Trigonitis is an inflammation of the vesical trigone region of the urinary bladder. The vesical trigone is a triangular region of the bladder wall, and the three points of the triangle correspond to the locations at which the urethra and ureters connect. 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 the symptoms.
The vesical trigone is the structure that allows the body to detect when the bladder is full. This flat, smooth region is highly sensitive, and as the bladder fills and expands, this area is stretched as well. When it gets big enough, the bladder signals to the brain that it needs to be emptied; the more the vesical trigone expands, the stronger the signals become. Diseases that affect this section of tissue, therefore, tend to cause problems with urination.
Causes
There are multiple theories as to what causes this problem. Trigonitis occurs most often in women of childbearing age, but occasionally men develop it too. For this reason, the cause is thought by some researchers to be related to levels of the hormone estrogen. Some studies suggest there is a correlation between family or childhood history of bladder infections and the occurrence of trigonitis, however, so others believe that repeated infections might lead to chronic inflammation of the vesical trigone region.
Symptoms
Trigonitis causes bladder pain, reduced bladder capacity, and an abnormal increase in the frequency and urge to urinate, particularly at night. For some, the problem can lead to increased pain when sitting in certain positions or discomfort during sex. In addition, some people experience sensitivity 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 complaint called interstitial cystitis. This similarity means that trigonitis is often misdiagnosed. The main difference between the two is that the inflamed vesical trigone of a person with trigonitis takes on a cobblestone pattern that is absent in someone with interstitial cystitis.
Confirmation of diagnosis requires a cystoscopic examination, which is performed by a medical professional. During this process, a lens fixed to a long hollow tube is inserted into the bladder via the urethra. With the lens, the doctor is able to examine the examine the inside of the bladder and see if the relevant area is inflamed. Cystoscopy is most often performed under light sedation as an outpatient procedure.
Treatment
There is no standard treatment for trigonitis, and what is effective for one person might 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 at low doses. Antibiotics are prescribed when infection accompanies the bladder inflammation. Another type of treatment, called a bladder coating or instillation, is sometimes used to provide fast pain relief. A bladder coating is applied to the organ via a catheter and is typically a cocktail of medications used to control pain and inflammation, and to help the bladder heal.
Surgical procedures, such as bladder augmentation or cystectomy, are considered only after all other options have been exhausted. In a bladder augmentation, the bladder is expanded and strengthened with the addition of sections of intestinal tissue. Cystectomy is a last-resort treatment that involves the removal of the bladder, followed by reconstructive surgery.
Self Care
For some people, medication 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 enhance the relief that medication provides and help a person with the disease feel more in control of her symptoms.
Many people find that eliminating certain foods from the diet can help to reduce the frequency and severity of flare-ups. Trigger foods are not the same for everybody, but can include citrus fruits and certain types of fruit juices, chocolate, grains, caffeine, and carbonated drinks. Wearing non-restrictive clothing and stopping smoking are two other options that can often help relieve symptoms.
