Last reviewed by Dr. Raj MD on January 12th, 2022.
What is Trigonitis?
This medical condition is an inflammation of the vesical trigone region of your urinary bladder and is when the cells that line your lower part of your bladder undergo changes into a different type of cell. The cellular changes are non-cancerous and have no potential to become cancerous.
Vesical trigone means “triangular region” of your bladder wall with the three points of the triangle corresponding to the locations at which your ureters and urethra connect. It is the structure that allows your body to detect when your bladder is full. The vesical trigone is a smooth, flat region that is highly sensitive and as your bladder fills and expands so does this region. When the vesical trigone gets big enough your bladder will signal the brain that it needs to be emptied and as it expands more the stronger the signal becomes. This medical condition most often affects women who are of childbearing age but men will occasionally develop trigonitis. It is almost never found in children.
The most common symptoms of this medical condition are urinary problems and bladder pain but some may not have any symptoms at all. Having trigonitis could also cause:
- Bladder pain
- An abnormal increase in the urge to urinate and the frequency of urination, especially at night.
- Bladder capacity that is reduced.
- Dysuria which is pain or discomfort when urinating
- Hematuria which is blood in the urine
- Pain or discomfort in your pelvic area.
For some people who are suffering from trigonitis they may have discomfort during sex or increased pain when they are sitting in certain positions. For some people these symptoms can be triggered by having sensitivity to certain foods they eat. The symptoms that a person has may not even be specific for trigonitis and instead be symptoms of prostatitis in men and urinary tract infections in women.
What the exact cause of trigonitis is not known at this time but there are several different theories as to what is the cause. If a disease is affecting the vesical trigone it can cause problems with your urination. Because it affects mostly women who are of childbearing age one theory is that it could be related to the levels of the hormone estrogen. In men it could be related to their levels of progesterone, especially when they are undergoing hormonal therapy for prostate cancer.
Another theory is that there may be a correlation between childhood or family history of bladder infections. It is also thought that having repeated bladder and urination infections could lead to chronic inflammation of this particular region. It could also be cause from chronic irritation associated with the long term insertion of an indwelling urinary catheter that is used for urinary retention, after surgery, or urinary incontinence.
How is Trigonitis Diagnosed?
Trigonitis is often misdiagnosed because the symptoms of this particular medical condition are almost identical to those of interstitial cystitis. The main difference between trigonitis and interstitial cystitis is that with trigonitis your inflamed vesical trigone would have a cobblestone pattern but would be absent if you had interstitial cystitis. To make a confirmed diagnosis you would have to have a cystoscopic examination which is when a lens that is fixed to a long tube that is hollow and is inserted into your bladder via your urethra. Your physician will be able to examine the inside of your bladder with the lens to see if there is inflammation in the relevant area. Normally this procedure is an outpatient procedure done under light sedation.
There is not standardized treatment plan at this time but there are several different medications that can help to control the symptoms. In addition which treatment might work for one person might not work for another. Some of the medications that your physician might suggest include:
- A prescription for muscle relaxers to help relieve your bladder spasms
- Either over-the-counter or prescription anti-inflammatory medications
- A prescription for antidepressants which when taken at a low dosage can help to reduce pain
- Antibiotics if there is an infection that is accompanying your bladder inflammation
- Using an instillation or bladder coating is sometimes used to give you fast pain relief. If this is the method of treatment the bladder coating or instillation will be applied to the organ via a catheter. It is a cocktail of medications that is used to control inflammation and pain along with helping your bladder heal.
After all other treatment options have been tried having a surgical procedure like a cystectomy, which is the removal of your bladder and reconstructive surgery or bladder augmentation which is reconstructive surgery to increase the reservoir capacity of your bladder by strengthening and expanding it with the addition of sections of intestinal tissue. Having a cystectomy is a treatment that is used as a last resort since it involves removal of your bladder.
For some people taking medication can give them a permanent cure but it is much more common for this medical condition to become chronic with symptoms that are uncontrollable along with occasional urinary problems and flare-ups of pain. It may also help to eliminate certain from foods from their diet to help reduce the severity and frequency of flare-ups. Not everyone has the same trigger foods but some of the trigger foods can include chocolate, grains, certain fruit juices, carbonated drinks, and caffeine. Two other self care options to help relieve the symptoms include stop smoking and wear clothing that is non-restrictive.