Urethral syndrome

1. URETHRAL SYNDROME
 Urethral syndrome is a condition that affects
the urethra, which is the tube that extends from
your bladder to the outside of your body.
 The urethra is responsible for transporting urine out
of the body. People with urethral syndrome have an
inflamed or irritated urethra.
 Urethral syndrome is also known as symptomatic a
bacteriuria. It has many of the same symptoms
as urethritis, which is an infection and inflammation
of the urethra.
 These symptoms include abdominal pain and
frequent, painful urination. Both conditions cause
irritation to your urethra. Urethritis usually develops
because of a bacteria or virus, but urethral
syndrome often has no clear cause.
 Adults of any age can develop this condition, but
it’s most common in women.
CAUSES

2.  Urethral syndrome has various causes. Common
causes may include physical problems with the
urethra, such as abnormal narrowing or urethral
irritation or injury.
 The following can cause irritation to the urethra:
 Scented products, such as perfumes, soaps,
bubble bath, and sanitary napkins
 Spermicidal jellies
 Certain foods and drinks containing caffeine
 Chemotherapy and radiation
 Injury to the urethra can be caused by certain
activities, such as:
 Sexual activity
 Diaphragm use
 Tampon use
 Bike riding
 The condition is considered urethritis if a bacterial
or viral infection is found. In some cases, however,
tests won’t be able to find any infection.
RISK FACTORS

3.  These factors may increase your risk of developing
urethral syndrome:
 Having bladder or kidney infections caused by
bacteria
 Taking certain medications
 Having sex without a condom
 Contracting sexually transmitted infections (STIs)
 Engaging in sexual intercourse (for women)
SYMPTOMS
 In both sexes, urethral syndrome can cause:
 Lower abdominal pain
 A feeling of pressure in the abdomen
 A sense of urgency to urinate
 More frequent urination
 Trouble urinating
 Pain during urination
 Pain during sex
 Blood in the urine
 There are also a few symptoms found only in men.
These include:
 Swelling of the testicles
 Pain while ejaculating
 Blood in the semen

4.  Discharge from the penis
 In women, urethral syndrome can also cause
discomfort in the vulvar area.
DIAGNOSIS
 A diagnosis is usually made when more common
causes of the symptoms are ruled out. These causes
include infections caused by viruses and bacteria.
 Doctor will first want to review your symptoms and
medical history. They may also perform a physical
examination and take a urine sample. Your doctor
may decide to take a blood sample or perform
an ultrasound on your pelvic region.
 If the first few treatments don’t work, your doctor
may need to use a scope to view the inside of your
urethra.
Diet
 Intake of foods and liquids that are excreted as
irritants in the urine may worsen symptoms.
 Patients should avoid highly acidic foods. These
typically include spicy foods, but a more complete,
although not comprehensive, list is provided below.

5.  Food reactions can be extremely individualized.
Some patients may find that some of these foods
worsen their symptoms, while others do not. The
most recommended approach is to initiate a bland
diet, excluding all of the suspect foods; then,
gradually reintroduce individual foods, one per
week, while noting symptoms.
 If symptoms worsen upon introduction of a
particular food, that food should be eliminated from
the diet on a long-term basis.
 Alcohol and other beverages that may worsen
syndromes include the following:
 Beer
 Champagne
 Liquor
 Wine
 Coffee (decaffeinated, regular)
 Soda (e.g., cola)
 Tea (decaffeinated, regular, iced)
 Condiments that may worsen syndromes include
the following:
 Barbecue sauce
 Capers
 Chutney
 Cocktail sauce
 Corn relish
 Cranberry sauce
 Horseradish
 Hot pepper sauce

6.  Ketchup
 Mustard
 Pickles
 Relishes
 Roasted peppers
 Salsa
 Sauerkraut
 Sweet and sour sauce
 Tartar sauce
 Vinegar
 Worcestershire sauce
 A diet high in vegetables, fruits, and dairy products
reduces the acidity of urine. The Interstitial Cystitis
Network has developed low-acid recipes specifically
for patients with IC and urethral syndrome (see The
IC Chef). Calcium glycerophosphate, marketed as
Prelief, can be sprinkled over foods to reduce
acidity.
 Dietary supplementation with sodium bicarbonate or
potassium bicarbonate can provide relief for some
patients.
 Increased fluid intake is advisable. Because many
drinks increase acidity, patients may be prone to
dehydration.
 This also may be an attempt by the patient to
decrease urinary frequency by decreasing urine
output. In fact, more concentrated urine is more
acidic and contains a higher concentration of

7. irritants. Patients should be encouraged to drink
plenty of fluid, specifically water.
TREATMENT
 Doctors may use a number of approaches to treat
this condition.
 Lifestyle changes, medications, and (in rare cases)
surgery can help relieve symptoms and prevent the
condition from coming back.
Medications
 The following are the most common classes of
medications used for urethral syndrome:
 Antibiotics, which are often used if your doctor
suspects an infection that isn’t appearing on
tests
 Anesthetics, such as phenazopyridine (Pyridium)
and lidocaine (AneCream)
 Antispasmodics, such as hyoscyamine (Levsin)
and oxybutynin (Ditropan XL)
 Antidepressants, such
as amitriptyline and nortriptyline (Pamelor),
which act on your nerves to help relieve chronic
pain

8.  Apha-blockers, such as doxazosin (Cardura)
and prazosin (Minipress), which improve blood
flow by relaxing the muscles in your blood
vessels
PREVENTION
 If you’ve had this condition in the past, you can take
these steps to help ensure it doesn’t happen again
in the future:
 Avoid products known to irritate the urethra.
 Use protection during sex.
 Get tested and treated promptly if you suspect
or know you have an STI.
 Make an effort to urinate as soon as possible
after sexual intercourse.
 Wipe your genital area using a front-to-back
motion.
 Avoid wearing jeans and pantyhose that are
too tight.
 Wear cotton instead of nylon underwear.
OUTLOOK
 There’s often no obvious bacterial or viral cause for
urethral syndrome, but the symptoms, pain, and

9. discomfort that the condition causes often require
treatment.
 The goal of treatment in urethral syndrome is to
relieve the discomfort and urinary frequency.
 This often involves a trial-and-error approach that
uses behavioral, dietary, and medical therapy.
 The urologist must gain the confidence of these
patients and should provide assurance and
encouragement throughout therapy.
 Pharmacologic therapy is discussed in detail in
Medication. Medications include the following:
 Hormone replacement
 Anesthetics
 Antispasmodics
 Tricyclic antidepressants (TCAs)
 Muscle relaxants
 Alpha-blockers
 Behavioral therapy, including biofeedback,
meditation, and hypnosis, has been used with some
success. Biofeedback has the most promise in
individuals whose symptoms are due to a failure to
relax the pelvic musculature during voiding.
 Attempts at relaxation while undergoing
electromyelography monitoring can help the patient
retrain their muscles to allow them to void normally.

10.  Dietary therapy is geared primarily at increasing
urinary pH.
 Palleschi and colleagues reported significant and
comparable symptom improvement with the oral
phytotherapeutic product Cistiquer and intravesical
gentamicin plus betametasone in a randomized
study of 60 women with urethral syndrome and
trigonitis.
 The dropout rate and the incidence of infection were
higher in the intravesical treatment group.
Reference:-
 Kapitan Pediatrics Book
 GHAI Essential Pediatrics (Eighth Edition)
 Health line ( https://www.healthline.com )
 WebMd ( https://www.webmd.com )
 Mayo Clinic ( https://www.mayclinic.org )
 My Self