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]
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.