Urethral syndrome

Urethral syndrome
Specialty	Urology

Urethral syndrome is defined as symptoms suggestive of a lower urinary tract infection but in the absence of significant bacteriuria with a conventional pathogen.^[1] It is a diagnosis of exclusion in patients with dysuria and frequency without demonstrable infection.^[2] In women, vaginitis should also be ruled out.^[3]

Signs indicative of urethral syndrome include a history of chronic recurrent urinary tract infections (UTI) in the absence of both conventional bacterial growth and pyuria (more than 5 white blood cells per high power field).^[3] Episodes are often related to sexual intercourse.

Some physicians believe that urethral syndrome may be due to a low grade infection of the Skene's glands on the sides and bottom of the urethra.^{[citation needed]} The Skene's glands are embryologically related to the prostate gland in the male, thus urethral syndrome may share a comparable cause with chronic prostatitis.^{[citation needed]}

Possible non-infective causes include hormonal imbalance,^[3][4] trauma, allergies, anatomical features such as diverticula, and post-surgical scarring and adhesions.^[1]

In a small minority of cases of the urethral syndrome, treatment with antibiotics is effective, which indicates that in some cases it may be caused by a bacterial infection which does not show up in either urinalysis or urine culture.^[3] For chronic urethral syndrome, a long term, low-dose antibiotic treatment is given on a continuous basis or after intercourse each time if intercourse appears to trigger symptoms.^{[citation needed]}

As low oestrogen^[3] may also be considered a source for urethral syndrome, hormone replacement therapy and oral contraceptive pill (birth-control pills) containing oestrogen are also used to treat the symptoms of this condition in women.^[4]

• Interstitial cystitis
• Prostatitis

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