URETHRAL SYNDROME

Urethral syndrome refers to a primarily female syndrome in which women suffer from irritative bladder symptoms (urinary frequency, urgency, burning, and more) in the absence of any objective urologic findings. That is to say, when they under medical evaluation their physicians discover no specific findings to account for their symptoms. Because the symptoms of urethral syndrome are similar to symptoms common for many irritative bladder problems, the diagnosis of urethral syndrome is often delayed.

Symptoms, Causes, and Diagnosis

Once again, the irritative symptoms accompanying urethral syndrome include: urinary frequency, urgency and burning in addition to possible low buck pain, suprapubic pain, and hesitant or slowed urinary stream. Because these symptoms are so common with other urinary problems, your physician must eliminate other disease possibilities and diagnose urethral syndrome by exclusion.

Many urethral syndrome patients were initially told that they have recurrent urinary infections. Upon closer history, however, it is discovered that their supposed urinary infections have been poorly documented. Other disease processes which must be excluded are: Chlamydia infections, Ureaplasma infections, neurological disorders, gynecological disorders, bladder tumors, urethral narrowing, interstitial cystitis (see below) and more. Your physician may wish to perform certain tests in order to clarify the diagnosis. These tests may include X-ray studies and bladder studies. The X-rays may be done in order to be sure there is no stone or other physical abnormality. The bladder studies may include cystoscopy, which allows direct visual inspection of the interior of the bladder.

The true cause of urethral syndrome is not known. Some feel that it may be due to urethral stenosis (narrowing) but this is not well documented. Others feel that it may be due to infectious agents which are difficult to isolate, neurologic factors, or psychology factors.

Treatment

The challenge in treating a disease whose cause is uncertain is obvious. Because the most likely cause of urethral syndrome remains infectious, antibiotics are the first treatment choice of most physicians. If different antibiotic regimens fail, other treatments must be tried. These include looking into the bladder (cystoscopy) and perhaps burning some infected appearing areas using a special scope. Some physicians may try to instill different chemicals into the bladder to treat urethral syndrome. At still other times, a patient may respond to certain oral pharmaceutical agents which relax or otherwise relieve bladder symptoms.

Urethritis

Urethritis refers to a syndrome of inflammation of the urethra. It is also often called NSU (non-specific urethritis) or NGU (non-gonococcal urethritis). It is usually a sexually transmitted disease.

Symptoms and Signs

The classic signs and symptoms of NSU are burning upon urination and a light discharge. While a heavier, thicker discharge may occur this is usually more suggestive of gonorrhea. At times there may be no discharge at all and the only complaint may be a urethral itch.

Causes and Treatment of NSU

The most common cause of NSU is a microorganism called Chlamydia. It may also be caused by Ureaplasma (a different microorganism) or with lesser frequency a variety of others. Often it is difficult to know the exact cause of non-specific urethritis (hence the term "non-specific"). Because NSU is a syndrome caused by different organisms, treatment results are inconsistent. Current treatment recommendations usually include Tetracycline or Doxycycline or Erthyromycin. Other drugs are also commonly used. Because the sexual partner may also carry the infecting microorganism, it is important to treat each simultaneouly.

Interstitial Cystitis

Interstitial cystitis refers to an uncomfortable and annoying inflammatory condition of the bladder. The classic symptoms of interstitial cystitis include urinary frequency and suprapubic pain. The interstitial cystitis patient has a small capacity, irritated bladder. No one is certain of the cause.

The incidence of interstitial cystitis is much greater in females than in males. As with urethral syndrome (see above), many other more common urologic problems are diagnosed incorrectly before the proper diagnosis is made. Interstitial cystitis must be diagnosed with the use of the cystoscope, an instrument which can directly visualize the interior of the bladder.

Treatment

While there are numerous treatments for interstitial cystitis there is no outright cure. At times the disease may go away on its own while at times it may worsen. Effective treatments for interstitial cystitis have included overstretching of the bladder with water, instillation of a dilute silver nitrate solution into the bladder, steroid treatment and vitamins. Some of these treatments require general anesthesia in order to be tolerated. A common and effective treatment for the disease is to instill a chemical called DMSO into the bladder.

Summary

Both urethral syndrome and interstitial cystitis can be very frustrating and upsetting diseases. While neither disease is life threatening, each can cause disrupting symptoms and each is difficult to treat. An understanding physician can help significantly in the diagnosis and treatment of these problems.

Information provided by GU Logic (800) 451-8107.

The information provided in this section should in no way serve as medical advice. Readers are encouraged to confirm the information contained here with other sources and seek medical advice from a physician. Neither the authors nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete and they are not responsible for any errors or omissions or for the results obtained for the use of such information.

Return to Patient Information