Rigi10™ Malleable Penile Prosthesis
Also Known As
Atrophic urethritis, Urogenital atrophy (as it often coexists with vaginal and bladder atrophy), Genitourinary Syndrome of Menopause (GSM) - urethral component
Definition
Urethral atrophy is characterized by the thinning, drying, and inflammation of the urethral lining, primarily due to an estrogen deficiency. This condition is a common component of genitourinary syndrome of menopause (GSM), which affects the vagina, vulva, bladder, and urethra.¹ It results from the reduced estrogen levels typically experienced during and after menopause, though it can also occur due to other factors causing estrogen deprivation.² The urethra, like other urogenital tissues, possesses estrogen receptors, and the decline in estrogen leads to a reduction in collagen and elastin, decreased vascularity, and alterations in the local microbiome, making the tissue more fragile, less elastic, and prone to irritation and infection.³ The primary purpose of understanding and identifying urethral atrophy is to implement appropriate treatments that can alleviate symptoms such as dysuria, urgency, frequency, and recurrent urinary tract infections, thereby improving the quality of life for affected individuals.¹,²
Clinical Context
Urethral atrophy is clinically significant primarily in postmenopausal women, though it can also affect women experiencing estrogen deficiency due to other causes such as bilateral oophorectomy, pelvic radiation, chemotherapy, or certain hormonal treatments.²,³ Symptoms often include urinary urgency, frequency, dysuria (painful urination) , nocturia, stress urinary incontinence, and an increased susceptibility to recurrent urinary tract infections (UTIs).¹ These symptoms arise because the atrophic urethral mucosa is less able to provide a barrier against infection and may be more sensitive to irritants. Patient selection for treatment typically involves a clinical assessment of symptoms and, in some cases, urodynamic studies or cystoscopy, although diagnosis is often based on clinical presentation in the context of estrogen deficiency.¹ Expected outcomes with appropriate treatment, usually involving local estrogen therapy (e.g., creams, pessaries, rings), include a reduction in urinary symptoms, restoration of more normal urethral tissue, and a decrease in the frequency of UTIs.¹,³ Non-hormonal moisturizers and lubricants can also provide symptomatic relief.²