Surgical correction of the urethra in women with postcoital cystitis

Abstract

AIM: The aim of this study was to improve the results of surgical treatment of patients with postcoital recurrent cystitis.
 MATERIALS AND METHODS: From 2005 to 2021, in our clinic, extravaginal urethral transposition according to the method developed by us (RU No. 2408296 10.01.2011) was performed in 438 women aged 18 to 61 years (24 1.3 years). The examination involved taking the anamnesis, physical examination, examination of the genitals, evaluation of urinalysis and urine culture, and bladder ultrasound.
 RESULTS: Out of 438 women we operated on, 315 (71.9%) patients were examined in the long-term postoperative period. 297 (94.3%) patients had a positive result. Of these, 230 women had a full recovery and in 67 patients, cystitis occurs once or twice a year and is not always associated with intercourse. In 18 (5.7%) patients, the operation was ineffective, of which seven patients had exacerbations of cystitis after intercourse three years after the operation, and eleven patients had a reverse displacement of the urethra and the resumption of episodes of cystitis within a year after it. The repeated operation was performed in eight patients, it being effective in seven of them.
 CONCLUSIONS: The new method of extravaginal transposition of the urethra according to Komyakov allows for avoiding the disadvantages of previously used operations. The main indication for the intervention is the direct relationship of cystitis episodes with sexual intercourse. The best results may be achieved with the correct selection of patients and compliance with all the technical features of the operation developed in our clinic.