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 of the urethra. It includes inflammation or irritation not related to an infection.

Female Urethra

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Causes

The cause of urethral syndrome can be hard to find. Possible causes include irritation of the urethra from:

  • 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
  • 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)
  • Past sexually transmitted diseases
  • Bacterial infection of other parts of the urinary tract, such as the bladder or kidney
  • Medicine that reduces 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 urge or frequency of urination
  • Blood in the urine
  • Swelling and/or tenderness in the groin
  • Pain during sex

In men, urethral syndrome may specifically cause:

  • Discharge from the penis
  • Blood in semen
  • Pain during ejaculation
  • Swollen and/or tender testicles

Diagnosis

The doctor will ask about symptoms and past health. A physical and pelvic exam will be done. Urethral syndrome is usually diagnosed if there are no signs of an infection. Tests to rule out infections or other causes may include:

  • Urine tests or urethral swab tests for lab study
  • Tests for sexually transmitted diseases
  • Cystoscopy and/or urethroscopy
  • Pelvic ultrasound

Treatment

The first step may be to find what is causing the irritation. The doctor may recommend stopping use of certain products such as soaps or gels. Symptoms will often pass on their own once the irritation is removed.

Medicine may help to ease symptoms. Choices may include:

  • Antibiotics for a possible undetected infection
  • Medicine 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

Other steps that may help include:

  • Practicing safe sex, including using condoms.
  • Urinating right after having sex.
  • Treating sexually transmitted diseases quickly and completely. Make sure your partner is treated as well.
  • Drinking 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:

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.
Nongonococcal urethritis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/nongonococcal-urethritis. Accessed September 4, 2020.
Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137.
Last reviewed September 2020 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 1/5/2021

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