Urethral syndrome: Difference between revisions
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'''Urethral syndrome''' is characterised by a set of symptoms typically associated with lower urinary tract infection, such as painful urination ([[dysuria]]) and [[Frequent urination|frequency]]. It is a [[diagnosis of exclusion]], made when there is no significant presence of [[bacteriuria]] with a conventional [[pathogen]]<ref name="pmid7928838">{{cite journal |author=Hamilton-Miller JM |title=The urethral syndrome and its management |journal=J. Antimicrob. Chemother. |volume=Suppl A |pages=63–73 |series=33 |date=May 1994 |pmid=7928838 |doi= 10.1093/jac/33.suppl_A.63}}</ref> |
'''Urethral syndrome''' is characterised by a set of symptoms typically associated with lower urinary tract infection, such as painful urination ([[dysuria]]) and [[Frequent urination|frequency]]. It is a [[diagnosis of exclusion]], made when there is no significant presence of [[bacteriuria]] with a conventional [[pathogen]]<ref name="pmid7928838">{{cite journal |author=Hamilton-Miller JM |title=The urethral syndrome and its management |journal=J. Antimicrob. Chemother. |volume=Suppl A |pages=63–73 |series=33 |date=May 1994 |pmid=7928838 |doi= 10.1093/jac/33.suppl_A.63}}</ref> ruling out [[urinary tract infection]] <ref> Wilkinson I.B. et al, Oxford Handbook of Clinical Medicine, 10th edition, page (296), Oxford University Press, 2017 </ref> and when [[cystoscopy]] shows no inflammation of the bladder, ruling out [[interstitial cystitis]] and cystitis cystica. In women, [[vaginitis]] should also be ruled out.<ref name="pmid1859947">{{cite journal |vauthors = Brumfitt W, Hamilton-Miller JM, Gillespie WA|title = The mysterious "urethral syndrome"|journal = BMJ|volume = 303|issue = 6793|pages = 1–2|date = July 1991|pmid = 1859947|pmc = 1670265|doi = 10.1136/bmj.303.6793.1}}</ref> |
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==Causes== |
==Causes== |
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==Treatment== |
==Treatment== |
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In a small minority of cases of urethral syndrome, treatment with antibiotics is effective, which indicates that in some cases it may be caused by bacterial infection which does not show up in either [[urinalysis]] or urine [[Microbiological culture|culture]].<ref name="pmid1859947" /> 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|date=November 2012}} |
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 [[Microbiological culture|culture]].<ref name="pmid1859947" /> 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|date=November 2012}} |
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As low [[Estrogen|oestrogen]]<ref name="pmid1859947" /> 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.<ref name=":0">{{cite web |url=http://www.emedicine.com/MED/topic3081.htm |title=Urethral Syndrome |author=Terris, Martha K |work= eMedicine|access-date=2008-09-25}}</ref> |
As low [[Estrogen|oestrogen]]<ref name="pmid1859947" /> 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.<ref name=":0">{{cite web |url=http://www.emedicine.com/MED/topic3081.htm |title=Urethral Syndrome |author=Terris, Martha K |work= eMedicine|access-date=2008-09-25}}</ref> |
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Revision as of 20:36, 7 August 2021
| Urethral syndrome | |
|---|---|
| Specialty | Urology  |
Urethral syndrome is characterised by a set of symptoms typically associated with lower urinary tract infection, such as painful urination (dysuria) and frequency. It is a diagnosis of exclusion, made when there is no significant presence of bacteriuria with a conventional pathogen[1] ruling out urinary tract infection [2] and when cystoscopy shows no inflammation of the bladder, ruling out interstitial cystitis and cystitis cystica. In women, vaginitis should also be ruled out.[3]
Causes
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]
Treatment
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]
See also
References
- ^ a b Hamilton-Miller JM (May 1994). "The urethral syndrome and its management". J. Antimicrob. Chemother. 33. Suppl A: 63–73. doi:10.1093/jac/33.suppl_A.63. PMID 7928838.
- ^ Wilkinson I.B. et al, Oxford Handbook of Clinical Medicine, 10th edition, page (296), Oxford University Press, 2017
- ^ a b c d e Brumfitt W, Hamilton-Miller JM, Gillespie WA (July 1991). "The mysterious "urethral syndrome"". BMJ. 303 (6793): 1–2. doi:10.1136/bmj.303.6793.1. PMC 1670265. PMID 1859947.
- ^ a b Terris, Martha K. "Urethral Syndrome". eMedicine. Retrieved 2008-09-25.