{"id":60095,"date":"2025-12-16T15:58:45","date_gmt":"2025-12-16T14:58:45","guid":{"rendered":"https:\/\/www.dimann.com\/eco\/paper-2025-r01\/"},"modified":"2026-02-05T20:25:44","modified_gmt":"2026-02-05T19:25:44","slug":"white-paper-2026-r01","status":"publish","type":"page","link":"https:\/\/www.dimann.com\/en\/eco\/white-paper-2026-r01\/","title":{"rendered":"White Paper 2026-r01 \u2014 Full text"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"60095\" class=\"elementor elementor-60095 elementor-59874\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1ead5e06 eco-subnav e-con-full e-flex e-con e-parent\" data-id=\"1ead5e06\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;sticky&quot;:&quot;top&quot;,&quot;sticky_offset&quot;:94,&quot;sticky_offset_mobile&quot;:88,&quot;sticky_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;],&quot;sticky_effects_offset&quot;:0,&quot;sticky_anchor_link_offset&quot;:0}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5e799972 elementor-widget elementor-widget-image\" data-id=\"5e799972\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.dimann.com\/en\/eco\/\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"314\" height=\"68\" data-src=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2025\/12\/Logo-ECO-no-dimann-negativo.webp\" class=\"attachment-large size-large wp-image-60219 lazyload\" alt=\"\" data-srcset=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2025\/12\/Logo-ECO-no-dimann-negativo.webp 314w, https:\/\/www.dimann.com\/wp-content\/uploads\/2025\/12\/Logo-ECO-no-dimann-negativo-120x26.webp 120w, https:\/\/www.dimann.com\/wp-content\/uploads\/2025\/12\/Logo-ECO-no-dimann-negativo-186x40.webp 186w\" data-sizes=\"(max-width: 314px) 100vw, 314px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 314px; --smush-placeholder-aspect-ratio: 314\/68;\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-52e3f205 elementor-nav-menu__align-justify elementor-nav-menu--dropdown-mobile elementor-nav-menu--stretch elementor-hidden-mobile elementor-nav-menu__text-align-aside elementor-widget elementor-widget-nav-menu\" data-id=\"52e3f205\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;full_width&quot;:&quot;stretch&quot;,&quot;layout&quot;:&quot;horizontal&quot;,&quot;submenu_icon&quot;:{&quot;value&quot;:&quot;&lt;svg class=\\&quot;e-font-icon-svg e-fas-caret-down\\&quot; viewBox=\\&quot;0 0 320 512\\&quot; xmlns=\\&quot;http:\\\/\\\/www.w3.org\\\/2000\\\/svg\\&quot;&gt;&lt;path d=\\&quot;M31.3 192h257.3c17.8 0 26.7 21.5 14.1 34.1L174.1 354.8c-7.8 7.8-20.5 7.8-28.3 0L17.2 226.1C4.6 213.5 13.5 192 31.3 192z\\&quot;&gt;&lt;\\\/path&gt;&lt;\\\/svg&gt;&quot;,&quot;library&quot;:&quot;fa-solid&quot;}}\" data-widget_type=\"nav-menu.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t<nav aria-label=\"Menu\" class=\"elementor-nav-menu--main elementor-nav-menu__container elementor-nav-menu--layout-horizontal e--pointer-background e--animation-fade\">\n\t\t\t\t<ul id=\"menu-1-52e3f205\" class=\"elementor-nav-menu\"><li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-60951\"><a href=\"https:\/\/www.dimann.com\/en\/eco\/\" class=\"elementor-item\">Observatory<\/a><\/li>\n<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-60952\"><a href=\"https:\/\/www.dimann.com\/en\/eco\/white-paper-2026-r01-anteprima\/\" class=\"elementor-item\">White Paper<\/a><\/li>\n<\/ul>\t\t\t<\/nav>\n\t\t\t\t\t\t<nav class=\"elementor-nav-menu--dropdown elementor-nav-menu__container\" aria-hidden=\"true\">\n\t\t\t\t<ul id=\"menu-2-52e3f205\" class=\"elementor-nav-menu\"><li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-60951\"><a href=\"https:\/\/www.dimann.com\/en\/eco\/\" class=\"elementor-item\" tabindex=\"-1\">Observatory<\/a><\/li>\n<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-60952\"><a href=\"https:\/\/www.dimann.com\/en\/eco\/white-paper-2026-r01-anteprima\/\" class=\"elementor-item\" tabindex=\"-1\">White Paper<\/a><\/li>\n<\/ul>\t\t\t<\/nav>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6de667b5 no-custom-bullets elementor-hidden-desktop elementor-hidden-tablet elementor-widget elementor-widget-n-accordion\" data-id=\"6de667b5\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1840\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1840\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\">  <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1840\" class=\"elementor-element elementor-element-1d3d525e e-con-full e-flex e-con e-child\" data-id=\"1d3d525e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1840\" class=\"elementor-element elementor-element-711baba e-flex e-con-boxed e-con e-child\" data-id=\"711baba\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-339a23d elementor-widget elementor-widget-button\" data-id=\"339a23d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/www.dimann.com\/en\/eco\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">OBSERVATORY<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3fd5d0f elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"3fd5d0f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f2e0883 elementor-widget elementor-widget-button\" data-id=\"f2e0883\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/www.dimann.com\/en\/eco\/white-paper-2026-r01-anteprima\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">white paper<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5498693 e-con-full e-flex e-con e-parent\" data-id=\"5498693\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-ed007e2 e-con-full e-flex e-con e-child\" data-id=\"ed007e2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-3eccf3f e-con-full e-flex e-con e-child\" data-id=\"3eccf3f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-9c5a5ed e-con-full e-flex e-con e-child\" data-id=\"9c5a5ed\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-553477e elementor-widget elementor-widget-heading\" data-id=\"553477e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">white paper<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-85ead89 elementor-widget elementor-widget-heading\" data-id=\"85ead89\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">January 2026<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-42b7c22 elementor-widget elementor-widget-heading\" data-id=\"42b7c22\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\">Understanding Recurrent and Chronic Cystitis \u2014<\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-57344f2 elementor-widget elementor-widget-heading\" data-id=\"57344f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Psychological impact of an ongoing battle. Evidence from Italy. <\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e3013f5 e-con-full elementor-hidden-mobile e-flex e-con e-child\" data-id=\"e3013f5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-91be73b e-con-full e-flex e-con e-child\" data-id=\"91be73b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ad1de78 elementor-align-right elementor-widget elementor-widget-button\" data-id=\"ad1de78\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/mailchi.mp\/2b19cf1d979c\/download-white-paper\">\n\t\t\t\t\t\t<span 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17.4831 11.3086 17.3999 11.2041 17.295L4.45406 10.5459ZM20.25 19.125H3.75C3.45163 19.125 3.16548 19.2435 2.9545 19.4545C2.74353 19.6655 2.625 19.9516 2.625 20.25C2.625 20.5484 2.74353 20.8345 2.9545 21.0455C3.16548 21.2565 3.45163 21.375 3.75 21.375H20.25C20.5484 21.375 20.8345 21.2565 21.0455 21.0455C21.2565 20.8345 21.375 20.5484 21.375 20.25C21.375 19.9516 21.2565 19.6655 21.0455 19.4545C20.8345 19.2435 20.5484 19.125 20.25 19.125Z\" fill=\"white\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">download the white paper<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7cbe487 e-flex e-con-boxed e-con e-parent\" data-id=\"7cbe487\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-3594371 e-con-full e-flex e-con e-child\" data-id=\"3594371\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f4b6a20 elementor-toc--minimized-on-mobile eco-toc elementor-widget elementor-widget-table-of-contents\" data-id=\"f4b6a20\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h2&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;no_headings_message&quot;:&quot;Non sono state trovate intestazioni in questa pagina.&quot;,&quot;minimized_on&quot;:&quot;mobile&quot;,&quot;motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;marker_view&quot;:&quot;numbers&quot;,&quot;minimize_box&quot;:&quot;yes&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;motion_fx_devices&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;]}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t\t\t\t<h4 class=\"elementor-toc__header-title\">\n\t\t\t\tTable of contents\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button 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d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<div id=\"elementor-toc__f4b6a20\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5674528 e-con-full e-flex e-con e-child\" data-id=\"5674528\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-5bde7a2 e-con-full e-flex e-con e-child\" data-id=\"5bde7a2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-d8dd9ee e-con-full e-flex e-con e-child\" data-id=\"d8dd9ee\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-147e8a4 elementor-widget elementor-widget-heading\" data-id=\"147e8a4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Credits<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-766c337 elementor-widget elementor-widget-text-editor\" data-id=\"766c337\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>European Cystitis Observatory (ECO)<\/p><p>Version V1<\/p><p>2026<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-65428a0 elementor-widget elementor-widget-text-editor\" data-id=\"65428a0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>DOI<\/strong>: 10.5281\/zenodo.18185934<\/p><p><strong>License:<\/strong> CC BY 4.0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-472aefd e-con-full e-flex e-con e-child\" data-id=\"472aefd\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-50cec77 elementor-widget elementor-widget-heading\" data-id=\"50cec77\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">How to cite (APA)<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6c4e6cf elementor-widget elementor-widget-text-editor\" data-id=\"6c4e6cf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>European Cystitis Observatory (ECO). (2026). Understanding Recurrent and Chronic Cystitis &#8211; Psychological impact of an ongoing battle.<\/p><p>Evidence from Italy.<\/p><p>(Versione V1). Zenodo.  <a href=\"https:\/\/doi.org\/10.5281\/zenodo.18185934\" target=\"_blank\" rel=\"noopener nofollow noreferrer\">https:\/\/doi.org\/10.5281\/zenodo.18185934<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6cb8fc4 e-con-full e-flex e-con e-child\" data-id=\"6cb8fc4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-930e574 elementor-widget elementor-widget-heading\" data-id=\"930e574\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">How to cite (Harvard)<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3c86638 elementor-widget elementor-widget-text-editor\" data-id=\"3c86638\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>European Cystitis Observatory (ECO) (2026) \u00abUnderstanding Recurrent and Chronic Cystitis &#8211; Psychological impact of an ongoing battle.<\/p><p>Evidence from Italy.\u00bb.<\/p><p>Zenodo. doi:10.5281\/zenodo.18185934. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ac109c7 e-con-full e-flex e-con e-child\" data-id=\"ac109c7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6fab152 elementor-widget elementor-widget-heading\" data-id=\"6fab152\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Preface<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-930af0a elementor-widget elementor-widget-text-editor\" data-id=\"930af0a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><b>Cystitis<\/b> <b>is still a persistent healthcare challenge for many women in Italy<\/b>. <span style=\"font-weight: 400;\">Despite this, research exploring its impact on daily life\u2014by analyzing the psychological, social, and economic factors that influence it\u2014remains surprisingly limited.<\/span><\/p><p><span style=\"font-weight: 400;\">With this white paper,<\/span> <b>Dimann<\/b> <span style=\"font-weight: 400;\">launches the first in a series of studies aimed at<\/span> <b>gaining a deeper understanding of the social and behavioral dynamics surrounding cystitis,<\/b> <span style=\"font-weight: 400;\">considering them both as possible causes and as consequences of the condition.<\/span><\/p><p><span style=\"font-weight: 400;\">This first publication highlights two key aspects: on the one hand, the lack of data and research on the real impact of cystitis in everyday life; on the other, the tangible burden this condition places on women every single day.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4b349a7 e-con-full e-flex e-con e-child\" data-id=\"4b349a7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4fdbabc elementor-widget elementor-widget-heading\" data-id=\"4fdbabc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Executive summary<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c637058 elementor-widget elementor-widget-text-editor\" data-id=\"c637058\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><span style=\"font-weight: 400;\">In today\u2019s data-driven world, cystitis still represents a blind spot. This white paper was created with the aim of presenting  <\/span><b>the Dimann dataset,<\/b> <span style=\"font-weight: 400;\">which offers an unprecedented perspective on the daily challenges, risk factors, and psychological weight of cystitis on the lives of those affected.<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-71b30f7 e-con-full e-flex e-con e-child\" data-id=\"71b30f7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-da3fc70 elementor-widget elementor-widget-heading\" data-id=\"da3fc70\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Overview<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-07f0f3d elementor-widget elementor-widget-text-editor\" data-id=\"07f0f3d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Cystitis is a major public health issue, yet it is still often underestimated.<\/span><\/p><p><span style=\"font-weight: 400;\">It primarily affects women, and its incidence increases significantly with age, becoming particularly common among older people. A substantial proportion of patients develop recurrent or chronic cystitis, which involves persistent pain, discomfort, and emotional distress, with a profound impact on quality of life and productivity. <\/span><\/p><p><span style=\"font-weight: 400;\">Despite this, available data and research on the social and behavioral aspects of cystitis are very limited, revealing important gaps in the understanding of risk factors and the broader implications of cystitis.<\/span><\/p><p><span style=\"font-weight: 400;\">In this context, the<\/span> <b>Dimann dataset<\/b> <span style=\"font-weight: 400;\">introduces a valuable and innovative, person-centered perspective, and makes it possible to analyze the affected population with an unprecedented level of detail.<\/span><\/p><p><span style=\"font-weight: 400;\">With over <\/span><b>34,000 questionnaires collected across Europe<\/b><span style=\"font-weight: 400;\">, the dataset represents the largest and most comprehensive snapshot ever created of people living with cystitis.<\/span><\/p><p><span style=\"font-weight: 400;\">This resource makes it possible both to analyze behavioral risk factors and to assess consequences on quality of life\u2014two dimensions often overlooked in traditional clinical research.<\/span><\/p><p><span style=\"font-weight: 400;\"> In particular, the data highlight the strong psychological burden of the condition, revealing its wide-ranging impact on everyday life, interpersonal relationships, and emotional health.<\/span><\/p><p><span style=\"font-weight: 400;\">This new body of evidence reframes cystitis not only as a clinical issue, but also as a social one, underscoring the urgency of an integrated intervention that includes more effective diagnostic and therapeutic processes, targeted preventive actions, and comprehensive patient support.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7e423a9 e-con-full e-flex e-con e-child\" data-id=\"7e423a9\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f49fa4f elementor-widget elementor-widget-heading\" data-id=\"f49fa4f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Introduction<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2a79daf elementor-widget elementor-widget-text-editor\" data-id=\"2a79daf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><span style=\"font-weight: 400;\">This section introduces cystitis and the challenges associated with it, outlining its causes, prevalence, different types of infection, and the most common symptoms.<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-14efe57 elementor-widget elementor-widget-text-editor\" data-id=\"14efe57\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><b>Cystitis is a urinary tract infection (UTI) that presents as inflammation of the bladder wall.<\/b><span style=\"font-weight: 400;\">. It is estimated to affect about 40\u201360% of women worldwide at least once in their lifetime. <\/span><\/p><p><span style=\"font-weight: 400;\">Among them,<\/span> <b>over 20% experience recurrent episodes and at least 5% develop a chronic form that can persist for years [1-2].<\/b><span style=\"font-weight: 400;\">What appears to be an isolated infection often turns, in many cases, into a long-lasting and debilitating condition. <\/span><\/span><\/span><\/p><p><b>Women are significantly more at risk of developing cystitis than men,<\/b><span style=\"font-weight: 400;\"> mainly due to an anatomical difference: the female urethra is much shorter (about 5 cm, compared to 16 cm in men), offering bacteria a more direct path to the bladder <\/span><span style=\"font-weight: 400;\">[3]<\/span><span style=\"font-weight: 400;\">.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4e548ca elementor-widget elementor-widget-text-editor\" data-id=\"4e548ca\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">In addition to this structural vulnerability, hormonal factors play a role\u2014particularly reduced estrogen levels, whether physiologically with age or linked to certain conditions\u2014which can alter the balance of the vaginal and intestinal microbiota, creating a favorable environment for pathogenic bacteria to proliferate.<\/span><\/p><p><b>Sexual activity, pregnancy, and the use of certain contraceptive methods can also increase infection risk<\/b> <span style=\"font-weight: 400;\">by modifying the internal balance or mechanically facilitating bacterial ascent.<\/span><\/p><p><b>For both sexes, certain unhealthy habits can increase the likelihood of developing an infection.<\/b><span style=\"font-weight: 400;\">. Among the most relevant factors are insufficient hydration, poor diet, smoking, disrupted sleep rhythms, chronic stress, and irregular urination habits.<\/span><\/p><p><span style=\"font-weight: 400;\">Taken together, these elements show how cystitis does not stem from a single vulnerability, but rather results from multiple concomitant factors.<\/span><\/p><p><b>In men, although cystitis is less frequent, the risk increases significantly with age,<\/b> <span style=\"font-weight: 400;\">often in association with benign prostatic hyperplasia or the presence of other conditions.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b87c010 e-con-full e-flex e-con e-child\" data-id=\"b87c010\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ccd9edb elementor-widget elementor-widget-image\" data-id=\"ccd9edb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"625\" height=\"625\" src=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-1@3x.webp\" class=\"attachment-large size-large wp-image-60988\" alt=\"Graphic representation of the cystitis forms in women\" srcset=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-1@3x.webp 625w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-1@3x-120x120.webp 120w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-1@3x-186x187.webp 186w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-1@3x-384x384.webp 384w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-1@3x-600x600.webp 600w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-1@3x-390x390.webp 390w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-1@3x-420x420.webp 420w\" sizes=\"(max-width: 625px) 100vw, 625px\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">FIGURE 1 | Estimated distribution of cystitis forms in women.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dd88dd5 elementor-widget elementor-widget-heading\" data-id=\"dd88dd5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">The incidence of chronic cystitis is likely underestimated, because periods of remission may lead to misclassifying some cases as recurrent forms.<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-389d729 elementor-widget elementor-widget-text-editor\" data-id=\"389d729\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Although only a minority of cases develop into severe complications, such as kidney failure or sepsis <\/span><span style=\"font-weight: 400;\">[4]<\/span><span style=\"font-weight: 400;\">,<\/span> <b>the vast majority of patients live with a constellation of persistent and debilitating symptoms. <\/b><span style=\"font-weight: 400;\">. The most common include burning during urination, increased frequency and urgency, and pain localized in the lower abdomen [<\/span><span style=\"font-weight: 400;\">5]<\/span><span style=\"font-weight: 400;\">.<\/span><\/p><p><span style=\"font-weight: 400;\">These manifestations can be<\/span> <b>deeply disabling<\/b><span style=\"font-weight: 400;\">interfering with daily activities. Moreover, what makes cystitis particularly difficult is its  <\/span><b>tendency to become recurrent<\/b><span style=\"font-weight: 400;\">\u2014often resistant to conventional therapies and capable of reappearing cyclically. Over time,  <\/span><b>the impact goes well beyond physical discomfort: recurrent episodes generate uncertainty, anxiety, and a sense of vulnerability, and can lead to isolation or a perceived loss of autonomy [<\/b><span style=\"font-weight: 400;\">8]. <\/span><span style=\"font-weight: 400;\">. In this way, recurrent or chronic cystitis becomes far more than a simple medical condition: it becomes a long-term psychosocial burden capable of significantly reducing quality of life.<\/span><\/p><p><b>The recurrent nature of cystitis depends on specific predisposing factors and triggers.<\/b><span style=\"font-weight: 400;\">. The spectrum of infections is dominated by a relatively small group of pathogens: the most frequent is<\/span><b>Escherichia coli<\/b>,<span style=\"font-weight: 400;\"> followed by <\/span><i><span style=\"font-weight: 400;\">Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, Enterobacter cloacae, and Staphylococcus saprophyticus<\/span><\/i> <i><span style=\"font-weight: 400;\">[9]. <\/span><\/i><span style=\"font-weight: 400;\">. Together, these microorganisms account for the majority of urinary infections, each with its own virulence factors and resistance mechanisms that influence disease course.<\/span><\/p><p><span style=\"font-weight: 400;\">These pathogens are not merely \u201cpassive invaders\u201d: they possess a complex set of virulence strategies enabling them to adhere firmly to the urothelial epithelium, evade the host immune defenses, and establish protected reservoirs within the urinary tract that can reactivate infection when conditions become favorable\u2014even after completing therapy.<\/span><\/p><p><span style=\"font-weight: 400;\">Such adaptability explains<\/span> <b><span style=\"font-weight: 400;\">why many patients experience relapses even after apparent therapeutic success.<\/span><\/b><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-cbb8774 e-con-full e-flex e-con e-child\" data-id=\"cbb8774\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b9a2e6e elementor-widget elementor-widget-image\" data-id=\"b9a2e6e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1024\" height=\"563\" data-src=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/FIgure-2@3x.webp\" class=\"attachment-large size-large wp-image-60999 lazyload\" alt=\"Graphic representing the incidence of cystitis by age and sex\" data-srcset=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/FIgure-2@3x.webp 1266w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/FIgure-2@3x-120x66.webp 120w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/FIgure-2@3x-186x102.webp 186w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/FIgure-2@3x-690x379.webp 690w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/FIgure-2@3x-420x231.webp 420w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/FIgure-2@3x-700x385.webp 700w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/FIgure-2@3x-720x396.webp 720w\" data-sizes=\"(max-width: 1024px) 100vw, 1024px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/563;\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">FIGURE 2 | Incidence of cystitis by age and sex.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2aae0cb elementor-widget elementor-widget-heading\" data-id=\"2aae0cb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">In women, prevalence increases in connection with sexual activity, pregnancy, and menopause; in men, risk grows mainly after age 60, in relation to prostatic conditions.<br>Adapted from: AOGOI. \u201cUrinary tract infections in women from pre-adolescence to adulthood\u201d [6].<br>Model by: Zamparini E., G. Ital. Nefrol. (2012) [7].    <\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-df24f47 elementor-widget elementor-widget-text-editor\" data-id=\"df24f47\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">As a result, the relapse cycle becomes hard to break: each new episode increases patient discomfort and raises the risk of antibiotic resistance.<\/span><\/p><p><b>In some cases, the infection progresses beyond recurrence, taking on a chronic form <\/b><span style=\"font-weight: 400;\">that can persist over time without complete resolution.<\/span> <b>Chronic cystitis often develops due to incomplete or delayed treatments, missed diagnoses, or sometimes the absence of appropriate therapeutic intervention<\/b>.<span style=\"font-weight: 400;\">. Unlike recurrent cystitis\u2014where symptoms alternate with remission periods\u2014the chronic form is characterized by continuous, uninterrupted discomfort.<\/span><\/p><p><b>Diagnosis and therapy<span style=\"font-weight: 400;\"> also <\/span>remain a major challenge. <\/b><span style=\"font-weight: 400;\">Urine culture, considered the only truly definitive diagnostic tool for urinary infections, is not performed regularly in everyday clinical practice; moreover,<\/span> <b>many patients, underestimating or misinterpreting symptoms, delay medical evaluation.<\/b><\/p><p><span style=\"font-weight: 400;\">At the same time, healthcare providers sometimes resort to <\/span><b>empiric antibiotic therapy <\/b><span style=\"font-weight: 400;\">[9],<\/span><span style=\"font-weight: 400;\">especially in cases where symptom relief is prioritized over diagnostic confirmation. While this approach may offer temporary improvement, it carries significant risks. <\/span><\/p><p><span style=\"font-weight: 400;\">The absence of culture-supported diagnosis frequently leads to<\/span> <b>inappropriate antibiotic selection, incomplete pathogen eradication, and a higher likelihood of recurrence.<\/b><span style=\"font-weight: 400;\">. Even more concerning, widespread empiric therapy promotes antimicrobial resistance.<\/span><\/p><p><span style=\"font-weight: 400;\">Previous studies<\/span> <span style=\"font-weight: 400;\">[9]<\/span><span style=\"font-weight: 400;\"> have shown that indiscriminate antibiotic prescribing not only reduces cure rates but also prolongs hospital stays, increases relapse risk, and accelerates the emergence of resistance. This triggers a vicious cycle in which treatments become progressively less effective, putting pressure on both patients and the healthcare system as a whole. <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3e4f2d0 e-con-full e-flex e-con e-child\" data-id=\"3e4f2d0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d099b6d elementor-widget elementor-widget-image\" data-id=\"d099b6d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1024\" height=\"630\" data-src=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-3@3x.webp\" class=\"attachment-large size-large wp-image-61009 lazyload\" alt=\"Graph representing che survey results on knowledge of urinary infection prevention strategies (e.g. drinking plenty of water, mantaining proper intimate hygiene etc.)\" data-srcset=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-3@3x.webp 1127w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-3@3x-120x74.webp 120w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-3@3x-186x114.webp 186w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-3@3x-634x390.webp 634w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-3@3x-420x258.webp 420w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-3@3x-700x430.webp 700w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-3@3x-720x443.webp 720w\" data-sizes=\"(max-width: 1024px) 100vw, 1024px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/630;\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">FIGURE 3 | Survey results on knowledge of urinary infection (UTI) prevention strategies.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-44ff695 elementor-widget elementor-widget-heading\" data-id=\"44ff695\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Over 3,000 citizens from Spain, France, Germany, the United Kingdom, and Italy were interviewed about their knowledge and experience regarding UTIs.<br>Only one in five people was able to identify all main prevention strategies.Dati: European Association of Urology (EAU), 22\u201326 september 2025 [14].  <\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-48097dc e-con-full e-flex e-con e-child\" data-id=\"48097dc\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bd09fa9 elementor-widget elementor-widget-heading\" data-id=\"bd09fa9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Data and perspectives in the Italian context<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1726add elementor-widget elementor-widget-text-editor\" data-id=\"1726add\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><span style=\"font-weight: 400;\">This section highlights the lack of cystitis data in Italy and presents the Dimann dataset as a valuable resource to deepen understanding of the causes and impact of this condition.<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-550dd0f elementor-widget elementor-widget-text-editor\" data-id=\"550dd0f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><b>Within the Italian healthcare system, cystitis is one of the most common conditions.<\/b><span style=\"font-weight: 400;\">. Despite its prevalence, accurately estimating the true impact of cystitis in Italy remains complex\u2014especially regarding causes, risk factors, epidemiological trends, and consequences on the lives of affected people. For instance, non-uniform diagnostic criteria and heterogeneous case definitions make it  <\/span><b>difficult to compare studies and clinical settings <\/b><span style=\"font-weight: 400;\">[10].<\/span><span style=\"font-weight: 400;\">. Additionally, many individuals experiencing mild or recurrent symptoms tend not to consult a physician, leading to underestimation in national surveillance systems and official statistics.<\/span><\/p><p><span style=\"font-weight: 400;\">Data collection in Italy is further complicated by strong <\/span><b>regional variability and fragmentation of health information systems<\/b><span style=\"font-weight: 400;\">, which hinder building a unified epidemiological picture<\/span><span style=\"font-weight: 400;\"> [11]. <\/span><span style=\"font-weight: 400;\">. Moreover, while hospital registries and administrative databases mainly capture more severe or complicated UTIs, the vast majority of uncomplicated cystitis cases remain excluded from official statistics.<\/span><\/p><p><span style=\"font-weight: 400;\">Recent studies have highlighted major gaps in the evidence available for the Italian context, emphasizing that data remain dispersed and inconsistent <\/span><span style=\"font-weight: 400;\">[10\u201312]<span style=\"font-weight: 400;\">.<\/span><\/span><\/p><p><span style=\"font-weight: 400;\">Furthermore, available epidemiological studies often group cystitis within broader UTI categories, thereby obscuring patterns specific to cystitis and its risk factors. Differences related to age, comorbidities, sexual behavior, and hormonal status further contribute to population heterogeneity, making extrapolation from limited samples unreliable. <\/span><\/p><p><span style=\"font-weight: 400;\">Beyond the clinical dimension, the real impact of cystitis extends to quality of life and socioeconomic burden, causing reduced productivity, sexual distress, and psychological stress\u2014<\/span><b>factors rarely considered in existing research<\/b><span style=\"font-weight: 400;\"> [12]<span style=\"font-weight: 400;\">.<\/span><\/span><\/p><p><span style=\"font-weight: 400;\">Overall, current evidence suggests that the estimated burden of cystitis in Italy underestimates its real impact on the population, both clinically and socioeconomically.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a698f09 elementor-widget elementor-widget-heading\" data-id=\"a698f09\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">The Dimann dataset<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aaf3fd5 elementor-widget elementor-widget-text-editor\" data-id=\"aaf3fd5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">In this context,<\/span> <b>the Dimann dataset <\/b><span style=\"font-weight: 400;\">represents a valuable opportunity to analyze a large sample of individuals affected by cystitis in Europe.<\/span><\/p><p><span style=\"font-weight: 400;\">Collected as part of assessing D-mannose buyers in order to assign targeted products, the database includes <\/span><b>over 34,000 questionnaires <\/b><span style=\"font-weight: 400;\">from four European countries, providing an extensive data foundation to address questions that have so far remained largely unexplored.<\/span><\/p><p><span style=\"font-weight: 400;\">The data include, for example, behavioral factors associated with the onset of cystitis\u2014such as<\/span> <i><span style=\"font-weight: 400;\">personal hygiene, dietary habits, stress levels, and other psychological or lifestyle-related factors<\/span><\/i>\u2014all recognized for their potential to guide personalized prevention strategies and significantly reduce recurrence risk <span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">[13]<\/span>.<\/span><\/p><p><span style=\"font-weight: 400;\">Beyond identifying risk factors, the dataset also highlights the <\/span><i><span style=\"font-weight: 400;\">profound impact of cystitis on everyday functioning and emotional wellbeing<\/span><\/i><span style=\"font-weight: 400;\">, showing to what extent recurring pain and uncertainty affect quality of life and <\/span><b>offering a rare patient-centered perspective.<\/b><\/p><p>With <b>over 30<\/b> <span style=\"font-weight: 400;\">items dedicated to sociodemographic characteristics, dietary habits, clinical management of cystitis, and its impact on daily life and activities, the dataset provides a comprehensive view of both behavioral risk factors and psychological consequences linked to the condition.<\/span><\/p><p><span style=\"font-weight: 400;\">Currently, the dataset includes participants from<\/span> <b>Italy, France, Germany, and Spain<\/b><span style=\"font-weight: 400;\">, ensuring broad European representativeness, with further expansion planned in the coming months.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9db40d5 e-con-full e-flex e-con e-child\" data-id=\"9db40d5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d2fd87c elementor-widget elementor-widget-heading\" data-id=\"d2fd87c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">The Dimann dataset (Italian sample overview)\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d6b3d30 elementor-widget elementor-widget-text-editor\" data-id=\"d6b3d30\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><span style=\"font-weight: 400;\">This section provides a preliminary overview of the sociodemographic composition of the Italian sample within the Dimann dataset, along with the main cystitis-related variables.<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d45aca5 elementor-widget elementor-widget-text-editor\" data-id=\"d45aca5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">For Italian participants, the dataset includes over <\/span><b><span style=\"font-weight: 400;\">25,000 observations collected between 2022 and 2025.<\/span><\/b><\/p><p><span style=\"font-weight: 400;\">Each record contains responses to all sections of the questionnaire, allowing a full analysis of demographic characteristics, psychological and behavioral patterns, and reported symptoms.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-03765e6 e-con-full e-flex e-con e-child\" data-id=\"03765e6\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-daf74e7 elementor-widget elementor-widget-heading\" data-id=\"daf74e7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Gender<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e38e407 elementor-widget elementor-widget-text-editor\" data-id=\"e38e407\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">In the Italian sample, a clear female predominance emerged, with <\/span><b>98.1% women compared to 1.7% men.<\/b> <span style=\"font-weight: 400;\">This female predominance is likely linked to the targeting of<\/span> <span style=\"font-weight: 400;\">Dimann products, which are primarily aimed at women. The remaining 0.2% selected the \u201cother\u201d category. <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-74a4fa9 e-con-full e-flex e-con e-child\" data-id=\"74a4fa9\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-41fe80e elementor-widget elementor-widget-heading\" data-id=\"41fe80e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Age<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-240a322 elementor-widget elementor-widget-text-editor\" data-id=\"240a322\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Regarding age, individuals in the sample range<\/span> <b>from 18 to 99 years<\/b><span style=\"font-weight: 400;\">; however, participants over 60 are less represented than younger groups. The mean age is 40, with a median of 39, indicating a  <\/span><b>right-skewed distribution.<\/b><span style=\"font-weight: 400;\">. The third quartile (52 years) shows that <\/span><b>75% of respondents are 52 or younger.<\/b><span style=\"font-weight: 400;\"> These values suggest the dataset mainly represents adults in the young and middle-age range.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-41095d7 e-con-full e-flex e-con e-child\" data-id=\"41095d7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4159902 elementor-widget elementor-widget-image\" data-id=\"4159902\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1024\" height=\"393\" data-src=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-4@3x.webp\" class=\"attachment-large size-large wp-image-61019 lazyload\" alt=\"Graph representing the age distribution of italian individuals in the Dimann dataset\" data-srcset=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-4@3x.webp 1398w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-4@3x-120x46.webp 120w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-4@3x-186x71.webp 186w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-4@3x-690x265.webp 690w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-4@3x-420x161.webp 420w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-4@3x-700x268.webp 700w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-4@3x-720x276.webp 720w\" data-sizes=\"(max-width: 1024px) 100vw, 1024px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/393;\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">FIGURE 4 | Age distribution of Italian individuals in the Dimann dataset<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-317fe46 elementor-widget elementor-widget-heading\" data-id=\"317fe46\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Participant ages range from 18 to 99. The majority are under 60, indicating a sample skewed toward young and middle-aged adults. In the histogram, the solid red line represents the mean age (40), while the dashed red line indicates the median age (39), both showing a concentration of responses in early and mid-adulthood.   <\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4d9fecc elementor-widget elementor-widget-text-editor\" data-id=\"4d9fecc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">The third quartile is 52 years, meaning <\/span><b>75% of respondents are 52 or younger<\/b> <span style=\"font-weight: 400;\">(Table 1).<\/span><\/p><p><span style=\"font-weight: 400;\">However, the distribution observed among younger participants <\/span><b><span style=\"font-weight: 400;\">closely reflects the model proposed by Zamparini [7]<\/span><\/b>, which describes cystitis frequency across different life stages. <\/p><p><span style=\"font-weight: 400;\">As shown in the histogram, the number of respondents follows a pattern consistent with known epidemiological trends: higher incidence in young and middle adulthood, life periods typically associated with higher sexual activity, pregnancy, and then menopause.<\/span><\/p><p><span style=\"font-weight: 400;\">Unlike Zamparini\u2019s model, however, the histogram shows an opposite pattern beyond age 55. <\/span><\/p><p><span style=\"font-weight: 400;\">This anomaly does not indicate a real decline in cystitis incidence, but may rather reflect sample characteristics: individuals over 55 are less represented, possibly due to a lower tendency to respond to questions or because they are less reached by the brand\u2019s marketing tools.<\/span><\/p><p><span style=\"font-weight: 400;\">The sharp variations after this age threshold therefore stem from participation bias rather than an actual epidemiological change.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2301ee0 e-con-full e-flex e-con e-child\" data-id=\"2301ee0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d635afa elementor-widget elementor-widget-heading\" data-id=\"d635afa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Actions taken to investigate cystitis<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fa7e855 elementor-widget elementor-widget-text-editor\" data-id=\"fa7e855\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Understanding how people approach cystitis investigation is a valuable resource to assess awareness and diagnostic behaviors. In the Dimann dataset, respondents report a variety of actions taken after symptom onset. <\/span><\/p><p><b>Responses include:<\/b><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Urine culture with antibiogram<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Laboratory urine tests<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Urine dipstick test<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Medical consultation (without diagnostic tests)<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">No diagnostic action<\/span><\/li><\/ul><p><span style=\"font-weight: 400;\">Respondents appear to move along a broad spectrum of approaches, ranging from self-management and informal testing to medical consultation,<\/span> <b>each reflecting different levels of access to care and engagement with healthcare services.<\/b><\/p><p><span style=\"font-weight: 400;\">The marked variability observed in the distribution of responses (Figure 5) reflects the fragmentation and inconsistency of diagnostic pathways experienced by many respondents. <\/span><\/p><p><span style=\"font-weight: 400;\">This is shown by the fact that<\/span>,<b> although the majority (about 70%) report having had either a urine culture with antibiogram (55%) or laboratory urine tests (15%), an additional 19% state they performed no diagnostic tests<\/b> <span style=\"font-weight: 400;\">beyond completing the questionnaire itself.<\/span><\/p><p><span style=\"font-weight: 400;\">This wide discrepancy highlights the coexistence of proactive and passive approaches to cystitis management: on the one hand, people actively seeking medical confirmation; on the other, those who tend to minimize symptoms or forgo formal diagnosis.<\/span><\/p><p><span style=\"font-weight: 400;\">Moreover, the data confirm what was anticipated: the lack of a standardized national clinical approach to diagnosing and managing cystitis. This absence translates into heterogeneous diagnostic practices and therapeutic decisions, both among patients and healthcare professionals. <\/span><\/p><p><span style=\"font-weight: 400;\">Further evidence: about <\/span><b>10% report consulting a doctor <\/b><span style=\"font-weight: 400;\"> without being prescribed any urine test. This points to a serious inconsistency in clinical practice: even when respondents interact with the healthcare system, diagnostic procedures are not applied systematically. <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e3931c8 e-con-full e-flex e-con e-child\" data-id=\"e3931c8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9b86390 elementor-widget elementor-widget-heading\" data-id=\"9b86390\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Pathogens identified among respondents who underwent testing\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9f3ee0a elementor-widget elementor-widget-text-editor\" data-id=\"9f3ee0a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Subsequently, analysis focused on the subgroup of respondents who performed urine culture with antibiogram or laboratory urine testing, representing <\/span><b>70% of the total Italian sample.<\/b><\/p><p><span style=\"font-weight: 400;\">Results mainly show the presence of <\/span><b>Escherichia coli, found in about 55% <\/b><span style=\"font-weight: 400;\">of tested cystitis cases.<\/span><\/p><p><span style=\"font-weight: 400;\">As expected, E. coli emerges as the predominant pathogen, in line with consolidated epidemiological evidence on urinary tract infections. The second most frequent response, however, was  <\/span><b>\u201cno bacteria,\u201d<\/b><span style=\"font-weight: 400;\">highlighting a <\/span><b>heterogeneous subgroup of patients for whom urine culture showed no bacterial growth. <\/b><span style=\"font-weight: 400;\">This can be interpreted in different ways, falling into three main clinical situations: true abacterial cystitis, where urinary symptoms are present without a documented bacterial infection, often linked to irritative or inflammatory phenomena of another nature;<br>urine culture performed after antibiotic therapy, which can yield a <\/span><i><span style=\"font-weight: 400;\">false negative<\/span><\/i><span style=\"font-weight: 400;\"> because bacterial load has already been reduced or eradicated;<br>incorrect urine collection, with contamination or inadequate sample storage compromising bacterial growth in culture.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2fa7700 e-con-full e-flex e-con e-child\" data-id=\"2fa7700\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cdfe96c elementor-widget elementor-widget-heading\" data-id=\"cdfe96c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Did you know?<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aeaad89 elementor-widget elementor-widget-heading\" data-id=\"aeaad89\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Escherichia coli helps <b>protect the intestine<\/b> from harmful microbes and supports digestion by fermenting sugars to release energy. It also <b>produces essential vitamins<\/b>\u2014B1, B2, B6, B12, K and others\u2014important for skin, nerve, and metabolic health, acting at the same time as natural antioxidants that slow cellular aging. \n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5f66fff e-con-full e-flex e-con e-child\" data-id=\"5f66fff\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-76301d9 elementor-widget elementor-widget-heading\" data-id=\"76301d9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Psychological implications of chronic and recurrent cystitis<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dbedfa1 elementor-widget elementor-widget-text-editor\" data-id=\"dbedfa1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><span style=\"font-weight: 400;\">This section focuses on one of the most significant and relevant aspects of the Dimann dataset: detailed information on the psychological impact of cystitis and the assessment of its effects on quality of life for those affected.<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ec9de29 elementor-widget elementor-widget-text-editor\" data-id=\"ec9de29\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Among the various explored dimensions, the psychological and emotional burden of cystitis emerges as one of the most revealing and meaningful aspects of the Dimann dataset.<\/span><\/p><p><span style=\"font-weight: 400;\">Cystitis often hides a <\/span><b>deeper level of suffering that goes beyond physical discomfort:<\/b><span style=\"font-weight: 400;\"> the recurrent nature of the infection, its unpredictability, and the limitations it imposes on daily life contribute to a constant sense of frustration and anxiety.<\/span> <\/p><p><b>The relationship between stress and physical symptoms appears bidirectional:<\/b><span style=\"font-weight: 400;\">on the one hand, stress can increase susceptibility to infection and encourage recurrence; on the other, the discomfort and disruption of daily activities caused by cystitis tend to intensify tension and anxiety in everyday life. This  <\/span>self-reinforcing loop highlights the deep link between emotional wellbeing and physical health, showing how psychological strain can be both a consequence and a cause of the persistence of the condition.<\/p><p><span style=\"font-weight: 400;\">In the dataset, self-reported experiences provide a direct perspective on how cystitis influences emotional wellbeing, self-perception, and social relationships.<\/span><\/p><p><span style=\"font-weight: 400;\">Many respondents reported a <\/span><b>decline in self-confidence<\/b>,<span style=\"font-weight: 400;\"> as well as a growing<\/span> <\/p><p><span style=\"font-weight: 400;\">sense of limitation in their ability to carry out normal daily activities\u2014at work, in social or intimate settings, or during rest and leisure.<\/span><\/p><p><span style=\"font-weight: 400;\">These constraints gradually erode a sense of autonomy and spontaneity, which are fundamental to a balanced life. These circumstances highlight the need to interpret cystitis not only as a transient infection, but as a condition capable of profoundly affecting psychological state and overall quality of life. <\/span><\/p><p><span style=\"font-weight: 400;\">The emotional burden is both significant and underestimated, indicating the urgency of integrated care strategies that take into account not only the physical dimension, but also the mental and emotional dimension of the disease.<\/span><\/p><p><span style=\"font-weight: 400;\">For these reasons, the information contained in the Dimann dataset regarding perception of cystitis, its influence on mood, daily life, and overall wellbeing <\/span><b>represents a fundamental and long-awaited contribution to current research.<\/b><span style=\"font-weight: 400;\">. By documenting lived experiences of thousands of patients, the dataset captures dimensions of suffering rarely represented in traditional clinical research.<\/span><\/p><p><span style=\"font-weight: 400;\">To explore this psychological and perceptual dimension,<\/span> <b>three key questions from<\/b> <span style=\"font-weight: 400;\">the Dimann questionnaire were selected for analysis.<\/span><\/p><p><span style=\"font-weight: 400;\">These items were chosen because, taken together,<\/span><b> they offer a complete view of how people perceive cystitis and how it affects their emotional state and daily life.<\/b><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The first question asks respondents to define what cystitis represents for them, assessing how present the condition is in their lives\u2014from a temporary nuisance to a constant and discouraging burden.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The second question focuses on the concrete consequences of the infection, asking participants to indicate which aspects of their lives are affected by the need to urinate frequently.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The third question explores the psychological sphere, allowing respondents to independently identify the emotional repercussions of cystitis\u2014from loss of self-confidence to changes in habits and daily routines.<\/span><\/li><\/ul><p><span style=\"font-weight: 400;\">Taken together, these three perspectives provide a multifaceted understanding of how cystitis affects both the emotional and practical dimensions of people\u2019s lives.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3abf366 e-con-full e-flex e-con e-child\" data-id=\"3abf366\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-417b40d elementor-widget elementor-widget-heading\" data-id=\"417b40d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">What is cystitis for you?*<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-95e1d7d elementor-widget elementor-widget-heading\" data-id=\"95e1d7d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">An unexpected guest<br>An unwanted companion<br>A dead end<br>A nightmare<br>A hell<br><\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8770b4c e-con-full e-flex e-con e-child\" data-id=\"8770b4c\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e2d6e56 elementor-widget elementor-widget-heading\" data-id=\"e2d6e56\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Going to pee many times a day affects\u2026*<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d506996 elementor-widget elementor-widget-heading\" data-id=\"d506996\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Your mood<br>Your attitude toward others<br>Your work<br>Your leisure activities<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8ab2c81 e-con-full e-flex e-con e-child\" data-id=\"8ab2c81\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-85d4209 elementor-widget elementor-widget-heading\" data-id=\"85d4209\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Having cystitis affects\u2026*<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8963e10 elementor-widget elementor-widget-heading\" data-id=\"8963e10\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Your daily activities\nYour desire to be with others<br>Your romantic and sexual life<br>Your confidence and self-esteem<br>Your ability to travel<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-33db23d elementor-widget elementor-widget-heading\" data-id=\"33db23d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">*More than one answer possible<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e8c7ec4 e-con-full e-flex e-con e-child\" data-id=\"e8c7ec4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6c37b31 elementor-widget elementor-widget-heading\" data-id=\"6c37b31\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What is cystitis for you?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1b5dc5e elementor-widget elementor-widget-text-editor\" data-id=\"1b5dc5e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">The first question appears in the early stages of the questionnaire and invites respondents to describe how they perceive the infection.<\/span><\/p><p><span style=\"font-weight: 400;\">It offers<\/span> <b>five possible responses,<\/b><span style=\"font-weight: 400;\">carefully worded to capture a wide range of emotional reactions and reflect different levels of psychological involvement with the condition. In addition, participants could select  <\/span><b>more than one option<\/b><span style=\"font-weight: 400;\">to represent simultaneously the different facets of their emotional experience. This structure makes it possible to move beyond a single, uniform definition of cystitis, instead reflecting the complexity of how people internalize and experience their condition.  <\/span><\/p><p><span style=\"font-weight: 400;\">The resulting response distribution shows a spectrum of perceptions: for some, cystitis is an occasional and manageable nuisance; for others, it is a true <\/span><i><span style=\"font-weight: 400;\">\u201cnightmare\u201d<\/span><\/i> <span style=\"font-weight: 400;\">that deeply affects daily life and emotional wellbeing.<\/span><\/p><p><span style=\"font-weight: 400;\">As shown in Figure 7, respondents most frequently described cystitis as<\/span> <b>\u201ca nightmare\u201d<\/b><span style=\"font-weight: 400;\"><b> (28%),<\/b><\/span> <span style=\"font-weight: 400;\">an expression that reflects the <\/span><b>profound emotional distress<\/b> <span style=\"font-weight: 400;\">associated with recurrent or persistent symptoms.<\/span><\/p><p><span style=\"font-weight: 400;\">The second most frequent description,<\/span> <b>\u201can unwanted companion\u201d <\/b><span style=\"font-weight: 400;\"><b>(19.1%)<\/b><\/span>, <span style=\"font-weight: 400;\">conveys the feeling of living<\/span> <b>with a constant, invasive presence<\/b><span style=\"font-weight: 400;\">\u2014something tolerated, but never truly accepted.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0416dc6 e-con-full e-flex e-con e-child\" data-id=\"0416dc6\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4cc4481 elementor-widget elementor-widget-image\" data-id=\"4cc4481\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1024\" height=\"462\" data-src=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-7@3x.webp\" class=\"attachment-large size-large wp-image-61029 lazyload\" alt=\"\" data-srcset=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-7@3x.webp 1340w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-7@3x-120x54.webp 120w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-7@3x-186x84.webp 186w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-7@3x-690x312.webp 690w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-7@3x-420x190.webp 420w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-7@3x-700x316.webp 700w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-7@3x-720x325.webp 720w\" data-sizes=\"(max-width: 1024px) 100vw, 1024px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/462;\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">FIGURE 7 | What is cystitis for you?<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-401af9e e-con-full e-flex e-con e-child\" data-id=\"401af9e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5407e4a elementor-widget elementor-widget-heading\" data-id=\"5407e4a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Urinating many times a day affects...\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c37793d elementor-widget elementor-widget-text-editor\" data-id=\"c37793d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">When asked which aspects of their lives were most affected by the need to urinate frequently, respondents provided answers highlighting<\/span><b> the strong impact <\/b><span style=\"font-weight: 400;\">of cystitis on daily habits and emotional wellbeing.<\/span><\/p><p><span style=\"font-weight: 400;\">The most frequently selected option was <\/span><b>\u201cyour mood\u201d<\/b> <span style=\"font-weight: 400;\"><b>(28.6%),<\/b><\/span><span style=\"font-weight: 400;\">confirming how recurring symptoms and persistent discomfort directly affect emotional stability. The second most frequent response pattern was  <\/span><b>selecting all options (16.4%),<\/b><span style=\"font-weight: 400;\">as shown in Figure 8. This result underscores the multidimensional nature of cystitis\u2019 impact, suggesting that many people perceive the condition as an all-encompassing burden capable of influencing every aspect of their lives. Moreover, mood emerged as the most consistently affected area:   <\/span><b>even among those indicating multiple compromised domains, mood was almost always included.<\/b><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-17f2034 e-con-full e-flex e-con e-child\" data-id=\"17f2034\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2554dc2 elementor-widget elementor-widget-image\" data-id=\"2554dc2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1024\" height=\"495\" data-src=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-8@3x.webp\" class=\"attachment-large size-large wp-image-61039 lazyload\" alt=\"Graph representing the distribution of answers registered in the Dimann dataset to the question &quot;Going to pee many times a day affects...&quot;\" data-srcset=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-8@3x.webp 1296w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-8@3x-120x58.webp 120w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-8@3x-186x90.webp 186w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-8@3x-690x333.webp 690w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-8@3x-420x203.webp 420w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-8@3x-700x338.webp 700w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-8@3x-720x348.webp 720w\" data-sizes=\"(max-width: 1024px) 100vw, 1024px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/495;\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">FIGURE 8 | Going to pee many times a day affects\u2026<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b369ba2 e-con-full e-flex e-con e-child\" data-id=\"b369ba2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bad9eff elementor-widget elementor-widget-heading\" data-id=\"bad9eff\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Having cystitis affects...\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ee68c39 elementor-widget elementor-widget-text-editor\" data-id=\"ee68c39\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">When identifying the areas of life most affected by cystitis, the most frequently selected response was <\/span><b>\u201cromantic and sexual life\u201d<\/b> <span style=\"font-weight: 400;\"><b>(14.6%)<\/b><\/span>, <span style=\"font-weight: 400;\">confirming the profound impact of the condition on intimacy and emotional relationships (Figure 9).<\/span><\/p><p>Beyond this specific sphere, responses again show the pervasive nature of cystitis in everyday life: \u201cdaily activities\u201d emerged as the second most frequent category, reflecting how recurrent symptoms and physical discomfort interfere with personal routines and perceived autonomy.<\/p><p><span style=\"font-weight: 400;\">A considerable number of respondents, once again, selected all available categories. <\/span><\/p><p><span style=\"font-weight: 400;\">Particularly significant, however, is the fact that over <\/span><b>15%<\/b> <span style=\"font-weight: 400;\">of participants chose both \u201cromantic and sexual life\u201d and \u201cdaily activities,\u201d highlighting<\/span> <b>a strong intersection between emotional and practical consequences of cystitis.<\/b><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d34c835 e-con-full e-flex e-con e-child\" data-id=\"d34c835\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f702636 elementor-widget elementor-widget-image\" data-id=\"f702636\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1024\" height=\"486\" data-src=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-9@3x.webp\" class=\"attachment-large size-large wp-image-61049 lazyload\" alt=\"\" data-srcset=\"https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-9@3x.webp 1310w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-9@3x-120x57.webp 120w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-9@3x-186x88.webp 186w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-9@3x-690x328.webp 690w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-9@3x-420x199.webp 420w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-9@3x-700x332.webp 700w, https:\/\/www.dimann.com\/wp-content\/uploads\/2026\/01\/Figure-9@3x-720x342.webp 720w\" data-sizes=\"(max-width: 1024px) 100vw, 1024px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/486;\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">FIGURE 9 | Having cystitis affects...<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2cdfa7f e-con-full e-flex e-con e-child\" data-id=\"2cdfa7f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-42b572d elementor-widget elementor-widget-heading\" data-id=\"42b572d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Conclusions<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ef0aa1e elementor-widget elementor-widget-text-editor\" data-id=\"ef0aa1e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">The purpose of this white paper was to present the analytical and exploratory potential of the <\/span>D<b>imann dataset, collected over three years as part of a survey of D-mannose buyers, with the aim of identifying the most suitable product for each user profile.<\/b><\/p><p><span style=\"font-weight: 400;\">The dataset represents a valuable and promising resource in the current landscape of cystitis research, an area where high-quality data remain limited and many relevant dimensions are often overlooked. <\/span><\/p><p><span style=\"font-weight: 400;\">In particular<\/span>, <b>while the significant role of behavioral factors in the onset and recurrence of cystitis is recognized, these aspects have received little scientific attention over time. <\/b><span style=\"font-weight: 400;\">Furthermore, the dataset highlights the profound impact of cystitis on people\u2019s lives\u2014and especially on women, given the higher prevalence of the condition in females.<\/span><\/p><p><span style=\"font-weight: 400;\">Previous studies show that cystitis can compromise daily life and psychological wellbeing, often generating a vicious cycle in which stress caused by the disease contributes to new recurrences. However, despite these significant implications, research on the psychosocial burden of cystitis remains underdeveloped, neglecting both the impact on affected individuals\u2019 lives and its potential role in worsening the condition itself.  <\/span><\/p><p><span style=\"font-weight: 400;\">Even in this preliminary analysis of the described dynamics, data revealed that mood is the aspect most frequently influenced by cystitis, emerging as the most impacted both as a single choice and across the majority of combined responses. This observation strengthens evidence of cystitis\u2019 strong psychological component and underscores the importance of considering emotional wellbeing both in research and in therapeutic approaches. <\/span><\/p><p><span style=\"font-weight: 400;\">The impact on mental health and self-esteem becomes even more evident when comparing these results with responses about repercussions on daily life. In this sense, the areas most frequently indicated as affected were intimate\/relational life and daily activities, often selected together. <\/span><\/p><p><span style=\"font-weight: 400;\">Taken together, these results outline a deeply complex condition, highlighting the need for a more holistic approach that recognizes psychological and social repercussions as much as physiological manifestations.<\/span><\/p><p><span style=\"font-weight: 400;\">Addressing cystitis therefore requires not only appropriate medical treatment, but also active and ongoing research on its impact on lifestyle and condition management strategies.<\/span><\/p><p><span style=\"font-weight: 400;\">Such an approach is essential to fully grasp the complexity of the pathology and develop effective and sustainable therapeutic strategies\u2014not only clinically and economically, but also in terms of patients\u2019 long-term well-being.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a305303 e-con-full e-flex e-con e-child\" data-id=\"a305303\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f9a1ebc elementor-widget elementor-widget-heading\" data-id=\"f9a1ebc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Highlights<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ff9c945 e-con-full e-flex e-con e-child\" data-id=\"ff9c945\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6ef4769 elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"6ef4769\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"32\" height=\"32\" viewBox=\"0 0 32 32\" fill=\"none\"><path d=\"M28.0613 17.0605L19.0613 26.0605C18.7795 26.3423 18.3973 26.5006 17.9988 26.5006C17.6002 26.5006 17.218 26.3423 16.9363 26.0605C16.6545 25.7787 16.4961 25.3965 16.4961 24.998C16.4961 24.5995 16.6545 24.2173 16.9363 23.9355L23.375 17.4992H5C4.60218 17.4992 4.22064 17.3412 3.93934 17.0599C3.65804 16.7786 3.5 16.3971 3.5 15.9992C3.5 15.6014 3.65804 15.2199 3.93934 14.9386C4.22064 14.6573 4.60218 14.4992 5 14.4992H23.375L16.9387 8.05924C16.657 7.77745 16.4986 7.39526 16.4986 6.99674C16.4986 6.59823 16.657 6.21603 16.9387 5.93424C17.2205 5.65245 17.6027 5.49414 18.0012 5.49414C18.3998 5.49414 18.782 5.65245 19.0637 5.93424L28.0637 14.9342C28.2036 15.0738 28.3145 15.2396 28.3901 15.4221C28.4657 15.6046 28.5045 15.8003 28.5043 15.9979C28.5041 16.1955 28.4648 16.391 28.3888 16.5734C28.3128 16.7557 28.2014 16.9213 28.0613 17.0605Z\" fill=\"black\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2b126f9 elementor-widget elementor-widget-heading\" data-id=\"2b126f9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\"><i>In Italy, truly comparable national data do not exist <\/i>due to differences among regional surveillance systems and the absence of studies on risk factors specific to the Italian context. The Dimann dataset can help bridge this gap.\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1d66cb5 e-con-full e-flex e-con e-child\" data-id=\"1d66cb5\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-61a59c6 elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"61a59c6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"32\" height=\"32\" viewBox=\"0 0 32 32\" fill=\"none\"><path d=\"M28.0613 17.0605L19.0613 26.0605C18.7795 26.3423 18.3973 26.5006 17.9988 26.5006C17.6002 26.5006 17.218 26.3423 16.9363 26.0605C16.6545 25.7787 16.4961 25.3965 16.4961 24.998C16.4961 24.5995 16.6545 24.2173 16.9363 23.9355L23.375 17.4992H5C4.60218 17.4992 4.22064 17.3412 3.93934 17.0599C3.65804 16.7786 3.5 16.3971 3.5 15.9992C3.5 15.6014 3.65804 15.2199 3.93934 14.9386C4.22064 14.6573 4.60218 14.4992 5 14.4992H23.375L16.9387 8.05924C16.657 7.77745 16.4986 7.39526 16.4986 6.99674C16.4986 6.59823 16.657 6.21603 16.9387 5.93424C17.2205 5.65245 17.6027 5.49414 18.0012 5.49414C18.3998 5.49414 18.782 5.65245 19.0637 5.93424L28.0637 14.9342C28.2036 15.0738 28.3145 15.2396 28.3901 15.4221C28.4657 15.6046 28.5045 15.8003 28.5043 15.9979C28.5041 16.1955 28.4648 16.391 28.3888 16.5734C28.3128 16.7557 28.2014 16.9213 28.0613 17.0605Z\" fill=\"black\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b40e3d9 elementor-widget elementor-widget-heading\" data-id=\"b40e3d9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\"><i>Cystitis has a strong psychological influence.<\/i> <i>Most patients describe the condition as a nightmare.<\/i>\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c2af1e0 e-con-full e-flex e-con e-child\" data-id=\"c2af1e0\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6f1d312 elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"6f1d312\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"32\" height=\"32\" viewBox=\"0 0 32 32\" fill=\"none\"><path d=\"M28.0613 17.0605L19.0613 26.0605C18.7795 26.3423 18.3973 26.5006 17.9988 26.5006C17.6002 26.5006 17.218 26.3423 16.9363 26.0605C16.6545 25.7787 16.4961 25.3965 16.4961 24.998C16.4961 24.5995 16.6545 24.2173 16.9363 23.9355L23.375 17.4992H5C4.60218 17.4992 4.22064 17.3412 3.93934 17.0599C3.65804 16.7786 3.5 16.3971 3.5 15.9992C3.5 15.6014 3.65804 15.2199 3.93934 14.9386C4.22064 14.6573 4.60218 14.4992 5 14.4992H23.375L16.9387 8.05924C16.657 7.77745 16.4986 7.39526 16.4986 6.99674C16.4986 6.59823 16.657 6.21603 16.9387 5.93424C17.2205 5.65245 17.6027 5.49414 18.0012 5.49414C18.3998 5.49414 18.782 5.65245 19.0637 5.93424L28.0637 14.9342C28.2036 15.0738 28.3145 15.2396 28.3901 15.4221C28.4657 15.6046 28.5045 15.8003 28.5043 15.9979C28.5041 16.1955 28.4648 16.391 28.3888 16.5734C28.3128 16.7557 28.2014 16.9213 28.0613 17.0605Z\" fill=\"black\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1609497 elementor-widget elementor-widget-heading\" data-id=\"1609497\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\"><i>Diagnostic behaviors reveal systemic inconsistencies.<\/i> About 70% of respondents underwent urine culture or lab testing, while 19% took no diagnostic action, <i>highlighting heterogeneous medical practices and the need for awareness-raising.<\/i>\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a7ed695 e-con-full e-flex e-con e-child\" data-id=\"a7ed695\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3c129f3 elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"3c129f3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"32\" height=\"32\" viewBox=\"0 0 32 32\" fill=\"none\"><path d=\"M28.0613 17.0605L19.0613 26.0605C18.7795 26.3423 18.3973 26.5006 17.9988 26.5006C17.6002 26.5006 17.218 26.3423 16.9363 26.0605C16.6545 25.7787 16.4961 25.3965 16.4961 24.998C16.4961 24.5995 16.6545 24.2173 16.9363 23.9355L23.375 17.4992H5C4.60218 17.4992 4.22064 17.3412 3.93934 17.0599C3.65804 16.7786 3.5 16.3971 3.5 15.9992C3.5 15.6014 3.65804 15.2199 3.93934 14.9386C4.22064 14.6573 4.60218 14.4992 5 14.4992H23.375L16.9387 8.05924C16.657 7.77745 16.4986 7.39526 16.4986 6.99674C16.4986 6.59823 16.657 6.21603 16.9387 5.93424C17.2205 5.65245 17.6027 5.49414 18.0012 5.49414C18.3998 5.49414 18.782 5.65245 19.0637 5.93424L28.0637 14.9342C28.2036 15.0738 28.3145 15.2396 28.3901 15.4221C28.4657 15.6046 28.5045 15.8003 28.5043 15.9979C28.5041 16.1955 28.4648 16.391 28.3888 16.5734C28.3128 16.7557 28.2014 16.9213 28.0613 17.0605Z\" fill=\"black\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-af5b426 elementor-widget elementor-widget-heading\" data-id=\"af5b426\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\"><i>E. coli remains the predominant pathogen, <\/i>\naccounting for about 55% of identified infections.\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d6f7042 e-con-full e-flex e-con e-child\" data-id=\"d6f7042\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c53d10b elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"c53d10b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"32\" height=\"32\" viewBox=\"0 0 32 32\" fill=\"none\"><path d=\"M28.0613 17.0605L19.0613 26.0605C18.7795 26.3423 18.3973 26.5006 17.9988 26.5006C17.6002 26.5006 17.218 26.3423 16.9363 26.0605C16.6545 25.7787 16.4961 25.3965 16.4961 24.998C16.4961 24.5995 16.6545 24.2173 16.9363 23.9355L23.375 17.4992H5C4.60218 17.4992 4.22064 17.3412 3.93934 17.0599C3.65804 16.7786 3.5 16.3971 3.5 15.9992C3.5 15.6014 3.65804 15.2199 3.93934 14.9386C4.22064 14.6573 4.60218 14.4992 5 14.4992H23.375L16.9387 8.05924C16.657 7.77745 16.4986 7.39526 16.4986 6.99674C16.4986 6.59823 16.657 6.21603 16.9387 5.93424C17.2205 5.65245 17.6027 5.49414 18.0012 5.49414C18.3998 5.49414 18.782 5.65245 19.0637 5.93424L28.0637 14.9342C28.2036 15.0738 28.3145 15.2396 28.3901 15.4221C28.4657 15.6046 28.5045 15.8003 28.5043 15.9979C28.5041 16.1955 28.4648 16.391 28.3888 16.5734C28.3128 16.7557 28.2014 16.9213 28.0613 17.0605Z\" fill=\"black\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c0202ba elementor-widget elementor-widget-heading\" data-id=\"c0202ba\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\"><i>Nearly 30% of respondents report that cystitis affects their intimate and sexual relationships. <\/i>This sphere, like mood, is highly recurrent and appears alongside impaired daily activities <i>in a further 15% of cases.<\/i><\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-fd74914 e-con-full e-flex e-con e-child\" data-id=\"fd74914\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-411803c elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"411803c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"32\" height=\"32\" viewBox=\"0 0 32 32\" fill=\"none\"><path d=\"M28.0613 17.0605L19.0613 26.0605C18.7795 26.3423 18.3973 26.5006 17.9988 26.5006C17.6002 26.5006 17.218 26.3423 16.9363 26.0605C16.6545 25.7787 16.4961 25.3965 16.4961 24.998C16.4961 24.5995 16.6545 24.2173 16.9363 23.9355L23.375 17.4992H5C4.60218 17.4992 4.22064 17.3412 3.93934 17.0599C3.65804 16.7786 3.5 16.3971 3.5 15.9992C3.5 15.6014 3.65804 15.2199 3.93934 14.9386C4.22064 14.6573 4.60218 14.4992 5 14.4992H23.375L16.9387 8.05924C16.657 7.77745 16.4986 7.39526 16.4986 6.99674C16.4986 6.59823 16.657 6.21603 16.9387 5.93424C17.2205 5.65245 17.6027 5.49414 18.0012 5.49414C18.3998 5.49414 18.782 5.65245 19.0637 5.93424L28.0637 14.9342C28.2036 15.0738 28.3145 15.2396 28.3901 15.4221C28.4657 15.6046 28.5045 15.8003 28.5043 15.9979C28.5041 16.1955 28.4648 16.391 28.3888 16.5734C28.3128 16.7557 28.2014 16.9213 28.0613 17.0605Z\" fill=\"black\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0f583f6 elementor-widget elementor-widget-heading\" data-id=\"0f583f6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\"><i>Stress is a known risk factor, yet it is also an overlooked consequence of the condition.<\/i> 28% report that cystitis affects their mood, while over 10% state it impacts every aspect of their lives.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b699e31 e-con-full e-flex e-con e-child\" data-id=\"b699e31\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-816bd88 elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"816bd88\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"32\" height=\"32\" viewBox=\"0 0 32 32\" fill=\"none\"><path d=\"M28.0613 17.0605L19.0613 26.0605C18.7795 26.3423 18.3973 26.5006 17.9988 26.5006C17.6002 26.5006 17.218 26.3423 16.9363 26.0605C16.6545 25.7787 16.4961 25.3965 16.4961 24.998C16.4961 24.5995 16.6545 24.2173 16.9363 23.9355L23.375 17.4992H5C4.60218 17.4992 4.22064 17.3412 3.93934 17.0599C3.65804 16.7786 3.5 16.3971 3.5 15.9992C3.5 15.6014 3.65804 15.2199 3.93934 14.9386C4.22064 14.6573 4.60218 14.4992 5 14.4992H23.375L16.9387 8.05924C16.657 7.77745 16.4986 7.39526 16.4986 6.99674C16.4986 6.59823 16.657 6.21603 16.9387 5.93424C17.2205 5.65245 17.6027 5.49414 18.0012 5.49414C18.3998 5.49414 18.782 5.65245 19.0637 5.93424L28.0637 14.9342C28.2036 15.0738 28.3145 15.2396 28.3901 15.4221C28.4657 15.6046 28.5045 15.8003 28.5043 15.9979C28.5041 16.1955 28.4648 16.391 28.3888 16.5734C28.3128 16.7557 28.2014 16.9213 28.0613 17.0605Z\" fill=\"black\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3992b61 elementor-widget elementor-widget-heading\" data-id=\"3992b61\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\"><i>Mood is the most compromised aspect<\/i>: it is not only the most frequent response, but it also appears in combination with almost all other impact areas, indicating emotional distress as a cross-cutting element of the cystitis experience.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-beeb6c5 e-con-full e-flex e-con e-child\" data-id=\"beeb6c5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e193ab0 elementor-widget elementor-widget-heading\" data-id=\"e193ab0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Colophon and credits<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5a94def elementor-widget elementor-widget-text-editor\" data-id=\"5a94def\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><b>Issued by:<\/b><\/p><p>The European Cystitis Observatory (ECO).<br>Conclusions and interpretations are those of ECO.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aefd63e elementor-widget elementor-widget-text-editor\" data-id=\"aefd63e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Prepared by:<\/p><p><a href=\"https:\/\/www.namidi.it\/\">Nami Consulting<\/a> (Maria Ascolese, Erica Ravarelli) using a dataset provided by Dimann.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b6b4edb elementor-widget elementor-widget-text-editor\" data-id=\"b6b4edb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Funding:<\/strong><\/p><p>Yellow People Lab (owner of the Dimann brand). (<a href=\"https:\/\/ypl.ventures\/\">https:\/\/ypl.ventures\/<\/a>)<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9527aa4 elementor-widget elementor-widget-text-editor\" data-id=\"9527aa4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Clinical review:<\/strong><\/p><p>Dr. Oreste Risi, MD (Urologist).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-718bf6a elementor-widget elementor-widget-text-editor\" data-id=\"718bf6a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>How to cite:<\/strong><\/p><p>European Cystitis Observatory (ECO). (2026).<br>Understanding Recurrent and Chronic Cystitis &#8211;<br>Psychological impact of an ongoing battle.<br>Evidence from Italy. (Versione V1). Zenodo.  <br><a href=\"https:\/\/doi.org\/10.5281\/zenodo.18185934\">https:\/\/doi.org\/10.5281\/zenodo.18185934<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-91abe29 elementor-widget elementor-widget-text-editor\" data-id=\"91abe29\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>\u00a9 2026 Yellow People Lab Srl. Creative Commons Attribution 4.0 International <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2c3e467 e-con-full e-flex e-con e-child\" data-id=\"2c3e467\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-eb19afe elementor-widget elementor-widget-heading\" data-id=\"eb19afe\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">References<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c4c1762 elementor-widget elementor-widget-text-editor\" data-id=\"c4c1762\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ol><li><b> Foxman, B. (2003). Epidemiology of urinary tract infections: incidence, morbidity, and economic costs.  <\/b><b><i>Dis. Mon. <\/i><\/b><b>, 49(2), 53\u201370.<\/b><b><br><br><\/b><\/li><li><b> Boni, A. (2018, April 3). <\/b><b><i>Cistite: MELIUS PREVENIRE<\/i><\/b><b>. Medici Oggi, Milan.<\/b><b><br><br><\/b><\/li><li><b> Scholes, D., Hooton, T. M., Roberts, P. L., Stapleton, A. E., Gupta, K., &amp; Stamm, W. E. (2000). Risk factors for recurrent urinary tract infection in young women.  <\/b><b><i>J Infect Dis<\/i><\/b><b>, vol. 82.<\/b><b><br><br><\/b><\/li><li><b> Li, R., &amp; Leslie, S. W. (2025). <\/b><b><i>Cystitis<\/i><\/b><b> [Updated 2023 May 30]. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from:   <\/b><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482435\/\"> <b>https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482435\/<\/b><b><br><br><\/b><\/a><\/li><li><b> Kurotschka, P. K., G\u00e1gyor, I., &amp; Ebell, M. H. (2024). Acute Uncomplicated UTIs in Adults: Rapid Evidence Review.  <\/b><b><i>Am Fam Physician<\/i><\/b><b>, 109(2), 167\u2013174. PMID: 38393801. <\/b><b><br><br><\/b><\/li><li><b> AOGOI. (n.d.).  <\/b><b><i>Le infezioni delle vie urinarie nelle donne dalla pre-adolescenza all\u2019et\u00e0 adulta<\/i><\/b><b> [Internet]. Roma: AOGOI. <\/b><a href=\"https:\/\/www.aogoi.it\/media\/7921\/infezioni-vie-urinarie-donne-min.pdf\"> <b>https:\/\/www.aogoi.it\/media\/7921\/infezioni-vie-urinarie-donne-min.pdf<\/b><b><br><br><\/b><\/a><\/li><li><b> Zamparini, E., &amp; Viale, P. (2012). Bacterial and fungal urinary tract infections: epidemiology, pathogenesis and clinical management.  <\/b><b><i>G Ital Nefrol.<\/i><\/b><b>, 29(S56), S3\u2013S7.<\/b><b><br><br><\/b><\/li><li><b> Naber, K. G., Tir\u00e1n-Saucedo, J., Wagenlehner, F. M. E., &amp; RECAP group. (2022). Psychosocial burden of recurrent uncomplicated urinary tract infections. <\/b><b><i>GMS Infect Dis.<\/i><\/b><b>, 10, Doc01. https:\/\/doi.org\/10.3205\/id000078. PMID: 35463815; PMCID: PMC9006425. <\/b><b><br><br><\/b><\/li><li><b> Paris, D., Caltagirone, M., Minzulli, P., Valzano, A., Ferrara, F. E. O., &amp; Magliano, E. (2020). Epidemiology and antibiotic resistance in community-acquired lower urinary tract infections in the Milan area.  <\/b><b><i>Microbiologia Medica<\/i><\/b><b>, 35(2).<\/b><b><br><br><\/b><\/li><li><b> Fernandez, M. M., Bektas, M., Colosia, A., Kuper, K., Al-Taie, A., &amp; Kotb, R. (2024). <\/b><b><i>Evidence gaps in the burden of complicated urinary tract infection (cUTI).<\/i><\/b><b> Poster presented at the 34th European Congress of Clinical Microbiology &amp; Infectious Diseases (ECCMID), April 27, 2024, Barcelona, Spain.<\/b><b><br><br><\/b><\/li><li><b> Causio, F. A., Golinelli, D., Diedenhofen, G., Silenzi, A., Ferro, D., &amp; Baglivo, F. (2025). Fragmented but evolving: a response to the editorial \u201cthe Italian health data system is broken\u201d.  <\/b><b><i>The Lancet Regional Health \u2013 Europe<\/i><\/b><b>, 51. https:\/\/doi.org\/10.1016\/j.lanepe.2025.101256<\/b><b><br><br><\/b><\/li><li> <b> Ahn, St., &amp; Oh, Mm. (2022). Importance to Promote Awareness in Patients with Recurrent Cystitis. <\/b><b><i>Urogenit Tract Infect.<\/i><\/b><b>, 17(3), 71\u201375.<\/b><b><br><br><\/b><\/li><li><b> Cai, T., Tamanini, I., Collini, L., Brugnolli, A., Migno, S., Mereu, L., Tateo, S., Pilatz, A., Rizzo, M., Liguori, G., Bonkat, G., Wagenlehner, F. M. E., &amp; Bjerklund Johansen, T. E. (2022). Management of Recurrent Cystitis in Women: When Prompt Identification of Risk Factors Might Make a Difference.  <\/b><b><i>European Urology Focus<\/i><\/b><b>, 8(5).<\/b><b><br><br><\/b><\/li><li><b> European Association of Urology. (2025, September).  <\/b><b><i>Public survey on knowledge and experience of urinary tract infections<\/i><\/b><b> [Survey commissioned for Urology Week, 22\u201326 September 2025]. Supported by GSK. <\/b><\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-635b40c e-flex e-con-boxed e-con e-parent\" data-id=\"635b40c\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3062a28 elementor-widget__width-inherit elementor-cta--skin-classic elementor-animated-content elementor-bg-transform elementor-bg-transform-zoom-in elementor-widget elementor-widget-call-to-action\" data-id=\"3062a28\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"call-to-action.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-cta\">\n\t\t\t\t\t\t\t<div class=\"elementor-cta__content\">\n\t\t\t\t\t\t\t\t\t<div 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7.63409V15.5278C10.1701 14.6744 8.57441 14.3357 7.0125 14.5753L10 7.78659ZM8 24.5016C7.30776 24.5016 6.63107 24.2963 6.0555 23.9117C5.47993 23.5271 5.03133 22.9805 4.76642 22.341C4.50151 21.7014 4.4322 20.9977 4.56725 20.3188C4.7023 19.6398 5.03564 19.0162 5.52512 18.5267C6.01461 18.0372 6.63825 17.7039 7.31718 17.5688C7.99611 17.4338 8.69985 17.5031 9.33939 17.768C9.97893 18.0329 10.5256 18.4815 10.9101 19.0571C11.2947 19.6327 11.5 20.3094 11.5 21.0016C11.5 21.9298 11.1312 22.8201 10.4749 23.4765C9.81849 24.1328 8.92825 24.5016 8 24.5016ZM20.5 7.63409C20.7414 7.52559 21.0071 7.48257 21.2704 7.50934C21.5337 7.53611 21.7854 7.63173 22 7.78659L24.9837 14.5753C23.4218 14.3357 21.8262 14.6744 20.4962 15.5278L20.5 7.63409ZM24 24.5016C23.3078 24.5016 22.6311 24.2963 22.0555 23.9117C21.4799 23.5271 21.0313 22.9805 20.7664 22.341C20.5015 21.7014 20.4322 20.9977 20.5672 20.3188C20.7023 19.6398 21.0356 19.0162 21.5251 18.5267C22.0146 18.0372 22.6382 17.7039 23.3172 17.5688C23.9961 17.4338 24.6998 17.5031 25.3394 17.768C25.9789 18.0329 26.5256 18.4815 26.9101 19.0571C27.2947 19.6327 27.5 20.3094 27.5 21.0016C27.5 21.9298 27.1312 22.8201 26.4749 23.4765C25.8185 24.1328 24.9283 24.5016 24 24.5016Z\" fill=\"black\"><\/path><\/svg>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-cta__title elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\tAre you interested in the Observatory's activities?\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-cta__description elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\tDownload the White Paper and receive updates from the first European Cystitis Observatory.\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-cta__button-wrapper elementor-cta__content-item elementor-content-item \">\n\t\t\t\t\t<a class=\"elementor-cta__button elementor-button elementor-size-\" href=\"https:\/\/mailchi.mp\/2b19cf1d979c\/download-white-paper\" 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Evidence from Italy. download the white paper Table of contents &nbsp; Credits European Cystitis Observatory (ECO) Version V1 2026 DOI: 10.5281\/zenodo.18185934 License: CC BY 4.0 How to cite (APA) European Cystitis Observatory (ECO). [&hellip;]<\/p>\n","protected":false},"author":31,"featured_media":0,"parent":60080,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-60095","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>White Paper 2026-r01 \u2014 Full text | Dimann<\/title>\n<meta name=\"description\" content=\"Full version of the ECO 2026-r01 report on cystitis: methodology, limitations, citation guidelines, CC BY license, and Press Box\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.dimann.com\/en\/eco\/white-paper-2026-r01\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta 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