Trigonitis is an inflammation of the lower part (trigone) of the bladder around the openings of the ureters and urethra (tube leading out of the bladder). It usually occurs in women and is caused by a lack of oestrogen after the menopause or after a total hysterectomy causes the tissue of the vagina and adjacent bladder base to become thin, less supple, easily damaged and the sensory nerves in the bladder base become exposed to urine.
Painful frequent passage of urine and aching pain in the lower belly occur. The involuntary passage of urine with a cough or exercise is also common and bladder and urinary tract bacterial infections can easily occur. It is diagnosed by cystoscopy (passing a tube into the bladder through which it can be inspected).
Treatment involves long-term oestrogen supplementation by local application of cream in the vagina, tablets, patches, implants or injection. Progestogens may need to be given as additional treatment with the oestrogen. The prognosis is good while oestrogen hormone replacement therapy is continued.