Results of open prospective study of clinical assessment of efficacy and safety of Nifuratel during exacerbations of recurrent cystitis

The article presents the results of an open prospective study of the clinical assessment of the efficacy and safety of the use of nifuratel during exacerbations of recurrent cystitis. The aim of the program was to assess the change in the duration of the relapse-free course of recurrent cystitis and the effectiveness of the course treatment with Nifuratel-SZ in the treatment of recurrent cystitis. During a non-interventional program, Nifuratel-SZ has been shown to be an effective and well-tolerated drug for the treatment of recurrent uncomplicated lower urinary tract infection.

The specificity of the psychological functioning of patients with interstitial cystitis

Introduction. The use of psychotherapeutic strategies may be preferable for patients with interstitial cystitis, who do not respond to psychopharmacotherapy and even after somatotropic therapy. therapy, surgical interventions continue to experience uncomfortable sensations. However, many urologists, given the presence of the psychosocial etiology of cystitis in some patients, continue to advocate surgical treatment. Goal. Familiarizing urologists, gynecologists, and mental health professionals with the fact that cystitis consists of heterogeneous subtypes with corresponding pathogenic pathways, comorbid mental disorders, and emotional characteristics. Among these subtypes, the psychosocial phenotype should be distinguished, which has its own specifics, psychodynamics and requires appropriate complex treatment tactics. Materials and methods. 35 women from 25 to 48 years old suffering from recurrent cystitis for 7-12 years and 35 women without urological disorders. The following diagnoses are observed in patients: somatoform autonomic dysfunction of the genitourinary system (F45. 34); psychological factors in chronic recurrent cystitis (F54); recurrent depressive disorder, an episode of moderate severity (F33.1). The patients were examined using the questionnaire of the severity of psychopathological symptoms (SCL-90-R) and the scale of diagnosis of early maladaptive schemes (YSQ S3R). Results. The psychosocial phenotype of cystitis is represented by high somatization, the presence of obsessive-compulsive traits, interpersonal sensitivity, a tendency to develop depression and an anxiety spectrum of disorders. Among the maladaptive cognitive behavioral patterns, the following predominate: negativism/ pessimism, search for approval, feeling of vulnerability, lack of self-control, submission, self-sacrifice, feeling of abandonment and instability, distrust of other people. Conclusion. In addition to psychopharmacotherapy for the treatment of anxiety and depressive symptoms in patients with cystitis, psychotherapy aimed at minimizing difficulties in emotional awareness (alexithymia) and unresolved childhood trauma of relationships should be included in the treatment program. Multimodal psychodynamic psychotherapy and cognitive behavioral therapy can reduce symptoms, affect the immune and nervous systems, and the psychological well-being of patients with cystitis.

Treatment of recurrent cystitis during the post-COVID-19 recovery: a case report

In the modern literature on the coronavirus disease 2019 (COVID-19), much attention is paid to patients with a severe clinical course. But no less important is the recovery after disease. The first wave outcomes showed the significance of recovery period in such patients. Intensive drug therapy of COVID-19 increases the risk of iatrogenic complications, while the often long-term healing process is associated with a decrease in immune response, which activates latent infections and opportunistic pathogens. This necessitates an individual therapy selection, especially for elderly patients with comorbidities. The drugs of choice in such a situation should be as effective and safe as possible.The paper presents a case report of managing recurrent cystitis that developed during the post-COVID-19 recovery. The need for an additional search and assessing the significance of the revealed etiology, an integrated approach with the appointment of a broad-spectrum antiviral drug and a bacteriophage therapy is presented.

Urinary Microbiome Characteristics in Female Patients with Acute Uncomplicated Cystitis and Recurrent Cystitis

Traditionally, the diagnostic mainstay of recurrent urinary tract infection has been urinary culture. However, the causative uropathogen of recurrent cystitis has not been well established. Urine DNA next-generation sequencing (NGS) can provide additional information on these infections. Herein, we compared urine NGS results and urine cultures in patients with acute uncomplicated cystitis (AUC) and recurrent cystitis (RC), and evaluated the difference in microbiome patterns in the NGS results. Patients who underwent urine culture and NGS due to AUC or RC were retrospectively reviewed. All urine samples were collected via a transurethral catheter and studied utilizing a type of NGS called 16S ribosomal RNA gene amplification and sequencing. The sensitivity of urine NGS was significantly higher than that of conventional urine culture (69.0% vs. 16.7%, p < 0.05). The detection rate of urine NGS was slightly lower in the RC group than in the AUC group (67.7% vs. 72.7%). Microbiome diversity was significantly higher in the RC group compared to the AUC group (p = 0.007), and the microbiome composition was significantly different between the AUC and RC groups. In the urine NGS results, Pseudomonas, Acinetobacter, and Enterobacteriaceae were found in the AUC group, and Sphingomonas, Staphylococcus, Streptococcus, and Rothia spp. were detected in the RC group. Urine NGS can significantly increase the diagnostic sensitivity compared to traditional urine culture methods, especially in RC patients. AUC and RC patients had significant differences in bacterial diversity and patterns. Therefore, recurrent cystitis might be approached from a different perspective.

Morphological assessment of the mucous membranes of the bladder and vagina in chronic cystitis in women

The study involved 107 women aged 20 to 52 years with chronic recurrent cystitis (57 of them with leukoplakia) developing under conditions of a pathogenic and/or opportunistic infection. All patients underwent a conventional clinical and instrumental examination. Biopsy samples for culture-based and microscopic examination were taken from the area of the Pawlik’s trigone of the vagina and the Lieutaud’s trigone of the urinary bladder, in case of leukoplakia — from the field of visually healthy tissue. The carried out cytomorphological analysis and assessment of pathological processes in the adjacent tissues suggest that the infection from the vagina penetrates through the intersynaptic clefts, interstitial cell nests, the blood and lymphatic microcirculatory system into the bladder, causing cystitis inherent changes — from initial morphological forms to rough ones, up to leukoplakia. A complex of clinical, functional and pathomorphological changes that fit into the framework of the chronic cystovaginitis concept was identified.