Postcoital cystitis in menopause

Introduction. Symptoms of dysuria due to bladder inflammation associated with sexual intercourse (postcoital cystitis) negatively affect the psycho-emotional state of patients, reduce the quality of life and lead to the development of sexual dysfunction. With the advent of the possibility of antibacterial prophylaxis and improved sanitary and hygienic conditions, interest in surgical treatment of postcoital cystitis has decreased.

Material and methods. An open, prospective, non-comparative study included 56 patients with postcoital cystitis in different periods of menopause (perimenopause, menopause and postmenopause). At the time of inclusion, all women had symptoms of cystitis associated with recent (no more than 24 hours ago) sexual intercourse. Patients filled out a specially developed questionnaire and the Acute Cystitis Symptom Score (ACSS). They underwent urinalysis and urine culture with antibiogram.

All patients were prescribed Superlymph suppositories in a dose of 10 units as monotherapy according to the scheme: 1 suppository rectally in the evening, 1 suppository vaginally in the morning. Patients with leukocyturia and bacteriuria were initially given antibacterial therapy, after which they were prescribed Superlymph according to the scheme described above as monotherapy. The targeted cytokine therapy was prescribed for 1 month. During treatment, the patients continued to have sexual activity as usual. The efficiency of treatment was assessed immediately after completion of the course and 3 months after its completion. The efficiency was evaluated according to the incidence of postcoital cystitis.

Results. In patients included in the study, the first episode of cystitis occurred on average at the age of 33.1±2.4 years. In almost half of women (n=24 (42.9%)), the onset of cystitis was associated with sexual activity. During reproductive age, 42 (75%) women had postcoital cystitis, and 10 (23.8%) of them had only one episode. At the same time, every fourth woman (n=14 (25%)) suffered from first episode of postcoital cystitis during menopause. The average age of patients at which the first episode of postcoital cystitis occurred was 38.6 ± 7.7 years.

After a month of monotherapy with Superlymph, 31 patients (55.4%) did not report a single episode of postcoital cystitis, while after three months, 42 women (75.0%) achieved recurrence-free status. Of the 26 patients (46.4%) who were initially diagnosed with bacterial vaginosis, the vaginal normocenosis was found in 18 (69.2%) cases.

Conclusion. Postcoital cystitis can occur in women of any age, including those with a normal anatomy of the genitourinary system. Combined rectal and vaginal use of Superlymph suppositories at a dose of 10 U for a month helps to avoid relapse of postcoital cystitis in 55.4% of patients. Targeted cytokine therapy has a prolonged effect within three months after completion therapy, and 75% of women did not report relapses of postcoital cystitis.