Contacts: Streltsova Olga Sergeevna, strelzova_uro@mail.ru

The purpose of the study is to identify the features of the urethra state in patients with urethral pain syndrome (UPS) by the method of cross-polarization optical coherence tomography (CP OCT).

Materials and methods. The condition of the urethras of 69 patients were studied: 23 of them with UPS, 37 with inflammatory diseases, in 9 the state of the urethra was accepted as the norm. Everyone underwent cystoscopy with CP OCT, the neck of the bladder and the urethra were examined. The device «OCT – 1300U» was used; 396 CP OCT images were obtained. The thicknesses of the epithelial and connective tissue layers were measured in the CP OCT images of the urethra and bladder neck. The measurements were carried out by hand by two independent analysts using the standard functions of the ImageJ program. Statistical analysis of the data on changes in the thickness of the urethral tissue layers due to the duration of the disease (up to 1 year, and more than 1 year) and in relation to the age of each patient was performed according to standard method using of the corresponding methodology in «Statistica 12».

Results. In the studied groups independent and the unique nature of the group effect of age-related changes in the thickness of the urethral wall (ARCTUW) was revealed. Atrophy of the epithelial layer and fibrosis of the subepithelial structures were shown to be the predominant change in UPS. The thickness of the urethral tissue in UPS corresponded to an intermediate position relative to the «normal» and «inflammation» groups. Changes in tissue thickness initially most intensively occurred in the connective tissue, and then spread to the epithelium. In inflammation the changes initially were the most intense in the epithelium, and then propagate to the connective tissue.

Conclusion. This is the first time that the structure the urethra wall has been studied in vivo by the imaging method – CP OCT. It was revealed that the connective tissue layer of the urethra is actively involved in the pathogenesis of the UPS, and the rate of change in it with UPS is higher than with chronic inflammation of the infectious genesis.

For citation: Streltsova O.S., Kiseleva E.B., Molvi M.A., Lazukin V.F. Structural features of the urethra in patients with urethral pain syndrome. Experimental and clinical urology 2019;(3):170-177