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. 2023 Jun;30(6):514-519.
doi: 10.1111/iju.15161. Epub 2023 Feb 20.

Transvaginal ultrasonography for trigonitis diagnosis in women

Leopoldo Alves Ribeiro-Filho  1 , Natalia Doratioto Serrano Faria Braz  1 , Caio Vinicius Suartz  1 , Amaury Padilha Balsimelli  1 , Felipe Hirasaki  1 , Eduardo Miranda  1 , Matheus Siqueira  1 , Anuar Ibrahim Mitre  1 , Cristiano Mendes Gomes  1 , William Carlos Nahas  1
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Transvaginal ultrasonography for trigonitis diagnosis in women

Leopoldo Alves Ribeiro-Filho et al. Int J Urol. 2023 Jun.

Abstract

Objective: Chronic trigonitis (CT) is usually diagnosed through cystoscopy which is invasive and expensive. Thus, an accurate non-invasive diagnostic method is necessary. The objective of this study is to determine the efficacy of transvaginal bladder ultrasound (TBU) for CT diagnosis.

Methods: Between 2012 and 2021, 114 women (17-76 years old) with recurrent urinary tract infection (RUTI) and history of antibiotic resistance were evaluated with TBU by a single ultrasonographer. As a control group, TBU was performed in 25 age-matched women with no previous history of UTI, urological or gynecological conditions. All patients with RUTI had undergone a cystoscopy with biopsy for diagnostic confirmation at the time of trigone cauterization.

Results: Thickening of trigone mucosa (>3 mm) was detected in all patients with RUTI and represented the most relevant criteria for trigonitis diagnosis on TBU. Other TBU findings in CT are: irregular and interrupted mucosa lining (96.4%), free debris in the urine (85.9%), increased blood flow at doppler (81.5%), mucosa shedding and tissue flaps. Biopsy showed CT with erosive pattern (58%) or non-keratinizing metaplasia (42%). Diagnostic agreement index between TBU and cystoscopy was 100%. In the control group, normal trigone mucosa is ultrasonographically regular, continuous, with thickness ≤3 mm and there is no debris in the urine.

Conclusions: TBU proved to be an efficient, inexpensive and minimally invasive method to diagnose CT. To our knowledge, this is the first article that reports the use of transvaginal ultrasound as an alternative method for diagnosing trigonitis.

Keywords: chronic trigonitis; diagnosis; transvaginal ultrasound.

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References

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