Your Health - Urethral Syndrome

Urethral Syndrome

(Urethral Irritation)

Definition

Urethral syndrome is a term used to describe symptoms of urethritis , without any evidence of bacterial or viral infection as a cause. Urethritis is an inflammation, infection, or irritation of the urethra. It is most commonly seen in women. The urethra is the tube that carries urine out of the body from the bladder.

Female Urethra

Causes

Because there is no evidence of infection, the cause of urethral syndrome is often difficult to pinpoint. Possible causes include:

Undetected bacterial or viral infection of the urethra
Irritation of the urethra, caused by:
- Radiation exposure
- Chemotherapy
- Spermicidal jellies used during sexual intercourse
- Bubble baths
- Harsh soaps
- Scents or perfumes
- Injury to the urethra caused by a blow to the pelvic area
- Sexual intercourse (especially in women)
- Urinary irritants such as caffeine and certain foods
Specifically in women, irritation of the urethra may be caused by:
- Feminine hygiene sprays or douches
- Sanitary napkins
- Contraceptive gels
- Condoms
Structural problems, such as narrowing of the urethra

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include:

Sex: female
Factors that may lead to an undetected infection:
- Unprotected sex (without use of a condom)
- History of sexually transmitted diseases
- Bacterial infection of other parts of the urinary tract ( bladder , kidney )
- Medications that lower resistance to infections

Symptoms

The symptoms of urethral syndrome are similar to those of urethritis. Symptoms may include:

Pain and/or burning while urinating
Difficulty urinating (especially after intercourse)
Increase in urinary:
- Frequency
- Urgency
- Blood in the urine
Swelling and/or tenderness in the groin
Pain during intercourse
In men:
- Discharge from penis
- Blood in semen
- Pain during ejaculation
- Swollen and/or tender testicles

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam including a pelvic exam. Urethral syndrome is usually diagnosed when symptoms of urethritis are present, but there is no evidence of an infection as the cause.

Tests may include:

Urine tests or urethral swab tests for lab study
Tests for sexually transmitted diseases
Cystoscopy and/or urethroscopy—use of a thin, lighted tube to examine the inside of the bladder and/or urethra; this investigation is usually required when symptoms persist and/or do not respond to simple treatments.
Pelvic ultrasound —to look at the bladder and the reproductive system

Treatment

Treatment may include:

Medication

Antibiotics—given if your doctor thinks urethral syndrome may be due to an undetected infection
Anesthetics
- Phenazopyridine—may be given by your doctor to ease discomfort while urinating
- Intraurethral lidocaine jelly
Antispasmodics to decrease bladder muscle spasm (eg, oxybutynin [Ditropan])
Antidepressants such as a tricyclic antidepressant to relieve pain
Alpha-blocking drugs such as doxazosin (Cardura) to relax smooth muscle tone

Avoidance of Irritants

Avoid irritants that may cause urethral syndrome. Then, wait and see if your condition improves.

Surgery

Surgery may be done in cases where narrowing of the urethra is thought to be causing the urethral syndrome.

Prevention

Measures that may help prevent urethral syndrome include:

Avoiding the use of:
- Spermicidal jellies
- Bubble baths
- Harsh soaps
- Scents or perfumes
- Feminine hygiene sprays and douches
- Urinary irritant foods and beverages
Practicing safe sex, including using condoms
Urinating immediately after having sexual intercourse
Making sure sexually-transmitted diseases are treated quickly and completely for you and your partner
Regularly drinking plenty of fluids

RESOURCES:

National Institute of Diabetes & Digestive & Kidney Diseases
http://www.niddk.nih.gov/

US National Library of Medicine
http://www.nlm.nih.gov/

CANADIAN RESOURCES:

The Kidney Foundation of Canada
http://www.kidney.bc.ca/

The Kidney Foundation of Canada
http://www.kidney.ab.ca/

References:

Beers M. Merck Manual of Diagnosis and Therapy . Whitehouse Station, NJ: Simon and Schuster, Inc; 2001.

Costantine E, Zucchi A, Del Zingaro M, Mearini L. Treatment of urethral syndrome: a prospective randomized study with Nd: YAG laser. Urol Int . 2006;76:134-138.

Gittes RF, Nakamura RM. Female urethral syndrome. A female prostatitis? West J Med. 1996;164:435-438.

US National Library of Medicine website. Available at: http://www.nlm.nih.gov .

Last reviewed September 2009 by Adrienne Carmack, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.