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To the Editor:—
With regard to the brief query in "Questions and Answers" in The Journal (p. 264, Jan. 21, 1961) concerning trigonitis, it seems that Dr. Cook does not indicate any specific etiological factor for the pseudomembranous trigonitis. I feel it might be an indication of mechanical difficulties to the bladder neck, namely, bladder neck contractures. These are quite common in females. When the contractures become severe, they actually produce residual urine and trabeculations of the bladder, such as is found in the male. However, there are cases that do not show true decompensation, and these may be caused by chronic vaginitis, skenitis, and urethritis. But what produces the chronic recurrent vaginitis? Aside from cervicitis or endometritis, nothing much has been offered until recently, when Dr. R. O'Donnell of Las Vegas described his "I. R. H." syndrome, which stands for inadequate rupture of the hymen. The latter becomes ring-like,
Russell M. Pseudomembranous Trigonitis. JAMA. 1961;176(6):551. doi:10.1001/jama.1961.03040190073027
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