Management of honeymoon cystitis: a rare case report

¹Department of Obstetrics and Gynecological Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India

^&Corresponding author
Himanshi Sathawane, Department of Obstetrics and Gynecological Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India

Introduction    

Within a day and a half of sexual encounters or vaginal manipulations, persistent bladder irritation known as honeymoon cystitis frequently develops. It is manifested by frequent painful urination, abdominal pain, pollakiuria, frequent painful urination, and stomach discomfort are the symptoms. 11.5-2.5 percent of individuals with chronically exacerbated bladder irritation had a diagnosis of honeymoon cystitis [1]. Sometimes referred to as honeymoon cystitis, acute cystitis that develops following frequent sexual relations, is painful. Mild episodes of honeymoon cystitis frequently become well on their own in a few days. However, in rare situations, honeymoon cystitis may need to be treated [2]. Honeymoon triggers sexual activity, stress, dehydration, and prolonged incontinence are all symptoms of cystitis [3]. When you have sex for the first time, honeymoon cystitis frequently occurs. Early 20s women engage in sex more frequently and for the first time. Additionally, older women returning to a sexual relationship (such as after a divorce) are more prone to suffer UTI [4]. Strong and frequent urges to urinate, a burning feeling when urinating, and other symptoms of honeymoon cystitis urinating infrequently yet in tiny amounts, a bloody urine, foamy urine, strong-smelling urine, pain in the pelvis a mild fever, feeling pressure or discomfort in the lower abdomen [5]. The greatest technique to reduce honeymoon cystitis symptoms is to cleanse the bladder as frequently as you can. Try to consume eight glasses of water a day, and go to the bathroom regularly, especially after sexual activity. This will assist in eliminating any remaining germs [6]. Consume cranberries or cranberry juice often during especially hot weather. Cranberries make the bacteria very unpleasant [7].

Patient and observation     

Patient Information: a 24-year-old female housewife complaining of increase frequency of micturition since 1 year. She has frequency of micturition 20 - 30 times per day and pain in abdomen. She was treated with nitrofurantoin for same, but not relieved. Patient was conscious and oriented. Her duration of marriage is 1 month, her last menstrual period was 25/5/2022. History of dysmenorrhea during menstruation. Patient and her family members were psychological stable. She maintains good interpersonal relationship with others.

Clinical finding: on physical examination, there was state of health was unhealthy, conscious, body built thin, posture erect. General parameter height was 154 cm, weight 45 kg. Vital sign is Temperature 98°c, Pulse 84 b/m, respiration - 20 b/m, BP - 120/80 mmHg. An advance investigation was done such as cultural sensitivity test reveals organism isolated is E. coli (> 10⁵ cfu/ml) and sensitive to Imipenem, Meropenem, Nitrofurantoin, Fosfomycin.

Timeline of current episode: she has frequency of micturition 20 - 30 times per day and pain in abdomen.

Diagnostic assessment: urine examination shows yellowish colour, turbid appearance, 6-8/hpf epithelial cells and 25-30/hpf pus cells. Blood investigation liver function test; alkaline phosphate 101, ALT (SGPT) 42, AST(SGOT) 37, total protein 7.3, Albumin 4.2, total bilirubin 0.6, BC bilirubin conjugated 0.3, kidney function test; urea 25 mg/dl, creatinine 0.5 mg/dl, sodium 141mmol/L, potassium 3.8mmol/L haemoglobin 11.8%, WBC 8000, platelet count 1.56.

Diagnosis: all the above clinical and imaging results confirmed the diagnosis of honeymoon cystitis.

Therapeutic interventions: medication was administered Inj ondansetron 4 mg IV 8 hourly, Inj Pantoprazole 40 mg IV 12 hourly, Tab flavoxate hydrochloride 200 mg TDS, Tab tolterodine titrate 2 mg/ 4 mg.

Informed consent: written informed consent was obtained from the patient for the publication of this case report.

Discussion     

When a woman engages in sexual activity for the first time or after a prolonged period of abstinence, she may develop honeymoon cystitis. E. coli bacteria, which typically reside on the skin around the anus, can be transmitted to your urethra during intercourse [8]. The majority of episodes of acute, simple cystitis are caused by the bacteria Escherichia coli. Staphylococcus saprophyticus, Klebsiella, Enterococci, and Proteus are responsible for the remaining occurrences of honeymoon cystitis [9]. E. colibacteria, which are present in blood around the anus during sexual activity, may be transmitted to the urethra. Sexual activity helps transfer bacteria up the urinary system, where they can do the greatest damage and subsequently show up as urinary tract infection symptoms when bacteria colonies in the urinary tract [10]. If cystitis honeymoon is not treated quickly, it may develop into a chronic condition. In this situation, taking drugs to regain immunity is added to the antibiotic therapy. If cystitis honeymoon is not treated immediately, it might become chronic. In this case, taking medication to boost immunity is combined with antibiotic therapy [11].

Conclusion     

Development of urinary tract infection depends on virulence of host bacteria. Fever and stomach pains might develop, and the urine may occasionally include blood or pus. Avoiding caffeine, drinking enough water each day, regularly drinking cranberry juice, using appropriate lubrication before having any sexual contact, and emptying the bladder both before and after contact are recommended as the greatest preventative strategies for E. coli infection. By doing this, you may prevent bacteria from growing by removing them.

Competing interests     

The authors declare no competing interests.

Authors' contributions     

All the authors have read and agreed to the final manuscript.

References