Urethral syndrome

This is characterised by various lower urinary tract symptoms - particularly, episodic or persistent dysuria, urgency or frequency - in the absence of obvious bladder or urethral abnormality, or urinary tract infection. It is thought to affect 20-30% of all adult women, and particularly, is seen in young women.

Causes may include:

• psychogenic factors
• atrophic urethritis in peri- or post-menopausal women
• UTI with a low number of bacteria
• non-bacterial infection - Chlamydia trachomatis, Neisseria gonorrhoeae, Ureoplasma urealyticum
• urethral stenosis and spasm
• allergy
• trauma during sexual intercourse

Diagnosis is based upon the history, negative urine cultures, dynamic cysturethroscopy and urodynamic studies.

Urethral dilatation and urethral massage may be helpful as it may aid drainage of inspissated mucus from chronically infected periurethral glands. Vaginal oestrogen cream may be curative in patients with atrophic urethritis. Tetracyclines bring relief in some patients.