Cystitis after intimacy
Cystitis the day after sexual intercourse is a challenging situation. Every patient tells the same story in different ways during their appointment: 'as soon as sex happens, the next day—constant trips to the bathroom, sometimes with blood, pain in the lower abdomen, burning sensation in the urinary tract...'
And worst of all, it affects the family: the husband doesn't understand why his wife sadly refuses intimacy, the mother-in-law drops unnecessary hints, and doctors have one answer: antibiotics. A simple question like 'how can I conceive while on antibiotics?' remains unanswered...
Our results
How exactly do we help women with postcoital cystitis?
During the consultation, we gather a detailed medical history to determine when the episodes of cystitis began. We conduct a gynecological examination to pinpoint the location of the external urethral orifice. Perhaps most importantly, we endeavor to understand to what extent standard conservative treatments have NOT BEEN HELPFUL for our patient. This is crucial because we only recommend surgery when conservative therapy proves ineffective.
If we determine that conservative therapy is ineffective and the low positioning of the external urethral orifice is to blame, we offer a urethral transposition using Prof. Komyakov's modification, which requires specific preparation of vaginal tissues. After preparation, we hospitalize the patient for 5 days.
This surgery can be performed between the 7th and 17th days after the end of menstruation. It typically lasts about 1 hour. It's important to note that we leave a urinary catheter in place for 3-4 days following the procedure. Daily dressings are also conducted.
After the surgery, the patient remains in the hospital for 3-5 days. Typically, on the 4th day, we remove the catheter, ensure that urination has recovered well, and discharge the patient for outpatient treatment.
One month after the surgery, we invite the patient for an examination and removal of any remaining stitches. Three months post-operation, we also examine the patient and, ensuring there are no contraindications, allow resumption of sexual activity.
Symptoms such as lower abdominal pain, burning sensation, frequent urges to urinate, and sometimes blood in the urine... Occasionally accompanied by ascending pyelonephritis. These seem like typical manifestations of acute cystitis, which could stem from something as seemingly innocuous as a draft. However, the problem lies in the fact that this situation recurs every one to two days after sexual intercourse.
Outcome: The young woman begins to avoid sexual activity, refuses her husband... the family begins to fall apart.
Please scroll through these illustrations to understand how post-coital cystitis develops
Well, the logic here is clear: if it has escalated to acute cystitis, then you need to kill the bacteria somehow. But if they keep entering the urethra and bladder over and over again... Please tell me, what antibiotic can permanently destroy bacteria in the area near the rectum?
Its essence lies in the need to urinate after sexual intercourse. The idea is to flush out bacteria that have entered the urethra with a stream of urine. Another recommendation is to avoid positions that lead to cystitis.
This means that a woman should take a prophylactic dose of a specific antibiotic before sexual intercourse. Again, the question of "how to conceive while constantly taking antibiotics" remains unanswered. The next question with this approach is the development of bacterial resistance and decreasing effectiveness over time.
aimed at boosting immunity against E. coli, restoring the mucous membrane of the bladder with biologically active supplements or infusions into the bladder.
It should be noted that these methods are effective and often lead to results. However, unfortunately, not for everyone. It is for these women that eventually have to resort to surgical treatment.
There are two variants of this operation: the outdated and ineffective O'Donnell procedure, where the recurrence rate reaches 50 percent. The modern treatment method, however, is the extravaginal transposition of the external urethral orifice – Professor B.K. Komyakov's operation.
It's not difficult!
Advantages of the Komyakov operation at the Dilanian Clinic:
- High effectiveness with an extremely low recurrence rate;
- Minimal invasiveness, resulting in a short rehabilitation period and very low risk of complications;
- Absence of scars, marks, or other consequences that disrupt the aesthetics and functionality of female genital organs.
If you require treatment for postcoital cystitis, feel free to schedule an appointment. Our expertise in this area will help you in cases where standard therapy is ineffective.
Make an online appointment with Oganes E. Dilanyan MD,PhD
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