Squamous metaplasia of the trigone in women with recurrent cystitis syndrome

Abstract

膀胱鏡に膀胱三角部に白斑を示した44例の反復性膀胱炎の女子の同部生検をおこない検討した.組織学的に白斑部の上皮はさまざまなGradeの扁平上皮化生を示し, 粘膜下は線維下傾向を示したが, その傾向は, 頻回な膀胱炎症状既往を有する例ほど著しかった.軽～中等度の扁平上皮化生を示した群では尿道部細菌を認めたが, 重症な扁平上皮化生を示した群ではそれを認めなかった.以上よりみて, 尿道部細菌は扁平上皮化生の発生や初期の進展のひとつの要因と見做しうるが, 一層進展した上皮化生は, 同部細菌とは無関係に, 単に頻回な症状のくり返しのみで生じうることが推測された

Urocystic mucosal biopsies of the white patch on the trigone in 44 women complaining of dysuria and frequency with or without bacteriuria showed varying degrees of squamous metaplasia as well as submucosal fibrosis. The patients with more frequent episodes of such symptoms in the past had more severe squamous metaplasia with submucosal fibrosis. Introital bacteria were found in almost all patients with mild or moderate development of squamous metaplasia, but not in those with severe lesions. These facts suggest that introital bacteria may be one of the causative factors for the initiation and early development of these abnormal mucosal changes. However, the further progression to severe mucosal alteration seems to be independent of any bacteria and this severe mucosal alteration may result in recurrence of such symptoms.