What Is Urethral Syndrome?
This is the presence of the usual symptoms of an infection of the urine but without any evidence of such an infection. It is also sometimes called 'symptomatic abacteriuria' and can occur at any age.
What Causes Urethral Syndrome?
The history is important, and the diagnosis of urethral syndrome is one of exclusion.
It is much more common in men than women and there is usually no obvious cause found. Some possible triggering factors include;
• Sexual intercourse - many contraceptive gels and condoms are irritative. Sexual activity e.g, rough intercourse, prolonged oral sex, intercourse in a heavily chlorinated hot tub or in a shower using bath soap as a lubricant may be the etiology of urethral irritation.
• Vaginal douches and feminine hygiene products
• Spermicides, tampons and stress in general
• In women who have gone through the menopause, lack of female hormones may cause a thinning of, and inflammation of the tissues around the opening of the vagina.
What Are The Signs And Symptoms?
These are usually very similar to those of a urinary infection (cystitis);
• Pain or discomfort in the lower abdomen. The lower abdomen (supra pubic) discomfort is neither constant nor as severe as in interstitial cystitis or urethritis (infection and inflammation of the urethra). The pain may be relieved by voiding. At night, the pain is not severe enough to disturb sleep.
• A frequent urge to pass water (urinate). The urinary frequency associated with urethral syndrome is typically every 30-60 minutes during the daytime, with minimal increased frequency of urination at night (nocturia).
• Pain on urination (dysuria). Dysuria in patients with urethral syndrome is often described as a sensation of constant urethral irritation rather than the searing discomfort with urination that is reported by patients with an active lower urinary tract infection.
• Pain around the genital area generally.
Will I Have Any Tests Or Investigations?
Your doctor will examine you and ask you to provide a sample of urine for testing. This is sometimes called a 'clean catch' specimen where you clean the genital area from front to back with an antiseptic wipe. A small amount of urine is passed in mid-stream into a sterile container, and this is then sent for testing by your doctor for any infection present, and which antibiotics can be effective in killing these.
What Treatment Will I Need?
Treatment of acute urethral syndrome involves antibiotics. 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.
As a hormonal imbalance may also be considered a source for urethral syndrome, hormone replacement therapy, and oral contraceptive pill (birth-control pills) are also used to treat the symptoms of this condition.
What Course Will The Illness Follow?
Occasionally urethral syndrome may develop into a full-blown urinary infection, with headache, temperature and blood in the urine. Your doctor needs to treat you for this, but if urethral syndrome persists despite you and your doctor having done all you can to prevent it, a specialist may be asked to assess you.
Can I Do Anything To Help Myself?
• Remember to drink at least 8 glasses of water each day. Some women find drinking cranberry juice daily a great help in easing their symptoms.
• Use water to wash the genitals and avoid soaps and strong antiseptics
• Keep bubble baths etc. out of the bath
• Use non-perfumed white toilet paper
• Use sanitary products that do not contain perfume or deodorants
• Avoid vaginal douches
• Urinate before and after intercourse
• Avoid sexual positions that seem to irritate the vagina or vulva
• Wear cotton underwear rather than nylon
• Avoid very tight jeans or trousers.
Tell Your Doctor
1. When did your symptoms begin?
2. Have you had similar symptoms before?
3. Are your symptoms linked to intercourse?
4. Do you use vaginal douches or feminine deodorants?
5. Do you drink much fluid each day?
Ask Your Doctor
1. Does urethral syndrome cause any long-term damage?
2. Can I pass anything on to my partner?
3. Is it ever sexually transmitted?
4. Will I ever need any kind of operation for it?
5. Does diet make any difference to symptoms?
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