What is urethral syndrome?

The urethra is the tube leading out from the bladder. Urethral syndrome is an ill defined condition with a variety of symptoms including pain during micturition, urinary Frequency, feeling of pressure behind the pubic bone, and pain during intercourse. The latest suggested cause for this syndrome is infection in the tiny glands that secrete into the urethra. These glands may become infected without there being evidence of infection in the urine when tested. Antibiotics may work particularly when taken for prolonged courses usually small doses over several months. When the problem keeps recurring many urologists will dilate (stretch) the urethra.  Chronic urethritis is long-term inflammation of the urethra, the tube that carries urine from the body. Chronic urethritis continues for weeks to months. Chronic urethritis is usually caused either by a bacterial infection or structural problem that results in narrowing of the urethra. The condition is associated with a variety of systemic diseases, emotional disorders, and sexually transmitted diseases such as chlamydia and gonorrhea.E. coli, a common bacteria responsible for urinary tract infections, may also cause chronic urethritis. The use of personal hygiene products, especially feminine products, can cause chronic chemical urethritis.Symptoms   

  • Urinary Frequency/urgency
  • Urination discomfort, burning, or stinging of the urethra or lower abdomen during urination (see painful urination)
  • Urethral discharge (bloody or pus-like, and often foul-smelling)

Signs and tests    
  • Urinalysis may show infection or inflammation.
  • Urine culture (clean catch) confirms infection and can show what bacteria is causing the infection.
  • Urethral discharge culture or vaginal culture specimen(s) can rule out sexually transmitted diseases.
  • Cystoscopy and urethroscopy are used to directly examine the urethra. These tests may reveal a urethral stricture (narrowing), a urethral diverticulum (out-pouching), or a mass (such as a urethral tumor).

Treatment

   

If there is an infection, you will be given antibiotics. A follow-up urinalysis or culture will be done after you finish all of the medicine. Women who have repeated episodes of intercourse-related urethritis or cystitis may be prescribed a dose of preventive antibiotics. Such therapy is called peri-coital treatment, and involves taking the medicine shortly before or after intercourse. Phenazopyridine (Pyridium) may be prescribed to decrease urinary discomfort. You should stop using any possible chemical irritants. Expectations (prognosis)   In the majority of cases, the cause of the urethritis can be found and treatment will be given. Chronic urethritis, despite the cause, can lead to urethral strictures (narrowing) and may require surgery or another medical procedure to correct the problem.

Complications.    Prolonged, untreated infection may progress to continued narrowing of the urethra, resulting in difficulty in completely emptying the bladder. Recurrent urinary tract infections may also occur. Less commonly, pyelonephritis (kidney infection) or structural damage to the urinary tract system, including impairment of renal (kidney) function can occur. Prevention   Drinking plenty of water each day can help prevent urethritis. Women who have symptoms that occur within 24 hours of sexual intercourse should always urinate immediately after having intercourse. Taking a small dose of antibiotics after intercourse also decreases episodes of urethritis and cystitis.



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This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

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