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by Alan R

Urethral Syndrome

(Urethral Irritation)

Definition

The urethra is the tube that carries urine out of the body from the bladder. Urethral syndrome is a set of symptoms from inflammation or irritation of the urethra. It is not related to an infection from bacteria or a virus.
Female Urethra
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Causes

The cause of urethral syndrome can be hard to find. Possible causes include:
  • Irritation of the urethra, caused by:
    • Radiation therapy or 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 include:
  • 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 past health. A physical and pelvic exam will be done. Urethral syndrome is usually diagnosed when symptoms are present but there is no 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:

Medicine

  • Antibiotics for a possible undetected infection
  • Anesthetics to manage pain
  • Antispasmodics to reduce bladder spasms
  • Antidepressants
  • Alpha-blocking drugs to relax muscle tone

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.

RESOURCES

Centers for Disease Control and Prevention
https://www.cdc.gov
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES

HealthLink BC
https://www.healthlinkbc.ca
The Kidney Foundation of Canada
https://www.kidney.ca

References

Costantine E, Zucchi A, et al. Treatment of urethral syndrome: a prospective randomized study with Nd: YAG laser. Urol Int. 2006;76:134-138.
Gittes RF, Nakamura RM. Female urethral syndrome. A female prostatitis? West J Med. 1996;164(5):435-438.
Nongonococcal urethritis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116488/Nongonococcal-urethritis . Updated September 26, 2018. Accessed January 8, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrienne Carmack, MD
  • Review Date: 09/2018
  • Update Date: 01/08/2019
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