Publisher: Kenneth Kee
Publication Date: August 06, 2017
Binding: Kobo eBook
Recently I had seen a few cases of painful and difficult urination or dysuria.
I was going to write on dysuria but decided on Urethral Syndrome instead which has urinary frequency, urgency, dysuria, and supra-pubic discomfort as part of its syndrome and have a special chapter on dysuria.
What is Urethral Syndrome?
Urethral syndrome is defined as a medical disorder with lower urinary tract symptoms (urinary frequency, urgency, dysuria, and supra-pubic discomfort) but with no recognized urinary pathogen cultured from urine or any other objective discovery of urological defect.
The diagnosis of urethral syndrome is made based on the history, negative urine cultures, dynamic cystourethroscopy and urodynamic studies.
The term urethral syndrome is now controversial as there are no guided diagnostic criteria and there is some overlap with other diagnoses – e.g., interstitial cystitis.
The most frequent cause of Urethral Syndrome is urethral stenosis.
Presently other causes are:
1. Hormone imbalances,
2. Inflamed Skene glands and paraurethral glands (the "female prostate"),
3. Allergy to certain foods,
4. Environmental chemicals (e.g., douches, bubble bath, soaps, contraceptive gels, condoms),
5. Hypersensitivity following urinary tract infection, and
6. Trauma during sexual intercourse.
Following the early pain-causing episode, patients with urethral syndrome have both involuntary spasms and voluntary contraction of the pelvic musculature during the painful episode, which, besides any residual irritant or re-injury, begins a vicious circle of worsening poor function of the pelvic floor muscles.
Symptoms normally are:
1. Supra-pubic discomfort,
2. Dysuria, and
3. Urinary frequency
Diagnosis is by:
1. Urine dipstick analysis
2. Midstream specimen of urine for microscopy, culture and sensitivities.