Possibilities of magnetic resonance imagraphy in the diagnosis of inflammatory changes in the paraurethral glands in women.
Authors:   the office of neurourology and urodynamics of the urology clinic of the Federal State Budgetary Educational Institution of Higher Education «Military Medical Academy named after S.M. Kirov» of the Ministry of Defense of the Russian Federation, St. Petersburg, P.O. Kislitsyn ,   Saint-Petersburg, Russia, V.V. Protoshchak ,   the Department of Urology of the Federal State Budgetary Educational Institution of Higher Education «Military Medical Academy named after S.M. Kirov» of the Ministry of Defense of the Russian Federation, St. Petersburg; Saint-Petersburg, Russia, D.I. Kuplevatskaya ,   the Radiation Diagnostics Center, Sergey Berezin Medical Institute, St. Petersburg; Saint-Petersburg, Russia, E.V. Kvyatkovskaya ,   the Radiation Diagnostic Center of the Sergey Berezin Medical Institute, St. Petersburg; Saint-Petersburg, Russia, V.I. Kuplevatskiy ,   the Radiation Diagnostic Center of the Sergey Berezin Medical Institute, St. Petersburg; Saint-Petersburg, Russia, A.I. Lavrentieva ,   the Department of Technical Training of Personnel at the Sergey Berezin Medical Institute, St. Petersburg; Saint-Petersburg, Russia, L.M. Sinelnikov ,   the Department of Urology Clinic of the Federal State Budgetary Educational Institution of Higher Education «Military Medical Academy named after S.M. Kirov» of the Ministry of Defense of the Russian Federation, St. Petersburg; Saint-Petersburg, Russia, P.A. Babkin ,   the Department of Urology of the Federal State Budgetary Educational Institution of Higher Education «Military Medical Academy named after S.M. Kirov» of the Ministry of Defense of the Russian Federation, St. Petersburg; Saint-Petersburg, Russia, M.V. Paronnikov ,   the Department of Urology «Military Medical Academy named after S.M. Kirov» of the Ministry of Defense of the Russian Federation, St. Petersburg; Saint-Petersburg, Russia
Published: May 2024

Introduction. Inflammation of the paraurethral glands (skеneitis) is a complex urological disease, often hidden under the guise of other pathological conditions and causing recurrent lower urinary tract infection (UTI) in women. A significant problem for the diagnosis of skineitis at present is the absence or extremely low sensitivity and specificity of available laboratory, instrumental and radiation methods. Thus, the search for new ways to examine patients with recurrent UTI caused by chronic inflammation of the Skene’s glands is an important clinical and socio-economic task of modern healthcare. Materials and methods. The study involved 30 patients aged from 24 to 51 years who underwent magnetic resonance imaging (MRI) of the pelvis with contrast enhancement and targeted examination of the urethra and periurethral area using a device with a 3T fi ld strength. To study the MR semiotics of chronic inflammation of the gallbladder, in addition to standard MR protocols, high-resolution T2-weighted images with a slice thickness of 2 mm and T2-weighted Space 3D images in a sagittal projection with a slice thickness of 1 mm were used. The first group consisted of 16 urologically healthy women without complaints of dysuria, who underwent an assessment of the MRI anatomy of the normal female urethra. MRI of 14 respondents with chronic infl mmation of the paraurethral glands (second group) was performed to search for recurring (natural) changes characteristic of this disease. Such parameters as the diameter of the urethra, the separate thickness of its anterior and posterior walls, clarity at the boundary of the layers, and the presence of pathological changes and formations were studied. Results. Analysis of the obtained tomograms showed that urologically healthy respondents are characterized by symmetrical thickness of the walls of the urethra without pathological formations in it, as well as evenness and clarity of the contour at the boundary of the layers. When studying the results of examination of patients with chronic skeneitis, all of them (100%) noted the following recurring changes: an increase in the diameter of the urethra due to thickening of its posterior wall, in particular the submucosal layer, impaired differentiation at the border of the submucosal and muscular layers, the presence of small cystic changes in the structure of the posterior wall of the urethra (85.7%) or fragmentarily dilated ducts of the urinary tract (14%). Hypertrophy of the bulbospongiosus muscles, detected in 85.7% of respondents in the second group, is likely an indicator of frequent exacerbations and duration of the disease, and can be considered as an additional nonspecific criterion for this disease. Conclusions. These changes can tentatively, given the small sample, be considered pathognomonic MR signs of chronic skineitis. Thus, MRI of the pelvis with a targeted examination of the urethra and periurethral area can help in the differential diagnosis of patients with suspected inflammation of the paraurethral glands, establishing the correct diagnosis and prescribing adequate treatment.