Outcomes of Surgical Correction of the Urethra in the Management of Postcoital Cystitis: A Systematic Review and Meta-Analysis

Loran O.B., Vorobev V.A., Kosova I.V., Kasyan G.R., Sharakshinov B.K., Kostyuchenko D.O.

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, Moscow, Russia; 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, Moscow, Russia; 3) Bashkir State Medical University, Ufa, Russia; 4) Irkutsk State Medical University, Irkutsk, Russia; 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, Moscow, Russia; 6) Russian University of Medicine, Moscow, Russia; 7) MoscowExpert Clinic LLC, Irkutsk, Russia; 8) MEDICLINIC Clinical and Diagnostic Center LLC, Penza, Russia

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

Corresponding author: V.A. Vorobev – Doctor of Medical Sciences, M.D., Professor of the Department of Faculty Surgery and Urology at the Federal State Budgetary Educational Institution of Higher Education «Irkutsk State Medical University» of the Ministry of Health of the Russian Federation, Irkutsk, Russia; Associate Professor of the Department of Urology and Oncology of the Federal State Budgetary Educational Institution of Higher Education «Bashkir State Medical University» of the Ministry of Health of the Russian Federation, Ufa, Russia; e-mail: denecer@yandex.ru

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