What is Urethral Syndrome?

Urethral syndrome is a condition where people appear to have a bladder infection, with symptoms like painful and frequent urination, but testing does not reveal any trace of infection or anatomical abnormalities to explain the symptoms. There are a number of treatment options for urethral syndrome and patients should be aware that not all doctors accept it as a diagnosis, with some arguing that there's always an underlying cause, even if it is not immediately obvious. A urologist is usually involved in care of patients with this condition.

Patients with urethral syndrome tend to notice increased urinary frequency during the day and find that urinating is very painful. The urine is not discolored and testing of the urine indicates no presence of microorganisms. If the patient is examined, common explanations for these symptoms, like abnormal cell growths in the bladder, kidney obstruction, or narrowing of the urethra are not present. The patient may or may not have a history of urinary tract infections.

Diagnosis of urethral syndrome can be a lengthy process to rule out other possible causes. The patient's urine will be examined and medical imaging studies of the bladder and urethra can be requested. Endoscopy, where a camera is inserted into the urethra and threaded into the bladder, may also be a diagnostic tool. This is used to look for signs of physical changes that may not have showed up in other tests and can also be used to deliver treatments like cryoablation of suspicious tissue, where questionable cells are frozen until they explode, removing potentially dangerous cell growths.

Historically, urethral syndrome was sometimes treated with dilation, where the width of the urethra was surgically increased. This was designed to make urination more comfortable. Other treatments have included nerve stimulation around the pelvic area to address the pain signals associated with urinating, and the administration of antibiotics in case there are microorganisms that are not showing up in culture.

If a patient does not respond to treatment, more diagnostic tests may be recommended to look for potential causes that were missed, as well as checking for changes since the urethral syndrome was initially diagnosed. The patient may also be given drugs for pain management to make urination more comfortable. Dietary recommendations can be made to reduce the chances of having an irritant in the urine, as some foods can cause painful urination in patients with urinary tract inflammation.