Postcoital cystitis is inflammation of the bladder whose symptoms appear soon after sexual intercourse. It is based on bacteria from the intestinal flora entering the urethra and then the bladder. Below are definitions, the mechanism, risk factors, manifestations, and the diagnostic approach.
What postcoital cystitis is
Cystitis is inflammation of the bladder; in urological practice the term often denotes a symptomatic infection with inflammation of the bladder mucosa and changes in the urine sediment. In English-language literature, lower urinary tract infections are discussed, which include the bladder and urethra. The postcoital variant is a clinical situation in which episodes coincide in time with sexual intercourse. Urinary tract infections rank second among infections of the body, and women are affected approximately four times more often than men.
Why cystitis occurs after sexual intercourse
Urinary tract infections are usually caused by bacteria from stool that enter the urinary tract through the urethra. The female urethra is shorter and wider than the male one, so bacteria more easily reach the bladder. Frequent sex promotes the entry of microorganisms into the urethra — this is directly listed among the risk factors for lower urinary tract inflammation. The most common causative agent is Escherichia coli, which accounts for up to 95% of cases; Staphylococcus saprophyticus accounts for up to 20%, streptococci of groups B and D for 1–2%. Normally the urethra remains sterile as long as the immune system resists microorganisms.
Cystitis from sex: risk factors
Risk factors include age with menopause and decreased estrogen levels, a sedentary lifestyle, urolithiasis, previously experienced diseases of the urogenital system, difficulty urinating, prolonged use of a urinary catheter, diabetes, pregnancy, abnormal location of the urethra, and frequent sex. In women, the use of spermicide for contraception and of a condom without lubricant are additionally significant — both can cause irritation of the integument.
How cystitis after sex manifests
Symptoms depend on the form of the disease. In acute cystitis, there is stinging during urination, increased frequency of urges (up to several times an hour), pain in the lower abdomen that intensifies during urination, cloudy urine, a rise in temperature to subfebrile levels, and general malaise. Characteristic signs also include a sensation of incomplete bladder emptying, burning at the end of urination, darkening of the urine or an admixture of blood, and discomfort in the lower abdomen in women.
- pain or burning during urination;
- urges more often than usual, including at night;
- sudden imperative urges;
- cloudy urine or blood in it;
- pain in the lower abdomen or in the back under the ribs.
How postcoital cystitis is diagnosed
The diagnosis of acute cystitis is made with a typical clinical picture and rapid improvement under antibacterial treatment. In a protracted course, the cause is determined and the condition is differentiated from tuberculosis, ulcer, schistosomiasis, bladder cancer, and prostate cancer. Planned examination of women includes history taking, urinalysis, urine culture, examination of the vaginal microflora, gynecological examination, testing for sexually transmitted diseases, ultrasound of the urogenital organs, cystoscopy (after the acute inflammation subsides), and biopsy.
When to see a doctor
Sources do not provide a separate count of episodes for postcoital cystitis; recurrent infections serve as a guide — two in six months or three in twelve. A doctor is consulted when symptoms worsen or do not improve within 48 hours, with very high or low temperature, chills, pain in the lower abdomen or in the back under the ribs, blood in the urine, diabetes, pregnancy, weakened immunity, and also if infections recur.
Bladder inflammation by itself is not a reason to call an ambulance; 103 or 112 — if confusion, drowsiness, or difficulty speaking appears.
The material is for reference purposes and does not replace consultation with a doctor.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer