Vesical Ultrasonography and Internal Examination of Female Patients With Urethral Syndrome

Abstract

Transabdominal ultrasonography of the bladder and internal examination were performed in 80 female patients without pyuria. They were divided into 3 groups: urethral syndrome with trigonitis (49 cases), asymptomatic trigonitis (16 cases) and normal bladder (15 cases) by cystoscopy. Ultrasonography of trigonitis with or without symptoms showed focal dilation of the submucosal low echo zone and mucosal irregularity around the bladder neck. On the sagittal view, the thicknesses from the surface of mucosa to that of muscle layer within 2 cm from the bladder neck were 4 +/- 1 mm (mean +/- standard deviation) in the group with urethral syndrome and in that with asymptomatic trigonitis, and 3 +/- 1 mm in the normal bladder group. Mucosa of the trigonitis with or without symptom is patients with significantly thicker than that of those with normal bladder (p less than 0.01). On internal examination, tenderness at the upper frontal wall of the vagina was present in 10 of 11 cases (91%) with urethral syndrome, in 2 of 8 cases (25%) with asymptomatic trigonitis and in one of 9 cases (11%) with normal bladder. There was a significant difference (p less than 0.005) between the degree of inflammation and the number of cases with tenderness at the frontal wall of the vagina. From these results, transabdominal ultrasonographic measurement of mucosal thickness around the bladder neck and internal examination for tenderness at the frontal wall of vagina are thought to be useful methods for diagnosis and follow-up of urethral syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Transabdominal vesical sonography of urethral syndrome and stress incontinence

“…Local thickening of the mucosa was reported to persist for a long period, even after drug therapy (Chinese herbal medicines, such as, chorei‐to or chorei‐to‐go‐shimotsu‐to) controlled lower urinary tract symptoms 15 . Clinically, there is tenderness of the anterior vaginal wall near the bladder neck in patients with the urethral syndrome, while this is rare in patients with asymptomatic trigonitis 9 . Therefore, local thickening of the vesical mucosa means that inflammation has occurred around this site at some time, but does not necessarily reflect the current severity of inflammation or lower urinary tract symptoms.…”

“…The present study confirmed our previous finding that the vesical mucosal thickness did not differ between patients with asymptomatic trigonitis and patients with the urethral syndrome. 9 Local thickening of the mucosa was reported to persist for a long period, even after drug therapy (Chinese herbal medicines, such as, chorei-to or chorei-to-go-shimotsu-to) controlled lower urinary tract symptoms. 15 Clinically, there is tenderness of the anterior vaginal wall near the bladder neck in patients with the urethral syndrome, while this is rare in patients with asymptomatic trigonitis.…”

“…15 Clinically, there is tenderness of the anterior vaginal wall near the bladder neck in patients with the urethral syndrome, while this is rare in patients with asymptomatic trigonitis. 9 Therefore, local thickening of the vesical mucosa means that inflammation has occurred around this site at some time, but does not necessarily reflect the current severity of inflammation or lower urinary tract symptoms.…”

“…The present study confirmed our previous finding that the vesical mucosal thickness did not differ between patients with asymptomatic trigonitis and patients with the urethral syndrome 9 . Local thickening of the mucosa was reported to persist for a long period, even after drug therapy (Chinese herbal medicines, such as, chorei‐to or chorei‐to‐go‐shimotsu‐to) controlled lower urinary tract symptoms 15 .…”

“…[1][2][3][4][5][6][7][8] Recently, we investigated the transabdominal ultrasonographic features of the bladder neck in female patients. The findings included local mucosal thickening around the bladder neck in patients with asymptomatic trigonitis and urethral syndrome, 9 absence of the anterior edge of the vesical base plate in patients with stress incontinence, 10 and a small anteroposterior vesical wall angle at the bladder neck in patients with stress incontinence. 11 These findings were easily visualized on sagittal transabdominal ultrasonograms obtained with the patient in the supine position.…”