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Urethral syndrome is defined as symptoms suggestive of a lower urinary tract infection but in the absence of significant bacteriuria with a conventional pathogen. [1] It is a diagnosis of exclusion in patients with dysuria and frequency without demonstrable infection. [2] In women, vaginitis should also be ruled out. [3]
The symptoms of urethritis can include pain or a burning sensation upon urination , a white/cloudy discharge and a feeling that one needs to pass urine frequently. For men, the signs and symptoms are discharge from the penis, burning or pain when urinating, itching, irritation, or tenderness.
In women, urethritis can be diagnosed with a number of tests including: urine test, blood test, vaginal culture, cytoscopy, or a nucleic acid test. [18] Women will also have abdominal and pelvic exams to check for urethral discharge, and tenderness of the lower abdomen or urethra. [6]
It is estimated to be present in as low as 0.02% of all women and as high as 6% of all women, and 40% of women with lower urinary tract symptoms. [1] [2] Most symptomatic urethral diverticula are present in women from 30 to 60 years old. [3] 84% of periurethral masses are due to urethral diverticula. [1]
A post-void residual urine greater than 50 ml is a significant amount of urine and increases the potential for recurring urinary tract infections. [citation needed] In adults older than 60 years, 50-100 ml of residual urine may remain after each voiding because of the decreased contractility of the detrusor muscle. [7]
Treatment, depending on cause, may require prompt drainage of the bladder via catheterization, medical instrumentation, surgery (e.g., endoscopy, lithotripsy), hormonal therapy, or a combination of these modalities.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by pelvic or perineal pain without evidence of urinary tract infection, [8] lasting longer than 3 months, [9] as the key symptom. Symptoms may wax and wane. Pain can range from mild to debilitating. Pain may radiate to the back and rectum, making sitting uncomfortable.
When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidney infection (pyelonephritis). [9] Symptoms from a lower urinary tract infection include pain with urination, frequent urination, and feeling the need to urinate despite having an empty bladder. [8]