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Cureus . COVID-19-Associated Cystitis: De Novo Urinary Urgency Following SARS-CoV-2

tetano

Editor, Senior Moderator
Cureus


. 2025 Dec 16;17(12):e99386.
doi: 10.7759/cureus.99386. eCollection 2025 Dec.
COVID-19-Associated Cystitis: De Novo Urinary Urgency Following SARS-CoV-2

Trevor Virno[SUP] 1 [/SUP], Nate Tomilonus[SUP] 1 [/SUP], Joel Hart[SUP] 1 [/SUP], Carl Van Rensburg[SUP] 1 [/SUP], Douglas Walsh[SUP] 2 [/SUP]


Affiliations
Abstract

COVID-19 is widely recognized as a systemic disease with pulmonary, cardiovascular, and neurologic manifestations, yet growing evidence highlights the genitourinary tract as another important site of involvement. A distinct clinical entity, COVID-associated-cystitis (CAC), has been described in which patients develop de novo or worsening lower urinary tract symptoms (LUTS), such as urgency, frequency, and nocturia, without bacterial infection. This case report describes a 71-year-old woman who developed persistent urinary urgency following recovery from COVID-19, successfully treated with oxybutynin. The case is contextualized within the expanding literature on CAC, including evidence from biomarker studies, mechanistic analyses, and large cohort investigations. Emerging data support a pathophysiologic role for both inflammatory cytokine release and viral receptor expression in the bladder, with symptom overlap between CAC, overactive bladder (OAB), and interstitial cystitis. Recognition of CAC is clinically significant, preventing misdiagnosis as bacterial cystitis and guiding management using established OAB frameworks. The case underscores the importance of considering genitourinary sequelae of COVID-19 and contributes to the growing discussion on long COVID and bladder health.

Keywords: acute cystitis; coronavirus disease 2019 (covid-19); lower urinary tract symptoms; overactive bladder; urge incontinence.

 
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