Definition

Urethral syndrome is a set of symptoms from inflammation or irritation of the urethra that are not related to a bacterial or viral infection. The urethra is the tube that carries urine out of the body from the bladder.

Causes

Because there is no evidence of infection, the cause of urethral syndrome is often difficult to determine. Possible causes include:

• Undetected bacterial or viral infection of the urethra
• Irritation of the urethra, caused by:
  • Radiation exposure
  • Chemotherapy
  • Spermicidal jellies used during sex
  • Bubble baths
  • Irritating soaps
  • Scents or perfumes
  • Injury to the urethra caused by a blow to the pelvic area
  • Sexual intercourse (especially in women)
  • Urinary irritants, such as caffeine and certain foods
• In women, irritation of the urethra may be caused by:
  • Feminine hygiene sprays or douches
  • Sanitary napkins
  • Contraceptive gels
  • Condoms

Risk Factors

Urethral syndrome is most common in women. 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, such as the bladder or kidney
• Medications that reduce your ability to fight infections
• Structural problems, such as narrowing of the urethra

Symptoms

Urethral syndrome may cause:

• Pain and/or burning while urinating
• Difficulty urinating (especially after intercourse)
• Increase in urinary:
  • Frequency
  • Urgency
  • Blood in the urine
• Swelling and/or tenderness in the groin
• Pain during intercourse

In men, urethral syndrome may specifically cause:

• Discharge from the penis
• Blood in semen
• Pain during ejaculation
• Swollen and/or tender testicles

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. It will include a pelvic exam. Urethral syndrome is usually diagnosed when symptoms of urethritis are present without evidence of an infection.

Tests may include:

• Urine tests or urethral swab tests for lab study
• Tests for sexually transmitted diseases
• Cystoscopy and/or urethroscopy
• Pelvic ultrasound

Treatment

Treatment may include:

Prevention

To reduce your chance of urethral syndrome:

• Avoid the use of:
  • Spermicidal jellies
  • Bubble baths
  • Irritating soaps
  • Scents or perfumes
  • Feminine hygiene sprays and douches
  • Urinary irritant foods and beverages
• Practice safe sex, including using condoms.
• Urinate immediately after sexual intercourse.
• Make sure sexually transmitted diseases are treated quickly and completely for you and your partner(s).
• Drink plenty of fluids.

National Institute of Diabetes & Digestive & Kidney Diseases http://www.niddk.nih.gov

The Kidney Foundation of Canada http://www.kidney.ca

Gittes RF, Nakamura RM. Female urethral syndrome. A female prostatitis? West J Med. 1996;164:435-438.