Urethral syndrome

Alternative names

Urethritis - chronic

Definition

Chronic urethritis is an inflammation (irritation with swelling and presence of extra immune cells) of the urethra (the tube that carries urine from the body) that continues for weeks to months.

Causes, incidence, and risk factors

Chronic urethritis is usually caused either by a bacterial infection or structural problem (narrowing of the urethra). It may also be associated with a variety of systemic diseases, including emotional disorders. Urethritis may occur in either women or men.

The major symptoms of urethritis, painful urination and urinary frequency, are quite common. Among people experiencing such symptoms, 50% to 75% have either a first-time or recurrent bacterial infection of the urethra or bladder (cystitis), up to 10% are women with vaginitis, and the remainder are either men or women with urethral syndrome (symptoms present without any evidence of bacterial infection).

Organisms that cause a variety of sexually transmitted diseases are included among the group of possible causative agents. Importantly, sexually transmitted diseases such as chlamydia and gonorhea may cause urethritis.

Other common bacterial organisms that may be responsible for this condition include E. coli, a common bacteria responsible for Urinary tract infections. Common personal hygiene products, especially feminine products, can cause chronic chemical urethritis.

Symptoms

• Urinary frequency/urgency (increased number of time voiding and sensation of the need to void)
  
• Urination discomfort, burning, or stinging of the urethra or lower abdomen during urination (see painful urination)
  
• Urethral discharge (if present, may stain underwear and appear either bloody or pus-like, and is often foul-smelling)
  

Note: Symptoms are long-standing (chronic).

Signs and tests

• A urinalysis may indicate potential infection or inflammation.
  
• A urine culture (clean catch) is done to confirm infection and causative agent.
  
• Urethral discharge culture or vaginal culture specimen(s) may be obtained to rule out sexually transmitted diseases.
  
• Cystoscopy and urethroscopy may be performed to directly examine the urethra. These tests may reveal a urethral stricture (narrowing), a urethral diverticulum (out-pouching), or a mass (such as a urethral tumor).