment success, quality of life, and complications.

Results. The average success rate of surgical treatment was 87.7% (95% CI 80–92%), significantly higher than that of conservative approaches (10%). Extravaginal urethral transposition demonstrated the highest results (93% success rate, up to 77.9% complete absence of recurrence). Hymenoplasty and combined minimally invasive techniques provided 84–91% success rates but more frequently required repeat interventions. Complication rates were low (0–5%), mostly transient. Improved quality of life and sexual function were noted in 90% of patients.

Conclusion. Surgical treatment of PCC leads to a significant reduction in infection recurrence and improved quality of life in appropriately selected patients. However, the overall evidence base on this topic is limited: there are no randomized trials, the quality of existing studies is low, and sample sizes are small. Data on long-term efficacy, complications, and causes of treatment failure are virtually nonexistent. These limitations prevent a definitive recommendation for surgical correction as a treatment of choice for a wide range of patients. The obtained results should be interpreted with caution, and further prospective and controlled studies are needed to confirm the advantages of the surgical approach and develop clear indications.

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About the authors

Oleg B. Loran

State Budgetary Healthcare Institution of the city of Moscow «Moscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin» of the Department of Health of the City of Moscow; Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Сontinuing Professional Education» of the Ministry of Health of the Russian Federation

Author for correspondence.
Email: oleg_loran@gmail.com
ORCID iD: 0000-0002-7531-1511
SPIN-code: 7604-8138

Honored Scientist of Russian Federation, Academician of the Russian Academy of Sciences, M.D., Dr.Sc.(M), Full prof., Head, Dept. of Urology and Surgical Andrology, Full member of the European and International Associations of Urologists

Russian Federation, Moscow; Moscow

Vladimir A. Vorobev

Bashkir State Medical University; Irkutsk State Medical University

Email: denecer@yandex.ru
ORCID iD: 0000-0003-3285-5559
SPIN-code: 9896-6243

Doctor of Medical Sciences, M.D., Professor of the Department of Faculty Surgery and Urology, Associate Professor of the Department of Urology and Oncology

Russian Federation, Ufa; Irkutsk

Inga V. Kosova

Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Сontinuing Professional Education» of the Ministry of Health of the Russian Federation; State Budgetary Healthcare Institution of the city of Moscow City «Clinical Hospital named after V. P. Demikhov» of the Department of Health of the City of Moscow

Email: Kosovainga@mail.ru
ORCID iD: 0000-0002-0051-0583

Urologist at the Department of Urology, Doctor of Medical Sciences, M.D., Professor of the Department of Urology and Surgical Andrology

Russian Federation, Moscow; Moscow

Gevorg R. Kasyan

State Budgetary Healthcare Institution of the city of Moscow «Moscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin» of the Department of Health of the City of Moscow; Russian University of Medicine

Email: g.kasyan@outlook.com
ORCID iD: 0000-0001-7919-2217
SPIN-code: 6235-5990

Doctor of Medical Sciences, M.D., Professor of the Department of the Urology, Urologist, Head of the Department of Urology

Russian Federation, Moscow; Moscow

Bator K. Sharakshinov

Expert Clinic LLC

Email: bator_md@mail.ru
ORCID iD: 0009-0004-6292-1646

urologist

Russian Federation, Irkutsk

Denis O. Kostyuchenko

MEDICLINIC Clinical and Diagnostic Center LLC

Email: Doctor_1985@mail.ru
ORCID iD: 0009-0006-3946-6686

urologist

Russian Federation, Penza

References

  1. Li R., Leslie S.W. Cystitis. StatPearls, Treasure Island (FL): StatPearls Publishing; 2024.
  2. Apolikhin O.I., Wagenlehner F., Voitko D.A., Zolotukhin O.V., Naber K., Nazarenko D.G. et al. Epidemiological study of cystitis prevalence among women in Voronezh region. Eksperimentalnaya i Klinicheskaya Urologiya = Experimental and Clinical Urology. 2021;14:10–18. Russian (Аполихин О.И., Вагенленер Ф., Войтко Д.А., Золотухин О.В., Набер К., Назаренко Д.Г. и др. Эпидемиологическое исследование распространенности цистита у женщин Воронежской области. Экспериментальная и клиническая урология. 2021;14:10–18). https://doi.org/10.29188/2222-8543-2021-14-1-10-18.
  3. Kyzlasov P., Kazhera A., Udalov Y., Zabelin M. Surgical treatments of post coital cystitis. Chronic Recurrent Cystitis Is One of the Most Common Infectious and Inflammatory Diseases of the Urinary System in Women In Russia, up to 36 Million Cases Are Diagnosed Each Year A Very Common Cause of Acute and Chronic Recurrent Cystitis in Women Is an Anomaly in the Form of Female Hypospadias According to the Authors, Treatment of Postcoital Cystitis against the Background of Urethral Dystopia, Hypermobility of the Urethra, Urethrogimenal Adhesions Is Only Surgical The Article Reviews the Literature on Known Methods of Surgical Treatment Currently Used in Russia in the Treatment of Postcoital Cystitis in Women A Comparative Analysis of Surgical Methods of Treatment Is Carried out, Their Advantages and Disadvantages Are Highlighted 2018;Volume 7:00157. https://doi.org/10.15406/mojwh.2018.07.00157.
  4. Komyakov B.K., Shevnin M.V., Tarasov V.A., Shpilenya E.S., Komyakova E.B., Shestykh A.V. Psychoemotional status and assessment of preventive measures in patients with postcoital cystitis. Urologicheskie Vedomosti = Urology Reports (St. Petersburg). 2025;15:15–24. Russian (Комяков Б.К., Шевнин М.В., Тарасов В.А., Шпиленя Е.С., Комякова Е.Б., Шестых А.В. Психоэмоциональный статус и оценка предпринятых профилактических мер у пациенток с посткоитальным циститом. Урологические ведомости. 2025;15:15–24). https://doi.org/10.17816/uroved634362.
  5. O’donnell R.P. Relative hypospadias potentiated by inadequate rupture of the hymen: a cause of chronic inflammation of the lower part of the female urinary tract. J Int Coll Surg 1959;32:374–88.
  6. Hirschhorn R.C. Urethral-hymeneal fusion: a surgically correctable cause of recurrent cystitis. Obstet Gynecol 1965;26:903–8.
  7. Descazeaud C., Cuvelier G., Descazeaud A., Gestin B., Rivet A., Saïdani N. Evaluation of hymenal adhesions resection in the treatment of recurrent post-coital cystitis. Prog Urol 2022;32:1490–7. https://doi.org/10.1016/j.purol.2022.09.014.
  8. Snurnitsyna O.V., Inoyatov Zh.Sh., Lobanov M.V., Malinina O.Yu., Rapoport L.M., Enikeev M.E. Minimally invasive surgical treatment of female hypospadias and urethral hypermobility complicated by postcoital dysuria. Vestnik Urologii = Urology Herald. 2021;9:72–79. Russian (Снурницына О.В., Иноятов Ж.Ш., Лобанов М.В., Малинина О.Ю., Рапопорт Л.М., Еникеев М.Э. Малоинвазивное хирургическое лечение женской гипоспадии и гипермобильности уретры, осложненных посткоитальной дизурией. Вестник урологии. 2021;9:72–79). https://doi.org/10.21886/2308-6424-2021-9-1-72-79.
  9. Loran O.B., Gumin L.M., Dyakov V.V., and Gvozdev M.Yu. Method for Transposition of the External Opening of the Urinary Tract in Women. RU2132652C1, 1999. Russian (Лоран О.Б., Гумин Л.М., Дьяков В.В., Гвоздев М.Ю. Способ транспозиции наружного отверстия мочеиспускательного канала у женщин. RU2132652C1, 1999).
  10. Komyakov B.K. Results of 228 extravaginal urethral transpositions. Urologicheskie Vedomosti = Urology Reports (St. Petersburg). 2017;7:54–55. Russian (Комяков Б.К. Результаты 228 экстравагинальных транспозиций уретры. Урологические ведомости. 2017;7:54–55).
  11. Page M.J., McKenzie J.E., Bossuyt P.M., Boutron I., Hoffmann T.C., Mulrow C.D. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Systematic Reviews 2021;10:89. https://doi.org/10.1186/s13643-021-01626-4.
  12. Tarasov N.I., Shulgin A.S., Nuriev A.V. Diagnosis and modern surgical treatment of postcoital cystitis in women. Nepreryvnoe Meditsinskoe Obrazovanie i Nauka = Continuing Medical Education and Science. 2018;13:18–22. Russian (Тарасов Н.И., Шульгин А.С., Нуриев А.В. Диагностика причин и современный метод хирургического лечения посткоитального цистита у женщин. Непрерывное медицинское образование и наука. 2018;13:18–22).
  13. Feofilov I.V., Boboev M.M., Shkuratov S.S., Pochivalov A.K., Plugin P.S. Postcoital cystitis: surgical treatment results. Sibirskiy Meditsinskiy Vestnik = Siberian Medical Journal. 2021:19–23. Russian (Феофилов И.В., Бобоев М.М., Шкуратов С.С., Почивалов А.К., Плугин П.С. Посткоитальный цистит: результаты хирургического лечения. Сибирский медицинский вестник. 2021:19–23).https://doi.org/10.31549/2541-8289-2021-3-19-23
  14. Komyakov B.K., Shevnin M.V., Tarasov V.A., Nazarov T.Kh, Shpilenya E.S., Rychkov I.V. Surgical correction of vestibulo-vaginal frictional urethral dislocation in postcoital cystitis. Andrologiya i Genitalnaya Khirurgiya = Andrology and Genital Surgery. 2023;24:89–94. Russian (Комяков Б.К., Шевнин М.В., Тарасов В.А., Назаров Т.Х., Шпиленя Е.С., Рычков И.В. Оперативная коррекция вестибуло-вагинальной фрикционной дислокации уретры при посткоитальном цистите. Андрология и генитальная хирургия. 2023;24:89–94). https://doi.org/10.17650/2070-9781-2023-24-3-89-94.
  15. Inoyatov Zh.Sh., Snurnitsyna O.V., Lobanov M.V., Malinina O.Yu, Demidko Yu.L., Taratkin M.S. et al. Minimally invasive combined surgical treatment of postcoital cystitis. Andrologiya i Genitalnaya Khirurgiya = Andrology and Genital Surgery. 2020;21:20–25. Russian (Иноятов Ж.Ш., Снурницына О.В., Лобанов М.В., Малинина О.Ю., Демидко Ю.Л., Тараткин М.С. и др. Малоинвазивное комбинированное хирургическое лечение посткоитального цистита. Андрология и генитальная хирургия. 2020;21:20–25). https://doi.org/10.17650/2070-9781-2020-21-2-20-25.
  16. Eliseev D.E., Kholodova Zh.L., Abakumov R.S., Ovcharenko D.V. Complications of urethral meatus transposition in treatment of postcoital cystitis in women. Eksperimentalnaya i Klinicheskaya Urologiya = Experimental and Clinical Urology. 2024;17:108–17. Russian (Елисеев Д.Э., Холодова Ж.Л., Абакумов Р.С., Овчаренко Д.В. Осложнения транспозиции наружного отверстия уретры при лечении посткоитального цистита у женщин. Экспериментальная и клиническая урология. 2024;17:108–17) https://doi.org/10.29188/2222-8543-2024-17-4-108-117.
  17. Komyakov B.K. Postcoital cystitis: perspective on the problem, technique and outcomes of extravaginal urethral transposition. Urologiia. 2025:135–40. Russian (Комяков Б.К. Посткоитальный цистит: взгляд на проблему, техника и результаты экстравагинальной транспозиции уретры. Урология. 2025:135–40). https://doi.org/10.18565/urology.2025.2.135-140.
  18. Komyakov B.K., Tarasov V.A., Shpilenya E.S., Shevnin M.V., Sinchenko I.V. Surgical correction of the urethra in women with postcoital cystitis. Zhurnal Akusherstva i Zhenskikh Bolezney = Journal of Obstetrics and Women’s Diseases. 2022;71:29–34. Russian (Комяков Б.К., Тарасов В.А., Шпиленя Е.С., Шевнин М.В., Синченко И.В. Оперативная коррекция уретры у женщин при посткоитальном цистите. Журнал акушерства и женских болезней. 2022;71:29–34). https://doi.org/10.17816/JOWD75907.
  19. Komyakov B.K., Ochelenko V.A., Shevnin M.V., Tarasov V.A., Melikov R.A. Postcoital cystitis as a cause of sexual dysfunction in women. Eksperimentalnaya i Klinicheskaya Urologiya = Experimental and Clinical Urology. 2023;16:134–39. Russian (Комяков Б.К., Очеленко В.А., Шевнин М.В., Тарасов В.А., Меликов Р.А. Посткоитальный цистит как причина сексуальной дисфункции у женщин. Экспериментальная и клиническая урология. 2023;16:134–39). https://doi.org/10.29188/2222-8543-2023-16-2-134-139.
  20. Gvozdev M.Yu., Bryanskikh E.P., Sazonova (Kalinina) N.A., Lazareva N.A., Sarukhanyan A.L. Distal urethral transposition: 10-year outcomes. Vestnik Urologii = Urology Herald. 2024;12:46–52. Russian (Гвоздев М.Ю., Брянских Е.П., Сазонова (Калинина) Н.А., Лазарева Н.А., Саруханян А.Л. Транспозиция дистальной уретры: 10-летние результаты лечения. Вестник урологии. 2024;12:46–52). https://doi.org/10.21886/2308-6424-2024-12-3-46-52.
  21. Reziciner S. Prevention of recurrent post-coital cystitis using hymenoplasty. Ann Urol (Paris) 1988;22:446–51.
  22. Smith P.J., Roberts J.B., Ball A.J. «Honeymoon» cystitis: a simple surgical cure. Br J Urol. 1982;54:708–10. https://doi.org/10.1111/j.1464-410x.1982.tb13630.x.
  23. Eliseev D.E., Kholodova Ya.G., Kholodova Zh.L., Abakumov R.S., Dobrokhotova Yu.E., Shaderkina V.A. Atypical cases of recurrent postcoital cystitis in women: acquired urethral hypermobility. Eksperimentalnaya i Klinicheskaya Urologiya = Experimental and Clinical Urology. 2021;14:105–09. Russian (Елисеев Д.Э., Холодова Я.Г., Холодова Ж.Л., Абакумов Р.С., Доброхотова Ю.Э., Шадеркина В.А. Нетипичные случаи рецидивирующего посткоитального цистита у женщин: приобретенная гипермобильность уретры. Экспериментальная и клиническая урология. 2021;14:105–9). https://doi.org/10.29188/2222-8543-2021-14-2-105-109.
  24. Raffee S., Atiemo H. Polydimethylsiloxane Erosion as a Cause for Recurrent Urinary Tract Infections. Journal of Endourology Case Reports 2019;5. https://doi.org/10.1089/cren.2019.0007.
  25. Kocjancic E., Mourad S., Acar O. Complications of urethral bulking therapy for female stress urinary incontinence. Neurourology and Urodynamics. 2019;38 Suppl 4. https://doi.org/10.1002/nau.23877.
  26. Eliseev D.E., Kholodova Zh.L., Abakumov R.S., Dobrokhotova Yu.E., Shaderkina V.A. Postcoital cystitis: surgical treatment. Eksperimentalnaya i Klinicheskaya Urologiya = Experimental and Clinical Urology. 2021;14:130–34. Russian (Елисеев Д.Э., Холодова Ж.Л., Абакумов Р.С., Доброхотова Ю.Э., Шадеркина В.А. Посткоитальный цистит: хирургическое лечение. Экспериментальная и клиническая урология. 2021;14:130–34). https://doi.org/10.29188/2222-8543-2021-14-1-130-134.
  27. Komyakov B.K., Tarasov V.A., Ochelenko V.A., Shpilenya E.S., Shevnin M.V. Pathogenesis and treatment of postcoital cystitis: are our current concepts correct? Urologiia. 2022:27–32. Russian (Комяков Б.К., Тарасов В.А., Очеленко В.А., Шпиленя Е.С., Шевнин М.В. Патогенез и лечение посткоитального цистита: верны ли наши представления об этом? Урология. 2022:27–32).https://doi.org/10.18565/urology.2022.2.27-32.

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2. Fig. 1. Forest diagram of surgical treatment success

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3. Fig. 2. Forest diagram of surgical treatment success

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4. Fig. 3. Forest diagram of improvement of quality of life after surgical treatment

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5. Fig. 4. Forest diagram of risks of complications after surgical treatment

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