Structural features of the urethra in patients with urethral pain syndrome

Streltsova, Olga; Kiseleva, Elena B.; Molvi, M.A.; Lazukin, V F

doi:10.29188/2222-8543-2019-11-3-170-177

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…Indeed, qualitative comparison of the CP OCT images in the studied groups showed that the condition of the epithelium and connective tissue structures of the mucosa in patients with UPS is not normal; the changes (epithelial atrophy and¯brosis) are similar to those in chronic in°ammation. The revealed changes in the CP OCT characteristics are comparable with the results of our previous studies of urinary bladder 48,49 and urethra 50 and investigations of other groups. 51,52 Using OCT, Meller et al 51 demonstrated thinning of the epithelium in atrophic rhinitis.…”

Section: Discussionsupporting

confidence: 90%

“…In our previous study of urethral wall using CP OCT, 50 it was shown that, compared with the \norm" group, in the \Inf" group, changes in the epithelial layer (its hyperplasia or atrophy) are more often observed in the initial stages of the disease, after which in°ammatory changes pass to the connective tissue stroma and are manifested by its brosis (shown as an increase in the level of the OCT signal in cross-polarization). By contrast, in the \UPS" group, at a structural level, the pathogenesis of the disease begins with changes in the connective tissue stroma (its¯brosis is also observed, which can be seen as a noticeable increase in the cross-scattering signal level, up to the appearance of the birefringence e®ect) with subsequent spread to the epithelial layer, most often causing its atrophy.…”

Section: Discussionmentioning

confidence: 99%

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In vivo assessment of structural changes of the urethra in lower urinary tract disease using cross-polarization optical coherence tomography

Kiseleva

Moiseev

Kuyarov

et al. 2020

J. Innov. Opt. Health Sci.

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The paper presents the results of a study of the female urethra in cases of urethral pain syndrome (UPS) and inflammatory diseases of the lower urinary tract using cross-polarization optical coherence tomography (CP OCT). Urethral wall structure was studied in 86 patients; 233 CP OCT images were collected. A comparative qualitative analysis of three groups of CP OCT images — “norm”, “Inflammation” and “UPS” — identified that despite the absence of a clear inflammatory factor in the patient’s examination, the urethral tissues in UPS were in an altered state. The changes in the urethral wall with UPS and in cases of inflammation were similar. Using a point scale, three experts independently performed visual scoring of the CP OCT images. Three parameters: epithelial contrast, cavities and the minimum signal depth in the co-channel were evaluated. It was found that, individually, the parameters correlate only weakly with the diagnosis. Area under the receiver operating characteristic (ROC) curve was from 0.51 to 0.78. The joint use of a number of visual signs has a greater diagnostic value than the use of the criteria individually. Area under the ROC curve using the developed cumulative criterion reached up to 0.87–0.89. This study could form the basis of a scoring system for assessing the state of the urethral tract using CP OCT images in real time. The CP OCT method provides information on the state of urethral tissues that cannot be obtained with traditional cystoscopy.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

In vivo assessment of structural changes of the urethra in lower urinary tract disease using cross-polarization optical coherence tomography

Kiseleva

Moiseev

Kuyarov

et al. 2020

J. Innov. Opt. Health Sci.

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“…Using the CP OCT method, we have previously shown that the thickness of the tissue of the urethral membrane in women is dependent on age [58]. The work reported that, with UPS, there are corresponding tendencies towards thinning of the epithelium and an increase in the thickness of the connective tissue matrix of the bladder neck, as occurs in women without pathology of the urological sphere, but that these processes proceed at a higher rate.…”

Section: Discussionmentioning

confidence: 99%

New Approaches in the Study of the Pathogenesis of Urethral Pain Syndrome

et al. 2020

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Introduction: Urethral pain syndrome (UPS) is still a pathology in which the diagnosis is formulated as a “diagnosis of exclusion”. The exact pathogenetic mechanisms are not yet fully understood and clear recommendations for the prevention and treatment of UPS are absent. Methods and Participants: A clinical and laboratory evaluation of 55 patients with established UPS included history taking, basic laboratory tests (e.g., complete blood count and clinical urine test), physical examination, uroflowmetry, and cystourethroscopy. Additionally, transvaginal ultrasound (TVUS) with compression elastography and cross-polarization optical tomography (CP OCT) were performed in 24 and 33 patients with UPS, respectively. The control group consisted of 14 patients with no complaints from the urinary system. Results: TVUS showed an expansion in the diameter of the internal lumen of the urethra, especially in the proximal region compared with the norm. Compression elastography revealed areas with increased stiffness (presence of fibrosis) in urethral and surrounding tissues. The performed CP OCT study showed that in UPS, the structure of the tissues in most cases was changed: trophic alterations in the epithelium (hypertrophy or atrophy) and fibrosis of underlying connective tissue were observed. The proximal fragment of the urethra with UPS underwent changes identical to those of the bladder neck. Conclusion: This paper showed that the introduction of new technology—CP OCT—in conjunction with TVUS will allow verification of structural changes in tissues of the lower urinary tract at the level of their architectonics and will help doctors understand better the basics of the UPS pathogenesis.

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“…Using the CP OCT method, we have previously shown that the thickness of the tissue of the urethral membrane in women is dependent on age [38]. The work reported that, with UPS, there are corresponding tendencies towards thinning of the epithelium and an increase in the thickness of the connective tissue matrix of the bladder neck, as occurs in women without pathology of the urological sphere, but that these processes proceed at a higher rate.…”

Section: Discussionmentioning

confidence: 99%

New Findings in the Study of the Pathogenesis of Urethral Pain Syndrome

Streltsova¹,

Kuyarov²,

Molvi³

et al. 2020

Preprint

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Urethral pain syndrome (UPS) is still a pathology in which the diagnosis is formulated as a "diagnosis of exclusion". The exact pathogenetic mechanisms are not yet fully understood and clear recommendations for the prevention and treatment of UPS are absent. The goal of the study was to assess the condition of the tissues in the female urethra in UPS, by using transvaginal ultrasound (TVUS) and cross-polarization optical tomography (CP OCT). TVUS showed an expansion in the diameter of the internal lumen of the urethra, especially in the proximal region compared with the norm. Compression elastography revealed areas with increased stiffness (presence of fibrosis) in urethral and surrounding tissues. When studied with CP OCT it was shown that with UPS, the structure of the tissues in most cases was changed: trophic alterations in the epithelium (hypertrophy or atrophy) and fibrosis of underlying connective tissue were observed. The proximal fragment of the urethra with UPS underwent changes identical to those of the bladder neck. This paper showed that the introduction of new technology — CP OCT — in conjunction with TVUS will allow verification of structural changes in tissues of the lower urinary tract at the level of their architectonics and will help doctors understand better the basics of the UPS pathogenesis.

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Structural features of the urethra in patients with urethral pain syndrome

Cited by 4 publications

References 3 publications

In vivo assessment of structural changes of the urethra in lower urinary tract disease using cross-polarization optical coherence tomography

In vivo assessment of structural changes of the urethra in lower urinary tract disease using cross-polarization optical coherence tomography

New Approaches in the Study of the Pathogenesis of Urethral Pain Syndrome

New Findings in the Study of the Pathogenesis of Urethral Pain Syndrome

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