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- 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.
What are the signs and symptoms of the
condition?
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.
What are the treatments?
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.
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.
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 simultaneously.
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.
Summary of this condition
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.
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