Trigonitis is inflammation of the trigone vesica region of the bladder, causing bladder pain and urinary problems. The cause is unknown, but it is believed to be related to estrogen hormone levels or chronic inflammation due to repeated infections. Diagnosis requires a cystoscopic examination, and treatment options include pain relief medication, antibiotics, and bladder lining instillation. Self-care options include eliminating trigger foods, wearing non-restrictive clothing, and quitting smoking. Surgical procedures are only considered as a last resort.
Trigonitis is an inflammation of the trigone vesica region of the urinary bladder. The trigone vesicae is a triangular region of the bladder wall and the three points of the triangle correspond to the locations where the urethra and ureters connect. The most common symptoms of this disease include bladder pain and urinary problems. Its exact cause is still unknown and there is no standardized treatment plan. There are, however, several medications that can help control symptoms.
The trigone is the structure that allows the body to sense when the bladder is full. This flat, smooth region is highly sensitive, and as the bladder fills and expands, this area is also stretched. When the bladder becomes large enough, it signals to the brain that it needs to be emptied; the more the trigone vesica expands, the stronger the signals become. Diseases that affect this section of tissue, therefore, tend to cause problems with urination.
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There are several theories as to what causes this problem. Trigonitis occurs most often in women of childbearing age, but men occasionally develop it as well. For this reason, some researchers believe that the cause is related to estrogen hormone levels. Some studies suggest that there is a correlation between a family or childhood history of bladder infections and the occurrence of trigonitis, however, others believe that repeated infections can lead to chronic inflammation of the trigone vesica region.
Symptoms
Trigonitis causes bladder pain, decreased bladder capacity, and an abnormally high frequency and need to urinate, particularly at night. For some, the problem can lead to increased pain when sitting in certain positions or discomfort during sex. Additionally, some people experience sensitivities to certain foods, and eating them can trigger symptoms.
Diagnosis
The symptoms of this disease are almost identical to those of a more common bladder disorder called interstitial cystitis. This similarity means that trigonitis is often misdiagnosed. The main difference between the two is that the inflamed trigone vesica of a person with trigonitis takes on a cobblestone pattern that is absent in someone with interstitial cystitis.
Confirmation of the diagnosis requires a cystoscopic examination, which is performed by a doctor. During this process, a lens attached to a long hollow tube is inserted into the bladder through the urethra. With the lens, the doctor is able to examine the inside of the bladder and see if the affected area is inflamed. Cystoscopy is often done under light sedation as an outpatient procedure.
Treatment
There is no standard treatment for trigonitis, and what works for one person may not work for another. Pain relief options include muscle relaxants to relieve bladder spasms, anti-inflammatories, and antidepressants, some of which can reduce pain when taken in low doses. Antibiotics are prescribed when infection accompanies bladder inflammation. Another type of treatment, called a bladder lining or instillation, is sometimes used to provide quick pain relief. A bladder lining is applied to the organ via a catheter and is typically a cocktail of drugs used to control pain and inflammation and to help the bladder heal.
Surgical procedures, such as bladder augmentation or cystectomy, are only considered after all other options have been exhausted. In a bladder augmentation, the bladder is expanded and strengthened by adding sections of intestinal tissue. Cystectomy is a last-resort treatment that involves removing the bladder, followed by reconstructive surgery.
Self care
For some people, medications can provide a permanent cure for this disease, but it is much more common for trigonitis to become a chronic condition in which symptoms are controllable, with occasional flare-ups of pain and urinary problems. Exploring self-care options can increase the relief medications provide and help a person with the disease feel more in control of their symptoms.
Many people find that eliminating certain foods from their diet can help reduce the frequency and severity of flare-ups. Trigger foods aren’t the same for everyone, but they can include citrus fruits and some types of fruit juices, chocolate, cereals, caffeine, and sodas. Wearing non-restrictive clothing and giving up smoking are two other options that can often help relieve symptoms.
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