Epithelium of Vaginal Type in the Female Trigone: The Clinical Problem of Trigonitis

Cifuentes, Luis Fernández

doi:10.1016/s0022-5347(17)69738-6

Cited by 32 publications

(40 citation statements)

References 7 publications

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“…Tyler (1962) found the change in 12 of 14 premenopausal women and 17 of 34 postmenopausal but none in stillbirths, newborn infants, or children. Similar figures are given by Cifuentes (1947).…”

Section: Discussionsupporting

confidence: 74%

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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: Discussionsupporting

confidence: 74%

“…The clinical name will therefore be retained. The condition has been described by various authors (Heymann, 1905;Ryall, 1929;Orr, 1933;Fowler, 1936;Cifuentes, 1947;Ney and Ehrlich, 1955;Clarke and Gherardi, 1962). All of these refer to young menstruating women with no cases before the menarche and a decreasing incidence after the menopause.…”

Section: Discussionmentioning

confidence: 99%

Histological findings in pseudomembranous trigonitis

Henry¹,

Fox²

1971

J Clin Pathol

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“…It is present in the trigone in 75-86% of women [34], is considered to be a normal finding, and should not be labeled metaplasia [17].…”

Section: Keratinizing Squamous Metaplasiamentioning

confidence: 99%

Preneoplastic non-papillary lesions and conditions of the urinary bladder: an update based on the Ancona International Consultation

et al. 2001

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The result of the meeting is represented by a refined classification of the non-papillary intraepithelial lesions and conditions of the urothelium. This classification includes epithelial abnormalities (reactive urothelial atypia and flat urothelial hyperplasia), presumed preneoplastic lesions and conditions (keratinizing squamous and glandular metaplasia, and malignancy-associated cellular changes), as well as preneoplastic (dysplasia) and neoplastic non-invasive (carcinoma in situ) lesions. Each of these lesions is defined with strict morphological criteria in order to provide more accurate information to urologists in managing patients.

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“…Oestrogens have been thought to predispose to its formation, for it has been found in normal women and female neonates but not in normal men (Cifuentes, 1947;Ney and Ehrlich, 1955;Tyler, 1962;Streitz, 1963); however it has also been described in prepubertal girls (Streitz, 1963) and postmenopausal women (Cifuentes, 1947;Tyler, 1962). Longstanding urinary infection has been considered an important predisposing factor (Heymann, 1905;Stirling and Ash, 1941;Connery, 1953;Abeshouse and Tankin, 1956;Politano, 1956;Holley and Mellinger, 1961;Smith, Webb, and Price, 1962;Clarke and Gherardi, 1962;Streitz, 1963;O'Flynn and Mullaney, 1967), a view which has experimental support (Ball, Field, Roe, and Walters, 1964).…”

Section: Discussionmentioning

confidence: 99%

The relationship between urinary infection, cystoscopic appearance, and pathology of the bladder in man

1974

J Clin Pathol

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The occurrence of squamous change in the bladder epithelium was studied in bladder biopsies from patients with recurrent urinary infections or symptoms of cystitis and comparisons were made with sections taken at necropsy from control subjects. Two types of squamous change, termed `vaginal' and `cornified', are described. Vaginal change was frequent in females, and seemed to be a normal finding in them, but was not observed in males. It did not seem to be caused by urinary infection. Cornified change was also common in females and was found in one (infected) man. Like vaginal change it was most often found in sections from the trigone. Urinary infection may predispose to its formation but we were unable to prove this. Squamous change did not seem to cause symptoms, and could not usually be recognized at cystoscopy. The varieties described are so common that they are unlikely to be markedly precarcinomatous.

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Epithelium of Vaginal Type in the Female Trigone: The Clinical Problem of Trigonitis

Cited by 32 publications

References 7 publications

Histological findings in pseudomembranous trigonitis

Histological findings in pseudomembranous trigonitis

Preneoplastic non-papillary lesions and conditions of the urinary bladder: an update based on the Ancona International Consultation

The relationship between urinary infection, cystoscopic appearance, and pathology of the bladder in man

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