Analysis of risk predictors for the recurrence of chronic recurrent cystitis in women

Objective. To identify risk factors for recurrent episodes of chronic relapsing cystitis (CRC) in women.

Materials and methods. The study included 108 patients (women; median age 40.0 [28; 55.5] years old) with a confirmed diagnosis of chronic recurrent cystitis. Patients underwent a comprehensive set of diagnostic and therapeutic procedures in accordance with the clinical protocol for the diagnosis and treatment of adult patients with urological diseases -in health care provided in outpatient and inpatient settings at district, regional, and national healthcare facilities of the Republic of Belarus, approved by the Order of the Ministry of Health of the Republic of Belarus No. 920 dated 22.09.2011. And furthermore, the occurrence of chronic cystitis recurrences was monitored within a year, after which the patients were divided into two groups: a group with disease recurrence (study group) —27 patients and a group without recurrence of CRC (comparison group) — 81 patients.

Results. Direct correlations were identified between lymphoid infiltration and stromal vascular congestion in bladder biopsy specimens (r_s=0.71; p<0.0001), between lymphoid infiltration in bladder biopsies and pelvic venous congestion (r_s=0.36; p<0.0001), and between stromal vascular congestion in bladder biopsies and pelvic venous congestion (r_s=0.51; p<0.0001). When analyzing recurrence cases it was revealed that 81.5% (22/27) of patients in the study group there has been a combination of pelvic varicose veins and characteristic morphological changes in the bladder mucosa (venous congestion and stasis, acanthotic strands, and lymphoid infiltration), whereas this combination was observed in 11.1% (9/81) of patients in the comparison group. Predictors of the risk of chronic cystitis exacerbation have been identified. The authors have developed and proposed an algorithm for assessing the probability of chronic cystitis recurrence in women.

Conclusion. The identified associations between morphological changes in the urinary bladder (lymphoid infiltration, venous congestion and stasis, acanthotic strands) and pelvic varicosities, combined with their high prevalence (81.5%) in patients with recurrent CRC, indicate that these factors influence the likelihood of CRC recurrence. This necessitates appropriate diagnostic and therapeutic measures aimed at eliminating these risk factors to reduce the probability of CRC recurrence.

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