An Anomalous Vaginal Insertion into the Bladder: A Case Report

Weiss, Jerome M.; Dykhuizen, Robert F.

doi:10.1016/s0022-5347(17)62941-0

Cited by 7 publications

(1 citation statement)

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“…Thus it is possible for a Mullerian component to contribute to the trigone. Weiss and Dykhuizen (1967) support this view by recording a case of anomalous vaginal insertion into the bladder. It is certain, however, that the trigone is anatomically distinct from the remainder of the bladder and it may be that its epithelium does have the capacity to respond to female hormones.…”

Section: Discussionmentioning

confidence: 74%

Histological findings in pseudomembranous trigonitis

Henry¹,

Fox²

1971

J Clin Pathol

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SYNOPSIS Pseudomembranous trigonitis presents in females with the urethral syndrome and a characteristic lesion restricted to the trigone of the bladder. The histology shows 'vaginal metaplasia' of the epithelium together with underlying oedema and vascular dilatation, but no significant inflammation. Thirty-one such cases are included in the study. The possible role of oestrogen stimulation is discussed, together with a suggestion that the trigone has an embryological derivation distinct from the remainder of the bladder, allowing the trigonal epithelium to respond to oestrogenic stimulation in a manner denied to the vesical transitional epithelium.The 'urethral syndrome' is one of the causes of urgency and frequency of micturition in the female, which may be distressing at times. While this may be due to a number of factors, a certain proportion of these women have a normal urine, which is sterile on culture, and a characteristic lesion of the trigone on cystoscopy. Biopsy reveals a metaplasia of the trigonal epithelium which comes to resemble that of the vagina. This condition was first described by Heymann (1905) as 'trigonal cystitis' and has since passed under a variety of names, including pseudomembranous trigonitis, urethrotrigonitis, granular trigonitis, and vaginal or squamous metaplasia of the trigonal epithelium. In a survey of this condition endoscopic biopsy has been performed in 31 cases and the histological findings are described here. Three male patients are also included, two with a papillary transitional-cell carcinoma of bladder and one on oestrogen therapy for carcinoma of the prostate. Clinical FindingsThe 31 patients were all women with urgency and frequency of micturition. Their ages ranged from 15 to 73 with a mean of 38 years. Nine patients were postmenopausal. The urine was normal on routine testing and sterile on culture. Clinical examination was negative. Cystoscopic FindingsOn endoscopy, the changes are confined to the

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Section: Discussionmentioning

confidence: 74%