Urethral Syndrome, (Urination Disorder) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

by Kenneth Kee

Overview

Urethral Syndrome
Recently I had seen a few cases of painful and difficult urination or dysuria.
I was going to write on dysuria but decided on Urethral Syndrome instead which has urinary frequency, urgency, dysuria, and supra-pubic discomfort as part of its syndrome and have a special chapter on dysuria.
What is Urethral Syndrome?
Urethral syndrome is defined as a medical disorder with lower urinary tract symptoms (urinary frequency, urgency, dysuria, and supra-pubic discomfort) but with no recognized urinary pathogen cultured from urine or any other objective discovery of urological defect.
The diagnosis of urethral syndrome is made based on the history, negative urine cultures, dynamic cystourethroscopy and urodynamic studies.
The term urethral syndrome is now controversial as there are no guided diagnostic criteria and there is some overlap with other diagnoses – e.g., interstitial cystitis.
The most frequent cause of Urethral Syndrome is urethral stenosis.
Presently other causes are:
1. Hormone imbalances,
2. Inflamed Skene glands and paraurethral glands (the "female prostate"),
3. Allergy to certain foods,
4. Environmental chemicals (e.g., douches, bubble bath, soaps, contraceptive gels, condoms),
5. Hypersensitivity following urinary tract infection, and
6. Trauma during sexual intercourse.
Following the early pain-causing episode, patients with urethral syndrome have both involuntary spasms and voluntary contraction of the pelvic musculature during the painful episode, which, besides any residual irritant or re-injury, begins a vicious circle of worsening poor function of the pelvic floor muscles.
Symptoms normally are:
1. Supra-pubic discomfort,
2. Dysuria, and
3. Urinary frequency
Diagnosis is by:
1. Urine dipstick analysis
2. Midstream specimen of urine for microscopy, culture and sensitivities.
3. Urethral swab for chlamydia, chlamydial-antigens in first-pass urine sample.
If there are chlamydia-negative and persistent symptoms, a sample is taken by supra-pubic aspiration or urethral catheterization and culture for 'fastidious' or slow-growing organisms.
Any organisms detected in this way are medically significant.
If no infection is found, consider cystoscopy to exclude non-infective causes.
Further investigations may also include pelvic ultrasound, MRI scan, intravenous urography and urodynamic studies.
General treatments

1. Any psychological problems should be identified and may require treatment but they are often not relevant

Behavioral treatment (such as biofeedback, meditation, and hypnosis) has been used with some success.

Biofeedback has the most promise in patients whose symptoms are because of a failure to loosen up the pelvic muscles during urination.

Attempts at relaxation while undergoing electromyelography monitoring can help the patient retrain their muscles to allow them to void normally.

2. Highly acidic foods, including spicy foods, should be avoided that may worsen syndromes
a. Alcohol and other beverages
b. Condiments
c. Fruits
d. Juices
e. Salad dressings
f. Snacks
g. Vegetables
h. Miscellaneous foods
3. Exercise and massage programs can be very helpful.
4. Urethral massage may help by increasing drainage of mucus from chronically infected periurethral glands.
Medicine
1. Treatment of urinary tract infections and chlamydial urethritis
2. Vaginal estrogen cream in patients with atrophic urethritis.
Other Medicines are:
1. Hormone replacement
2. Anesthetics
3. Antispasmodics
4. Tricyclic antidepressants (TCAs)
5. Muscle relaxants
6. Alpha-blockers
The previous surgery used to treat urethral syndrome has been urethral dilation.
InterStim therapy and YAG laser ablation can reduce or eliminate symptoms.

TABLE OF CONTENT
Introduction
Chapter 1 Urethral Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Dysuria
Chapter 8 Cystitis
Epilogue

Product Details

BN ID:	2940154493489
Publisher:	Kenneth Kee
Publication date:	08/05/2017
Sold by:	Smashwords
Format:	eBook
File size:	123 KB

About the Author

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 65. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical conditions seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog afamilydoctorstale.blogspot.com. This autobiolographical account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Conditions” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 550 amazon kindle books and some into Smashwords.com eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical conditions. The first chapter of all my ebooks is always taken from my blog A Simple Guide to Medical Conditions which was started in 2007 as a simple educational help to my patients on my first blog http://kennethkee.blogspot.com. The medical condition was described simply and direct to the point. Because the simple guide as taken from the blog was described as too simple, I have increased the other chapters to include more detailed description of the illness, symptoms, diagnosis and treatment. As a result there are the complaints by some readers of constant repetitions of the same contents but in detail and fairly up to date. He has published 550 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health conditions and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Bouna Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. All the PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"