Is trigonitis a neglected, imprecise, misunderstood, or forgotten diagnosis?

To consolidate our understanding of “trigonitis” and its relevance in current urologic practice, we reviewed the literature on this entity. The MEDLINE, EMBASE, and Cochrane databases (1905 to present) were systematically reviewed for any English language articles addressing the following terms: tri...

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Bibliographic Details
Published in:Lower urinary tract symptoms 2019-09, Vol.11 (4), p.182-188
Main Authors: Sadeghi, Zhina, MacLennan, Gregory, Childs, Stacy J., Zimmern, Philippe E.
Format: Article
Language:English
Subjects:
Adult
Female
Humans
infection of trigone
inflammation of trigone
Medical diagnosis
pseudomembranous
recurrent urinary tract infections and trigonitis
trigonitis
trigonitiscystitis cystica
Urinary Bladder - pathology
Urinary Bladder Diseases - diagnosis
Urinary Bladder Diseases - pathology
Urinary tract infections
Urology
Urothelium - pathology
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Summary:To consolidate our understanding of “trigonitis” and its relevance in current urologic practice, we reviewed the literature on this entity. The MEDLINE, EMBASE, and Cochrane databases (1905 to present) were systematically reviewed for any English language articles addressing the following terms: trigonitis, cystitis trigoni, cystitis cystica, squamous metaplasia, pseudomembranous trigonitis, vaginal metaplasia, infection or inflammation of the trigone, and trigonitis in recurrent urinary tract infections (rUTI). s or articles not focused on trigonitis, or those only repeating findings from other original articles on trigonitis, and studies in children or men were excluded. Reported histologic findings on trigonitis, theories regarding its pathophysiology, and therapeutic strategies were reviewed. From 57 relevant articles, only 27 focused on trigonitis. Cystoscopic evaluation of the trigone described inflammatory lesions of cystitis cystica, occasionally small stones or pus‐filled lesions, an appearance that should be differentiated from white patches of squamous metaplasia. Embryologic formation of the trigone, history of rUTIs, and effects of hormones on the trigone have been proposed as underlying pathophysiologic mechanisms. Numerous therapeutic strategies have been reported to treat symptomatic trigonitis, including antibiotic therapy, intravesical instillation of different agents, electrofulguration, and laser coagulation. However, no treatment indication criteria have been well established so far, and long‐term data are lacking. Despite several reports describing histologic and endoscopic findings of trigonitis, its prevalence, pathophysiology, and treatment have remained poorly defined. Its relevance in the management of rUTIs should be further evaluated.
ISSN:1757-5664
1757-5672
DOI:10.1111/luts.12264