Sadeghi Zhina, MacLennan Gregory, Childs Stacy J, Zimmern Philippe E
Urology Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.
Anatomic Pathology, Pathology Department, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Low Urin Tract Symptoms. 2019 Sep;11(4):182-188. doi: 10.1111/luts.12264. Epub 2019 Apr 15.
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). Abstracts 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.
为巩固我们对“膀胱三角区炎”及其在当前泌尿外科实践中的相关性的理解，我们回顾了关于该实体的文献。对MEDLINE、EMBASE和Cochrane数据库（1905年至今）进行了系统检索，以查找任何涉及以下术语的英文文章：膀胱三角区炎、膀胱三角区膀胱炎、囊性膀胱炎、鳞状化生、假膜性膀胱三角区炎、阴道化生、膀胱三角区感染或炎症以及复发性尿路感染（rUTI）中的膀胱三角区炎。排除未聚焦于膀胱三角区炎的摘要或文章、仅重复其他关于膀胱三角区炎的原始文章中的发现的文章以及儿童或男性研究。对报道的膀胱三角区炎的组织学发现、其病理生理学理论和治疗策略进行了综述。从57篇相关文章中，只有27篇聚焦于膀胱三角区炎。膀胱三角区的膀胱镜检查评估描述了囊性膀胱炎的炎性病变，偶尔有小结石或充满脓液的病变，这种表现应与鳞状化生的白色斑块相鉴别。膀胱三角区的胚胎形成、复发性尿路感染病史以及激素对膀胱三角区的影响已被提出作为潜在的病理生理机制。据报道，有多种治疗策略可用于治疗有症状的膀胱三角区炎，包括抗生素治疗、不同药物的膀胱内灌注、电灼和激光凝固。然而，目前尚未明确确立治疗指征标准，且缺乏长期数据。尽管有几篇报告描述了膀胱三角区炎的组织学和内镜检查结果，但其患病率、病理生理学和治疗仍未明确界定。其在复发性尿路感染管理中的相关性应进一步评估。
