Urethral syndrome

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Overview
Urethral syndrome is defined as 'symptoms suggestive of a lower tract urinary infection but in the absence of significant bacteruria with a conventional pathogen. There are other non-infective causes that should be considered such as trauma, allergies, and anatomical features like diverticula and post surgical scarring.

Presentation
Most women will give a history of chronic recurrent UTIs but the cultures seem to not show any conventional bacterial growth, and pyuria (more than 5 WBC per HPF) is absent. There may also be a history of these episodes often being related to sexual intercourse.

It is not fair to say that urethral syndrome is not due to infection because many physicians believe that it is due to a low grade infection of the Skene's glands on the sides and bottom of the urethra. At least symptoms often respond to antibiotics. The Skene's glands are embryologically related to the prostate gland in the male, thus urethral syndrome may almost be a type of chronic prostatitis in a woman.

Treatment
Treatment of acute urethral syndrome is antibiotics just the same as treatment for a UTI. For chronic urethral syndrome a long term, low dose antibiotic treatment is given on a continuous basis or after intercourse each time if that seems to be prominent in relationship to symptoms occurring.