Urethral Effects

Changes in the urethral mucosa occur in a near identical manner to those in the vaginal mucosa. There is a thinning and loss of rugation of the urethral mucosa associated with an increasingly hypovascular state. The urethral mucosa will become thin, pale, and there will be loss of mucosal coaptation along the length of the urethra. These changes are promptly reversible with intravaginal administration of local estrogen.

The changes in the vaginal and urethral mucosa occur in parallel. Therefore, a woman with vaginal atrophy can be assumed to have urethral atrophy. Attempts have been made to quantify urethral atrophy using urethral cytology. Our efforts to use this cytologic evaluation tool to quantify urethral atrophy have not been fruitful because patholo-gists are typically not familiar with urethral cytology, and thus we do not consider urethral cytology to be a reliable assessment tool.

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