Urethral Syndrome

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 urinatingDifficulty urinating (especially after intercourse) Increase in urinary: FrequencyUrgencyBlood in the urineSwelling and/or tenderness in the groinPain during intercourse In men: Discharge from penisBlood in semenPain during ejaculationSwollen and/or tender testicles DiagnosisThe 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 studyTests for sexually transmitted diseasesCystoscopy and/or urethroscopyuse 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 TreatmentTreatment may include:

MedicationAntibioticsgiven if your doctor thinks urethral syndrome may be due to an undetected infection Anesthetics Phenazopyridinemay be given by your doctor to ease discomfort while urinatingIntraurethral lidocaine jellyAntispasmodics to decrease bladder muscle spasm (eg, oxybutynin [Ditropan])Antidepressants such as a tricyclic antidepressant to relieve painAlpha-blocking drugs such as doxazosin (Cardura) to relax smooth muscle tone Avoidance of IrritantsAvoid irritants that may cause urethral syndrome. Then, wait and see if your condition improves. SurgerySurgery 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 jelliesBubble bathsHarsh soapsScents or perfumesFeminine hygiene sprays and douchesUrinary irritant foods and beveragesPracticing safe sex, including using condomsUrinating immediately after having sexual intercourseMaking sure sexually-transmitted diseases are treated quickly and completely for you and your partnerRegularly drinking plenty of fluids RESOURCES: National Institute of Diabetes & Digestive & Kidney Diseases

http://www.niddk.nih.gov US National Library of Medicinehttp://www.nlm.nih.gov CANADIAN RESOURCES: The Kidney Foundation of Canada: British Columbia Branchhttp://www.kidney.bc.ca/ The Kidney Foundation of Canada: Northern Alberta and the Territories Branchhttp://www.kidney.ab.ca References: 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. Merck Manual of Diagnosis and Therapy . Simon and Schuster, Inc; 2001. Terris MK. Urethral syndrome. eMedicine website. Available at: http://www.emedicine.com/ . US National Library of Medicine website. Available at: http://www.nlm.nih.gov . Last reviewed January 2008 by Adrienne Carmack, MDPlease 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.