Urethral syndrome is the presence of symptoms of a urinary tract infection when the usual evidence of an infection is not found. It is also sometimes called symptomatic abacteriuria, which means having symptoms with no bacteria.

Urethral syndrome tends to occur mainly in women and very rarely in men. Usually the doctor cannot find any infection or anything wrong with the kidneys or urinary tract, even though the usual tests may be done (such as urinalysis and urine culture).
Sexual activity may irritate a woman's urethra (the tube leading from the bladder to the outside of the body). Soaps, antiseptic creams, or spermicides may irritate the genital area. Dyes or perfumes in toilet tissue and feminine hygiene products, such as pads, tampons, and/or sprays, may also cause urethral syndrome. Psychological factors, such as stress, may also play a role.
Women of all ages may be affected by urethral syndrome. In women who have gone through menopause, the symptoms may be the results of inflammation of the vulva (vulvitis). Hormonal changes may cause thinning and inflammation of these tissues around the opening of the vagina.
The symptoms of urethral syndrome are:
  • pain and discomfort in the lower abdomen
  • a frequent urge to urinate
  • in women, pain around the vulvar region
  • pain with urination
Your doctor will examine you and ask you to provide a clean catch urine specimen. Your doctor may also order some blood tests.
For a clean catch specimen you will be asked to clean the genital area from front to back with a special antiseptic wipe and urinate a small amount into the toilet. Then you urinate into a sterile container. When the sterile container is about half full or you are almost done urinating, finish urinating into the toilet. This is also called a midstream urine specimen. The urine sample will be cultured and tested in the lab to see if there are any bacteria in the urine and to determine which antibiotics will kill the bacteria.
How is it treated?
There is usually no effective medical treatment for urethral syndrome if no infection has been found. Avoiding products that are known to cause irritation and allergic reactions, practicing good personal hygiene, and drinking a lot of fluids might help. Symptoms due to vulvitis may be relieved by estrogen pills or creams.
If your urine contains pus and a low number of bacteria (not enough to be considered a true infection) your doctor may prescribe an antibiotic. If sexual activity brings on symptoms of the syndrome, your doctor may prescribe pyridium, an anesthetic to relieve pain, or an antibiotic.
Following your doctor's recommended treatment and precautions may help you feel better in a week or two. If you continue to have symptoms after you have taken any medications prescribed for your symptoms and have done all that you can to avoid irritation and trauma to the urethra, your doctor may refer you to a urologist (a specialist in problems of the urinary tract) for further tests.
Urethral syndrome may develop into a full-blown urinary tract infection. Call your doctor if you develop any new symptoms, such as headache, fever, chills, or blood in your urine.
How can I take care of myself?
  • Drink 6 to 8 glasses of fluids each day to cleanse the bladder and rest of the urinary tract.
  • Keep the genital area clean using clear water. Do not wash the genital area with soap.
  • Don't use bubble-baths, bath oils, and/or other perfumed bath products.
  • Use white toilet tissue that is not perfumed.
  • Use sanitary pads and/or tampons that don't contain deodorants or perfumes.
  • Don't use feminine hygiene sprays and/or other perfumed feminine hygiene products.
  • Avoid sexual positions that cause irritation or injury to the urethra.
  • Urinate before and after intercourse.
  • If medications are prescribed, use them as directed.
  • Return to your doctor for a follow up exam if she or he recommends it.
In addition to taking the above steps, you can follow these measures:
  • Wear cotton underwear, which allows better air circulation than nylon. Pantyhose should have a cotton crotch.
  • Avoid tight clothes in the genital area, such as control-top pantyhose and tight jeans.
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