Urethral Syndrome

Urethral syndrome is a condition that causes irritation in your urethra — it may burn, feel itchy or achy, or even be painful. Your urethra is the tube that connects your bladder to the outside of your body. It can affect anyone. But you’re more likely to have it if you’re between 30 and 50 and female.

Urethral syndrome is pretty common. Between 2 and 3 out of every 10 females who have lower urinary tract symptoms may have it. It has similar symptoms to other conditions, like urinary tract infections (UTIs) and urethritis. But infections cause UTIs and urethritis. Many factors can cause urethral syndrome. This makes it challenging for healthcare providers to figure out the exact cause.

Other names for urethral syndrome include:

• Abacterial cystitis
• Frequency dysuria syndrome
• Symptomatic abacteriuria
• Urethral pain syndrome (UPS)

Symptoms of urethral syndrome

General urethral syndrome symptoms include:

• Blood in your pee (hematuria)
• Trouble peeing (urinary retention)
• Immediate urges to pee (urinary urgency)
• Peeing a lot, especially while you’re awake (frequent urination)
• Discomfort or pain during intercourse (dyspareunia)
• Pain in your genitals, lower abdomen and lower back
• Pressure in your abdomen
• Waking up to pee (nocturia)

Females may also have inflammation in their vulvas (vulvitis). Inflammation may last longer than three months (vulvodynia).

Males may also have:

• Blood in semen (hematospermia)
• Discharge from the penis (urethral discharge)
• Pain when they ejaculate
• Swollen testicles

What causes it?

Experts don’t know exactly what causes urethral syndrome. But they know that bacteria and viruses don’t cause it. They think that the following may contribute to inflammation:

• Abnormal narrowing of your urethra, which may include posterior urethral stenosis or urethral stricture
• Hormonal imbalances, like low estrogen
• Injury to your urethra, like from using tampons or a diaphragm, riding a bicycle or rough vaginal sex
• Pelvic floor dysfunction
• Sensitivity after a UTI, yeast infection or sexually transmitted infection (STI)
• Urethra spasms
• Stress

You may get additional irritation in your urethra from:

• Caffeine
• Alcohol
• Spicy foods
• Cancer treatments, including chemotherapy and radiation therapy
• Condoms and contraceptive gels, especially if they have spermicide
• Scented products, including soaps, perfumes and bubble baths

Are there other conditions that put me at a higher risk of getting it?

Yes. Bacterial infections of your bladder or kidneys and STIs may increase your risk of urethral syndrome. You may also have an increased risk if you take immunosuppressants or have a vaginal delivery without an incision in your perineum (episiotomy).

What are the complications?

Irritation in your sensitive areas can cause a lot of stress, especially if it affects your bathroom habits. It may cause you to avoid certain activities or stay close to home. This may lead to conditions like anxiety and depression. Talk to your provider or a therapist if urethral syndrome affects your mental health.

How is urethral syndrome diagnosed?

Your healthcare provider will first look at your health history and ask about your symptoms. They’ll also perform a physical exam and recommend some tests to help rule out other conditions with similar symptoms.

Tests that are used

Your healthcare provider may recommend:

• Pee tests and vaginal swabs to rule out UTIs, yeast infections and bacterial vaginosis
• Imaging tests to see your kidneys and ureters and rule out conditions like cysts, tumors and interstitial cystitis
• Cystoscopy to look inside your urethra and bladder
• Pap smear to rule out cervical cancer
• Urine cytology to rule out bladder cancer

How do you treat urethral syndrome?

Treatments for urethral syndrome focus on calming irritation and how much you pee. Your healthcare provider may recommend:

• Biofeedback to help your pelvis relax
• Medications to improve blood flow and relieve pain, including anesthetics, antispasmodics, antidepressants and alpha-blockers
• Meditation or hypnotherapy to reduce stress
• Urethral dilation to widen your urethra

When should I see my healthcare provider?

See your healthcare provider as soon as you notice urethral syndrome symptoms. They can rule out other conditions and recommend the best treatment.

You should also reach out if your provider diagnoses you with urethral syndrome and your symptoms don’t improve or get worse. You may need a different type of treatment.

Does urethral syndrome ever go away?

It depends. Some have symptoms throughout their lives. But for others, their symptoms go away over time with proper treatment and lifestyle changes. Your healthcare provider will give you a better idea of what to expect.

Is there anything I can do to feel better?

Making some lifestyle changes can help reduce urethral discomfort, like:

• Avoiding highly acidic foods
• Doing activities like yoga and tai chi to help control and relax your muscles
• Eating lots of fruits, veggies and dairy products
• Drinking more water
• Cutting back on alcohol
• Reducing stress
• Using unscented soaps and laundry detergents

What is the difference between urethral syndrome and urethritis?

Bacterial or viral infections cause urethritis. This includes nongonococcal urethritis. But infections don’t cause urethral syndrome. If you have lower urinary tract symptoms but don’t have an infection, you may have urethral syndrome.