The objective of the study was to study the role of menstrual cycle phases and pelvic inflammatory diseases in the pathogenesis of acute uncomplicated cystitis in women of reproductive age.
In this work we present the results of the study of incidence of acute uncomplicated cystitis, which preceded acute uncomplicated pyelonephritis in 232 women of reproductive age. Of the total number of patients, 178 (76.7%) indicated the presence of acute uncomplicated cystitis symptoms at the beginning of the disease. Group I consisted of 135 patients with acute uncomplicated cystitis in combination with pelvic inflammatory diseases (vaginitis, endometritis, salpingitis, oophoritis, et.). Group II consisted of 43 women with acute uncomplicated cystitis without concomitant of pelvic inflammatory diseases. These groups were divided according to the day of the menstrual cycle at which the disease began.
The distribution of the studied patients depending on the MC is shown in table 1.
Table 1: Frequency of AUC in women of reproductive age on different days of the MC.
p – value
|abs. n||%||±SE||abs. n||%||±SE|
|group І (n=135)||108||60,7||3,7||27||15,2||2,7||р<0,001|
|group ІІ (n=43)||40||22,5||3,1||3||1,7||1,0||р<0,001|
According to the data presented in the table in 83.2 ± 2.8% of the total group of women of reproductive age, acute uncomplicated cystitis begins from the 20 to the 5 day of menstrual cycle. The results of the study in groups indicate that 60.7% of women of group I and 22.5% of women of group II in the period from the 20 to the 5 day of the menstrual cycle the incidence of acute uncomplicated cystitis is 4 and 13 times, respectively higher than on other days of the cycle. In the period from the 20 to the 5 day of menstrual cycle acute uncomplicated cystitis occurs almost 3 times more often in the presence of pelvic inflammatory diseases (60.7 ± 3.7% vs. 22.5 ± 3.1%, p <0.001). In the period from 6 to 19 days, acute uncomplicated cystitis occurs almost 9 times more often in the presence of chronic inflammatory diseases of the pelvic organs (15.2 ± 2.7% vs. 1.7 ± 1.0%, p <0.001). This indicates that pelvic inflammatory diseases realize their pathogenetic potential outside the period in which the risks of occurrence or exacerbation of acute uncomplicated cystitis are maximum for women of reproductive age.
The period from the 20 to the 5 day of the menstrual cycle, which combines the luteal and menstrual phases, is the most dangerous for the occurrence of acute uncomplicated cystitis, regardless of the presence or absence of concomitant pelvic inflammatory diseases. This makes it possible to re-evaluate the principles of prevention of acute uncomplicated cystitis in women of reproductive age.