Gurzhenko Yu. M., Zaitsev V. I.

IMMUNOPROPHYLAXIS OF CHRONIC CYSTITIS IN WOMEN: A MODERN VIEW THROUGH THE PRISM OF EVIDENCE-BASED MEDICINE

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About the author:

Gurzhenko Yu. M., Zaitsev V. I.

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LITERATURE REVIEWS

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Scientific article

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The problem of effective prevention of chronic cystitis remains one of the most challenging in modern urology and urogynecology, primarily due to the diversity of pathogenetic mechanisms and the limitations of antibacterial approaches. Despite the long-term use of low-dose antibiotics, numerous studies demonstrate their poor long-term efficacy and negative impact on the microbiota resistome, manifested by an increase in multidrug-resistant UPEC strains. In the context of the global epidemiological crisis of antibiotic resistance, immunoprophylaxis is steadily moving into the category of first-line strategies, as reflected in the 2024 EAU guidelines. An extremely important adjunct to immunoprophylaxis is the correction of risk factors, among which vaginal dysbiosis and hypoestrogenism have the greatest impact. Data on the restoration of urothelial architecture following the use of topical estrogens clearly demonstrate that the effectiveness of immunoprophylaxis significantly increases with normalization of the epithelial layer. Therefore, in the perimenopausal period, immunoprophylaxis cannot be considered as monotherapy. The clinical success of immunoprophylaxis depends not on the selection of a single agent, but on proper patient stratification according to recurrence phenotype. It is the personalized approach that ensures maximum therapeutic efficacy and allows minimization of antibiotic use. In patients with perimenopausal and postmenopausal changes, the combination of immunoprophylaxis with local estrogen therapy is advisable, as it restores epithelial integrity and colonization resistance.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 1, 180, 39-54 pages, index UDC 616.62-002.52-085.37:615.919:576.809.7

DOI:

10.29254/2077-4214-2026-1-180-39-54