(A) Scant urothelial cell shedding and debris is seen in patients without recurrent urinary tract infections (rUTIs) already on vaginal estrogen therapy (VET). (B) Slightly increased urothelial cell shedding, inflammatory cells, and debris are seen in patients with rUTIs. (C) Patients with rUTIs not on VET demonstrate significantly more urothelial shedding, inflammatory cells, and debris. Black arrow, sloughed urothelium; red arrow head, neutrophils.