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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 (and semen, in people with male genitalia) out of the body. People with urethral syndrome have an inflamed or irritated urethra.
Urethral syndrome is also known as symptomatic abacteriuria. 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.
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. If this happens, your doctor will treat your symptoms as urethral syndrome.
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)
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
- discharge from the penis
In women, urethral syndrome can also cause discomfort in the vulvar area.
A diagnosis is usually made when more common causes of the symptoms are ruled out. These causes include infections caused by viruses and bacteria.
Your 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.
Doctors may use a number of approaches to treat this condition. Lifestyle changes, medications, and (in rare cases) surgery can help relieve your symptoms and prevent the condition from coming back.
Your doctor may ask you to stop using products or doing activities that can irritate your urethra, such as using scented soaps or going on long bike rides.
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
- alpha-blockers, such as doxazosin (Cardura) and prazosin (Minipress), which improve blood flow by relaxing the muscles in your blood vessels
In some cases, your doctor may need to widen your urethra by performing surgery or using dilators. Surgery is done only if the symptoms are thought to be due to constriction of the urethra. Constriction can occur due to injury, inflammation, and scar tissue.
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.
There’s often no obvious bacterial or viral cause for urethral syndrome, but the symptoms, pain, and discomfort that the condition causes often require treatment. Talk to your doctor to figure out if medications or lifestyle changes are best for you. These can provide relief and help prevent your symptoms from returning.