Alternative Names: It is also often called NSU (non-specific urethritis) or NGU (non-gonococcal urethritis).
Urethral Syndrome. This refers to a primarily female syndrome in which women suffer from irritative bladder symptoms (urinary frequency, urgency, burning, and more) in the absence of any objective urologic findings. That is to say, when they under medical evaluation their physicians discover no specific findings to account for their symptoms.
Urethral syndrome can be a very frustrating and upsetting disease. While this disease is not life-threatening, it can cause disrupting symptoms and be difficult to treat. An understanding physician can help significantly in the diagnosis and treatment of these problems.
The most common cause of NSU is a microorganism called Chlamydia. It may also be caused by Ureaplasma (a different microorganism) or with lesser frequency a variety of others. Often it is difficult to know the exact cause of non-specific urethritis (hence the term "non-specific").
The true cause of urethral syndrome is not known. Some feel that it may be due to urethral stenosis (narrowing) but this is not well documented. Others feel that it may be due to infectious agents which are difficult to isolate, neurologic factors, or psychology factors.
Because the most likely cause of urethral syndrome remains infectious, antibiotics are the first treatment choice of most physicians. If different antibiotic regimens fail, other treatments must be tried. These include looking into the bladder (cystoscopy) and perhaps burning some apparently infected areas using a special scope. Some physicians may try to instill different chemicals into the bladder to treat urethral syndrome. At other times, a patient may respond to certain oral pharmaceutical agents which relax or otherwise relieve bladder symptoms.
The classic signs and symptoms of NSU are burning upon urination and a light discharge. While a heavier, thicker discharge may occur, this is usually more suggestive of gonorrhea. At times there may be no discharge at all and the only complaint may be a urethral itch.
The irritative symptoms accompanying urethral syndrome include: urinary frequency, urgency and burning in addition to possible low back pain, pain above the pubic region, and a hesitant or slowed urinary stream. Because these symptoms are so common with other urinary problems, your physician must eliminate other disease possibilities and diagnose urethral syndrome by exclusion.
Many urethral syndrome patients were initially told that they have recurrent urinary infections. Upon closer examination of their history, however, it is discovered that their supposed urinary infections have been poorly documented. Other disease processes which must be excluded are: Chlamydia infections, Ureaplasma infections, neurological disorders, gynecological disorders, bladder tumors, urethral narrowing, interstitial cystitis and more. The physician may wish to perform certain tests in order to clarify the diagnosis. These tests may include X-ray studies and bladder studies. The X-rays may be done in order to be sure there is no stone or other physical abnormality. The bladder studies may include cystoscopy, which allows direct visual inspection of the interior of the bladder.
Because NSU is a syndrome caused by different organisms, treatment results are inconsistent. Current medical treatment recommendations usually include antibiotics (Tetracycline or Doxycycline or Erythromycin) and each organism that causes urethritis must be treated with the specific medication that is most effective against it. Other drugs are also commonly used. Because one's sexual partner may also carry the infecting microorganism, it is important to treat both simultaneously.
Vestibulitis may sometimes be part of bladder and/or urethral inflammation as seen in the interstitial cystitis or urethral syndrome. The lining of both vagina and bladder arise from the same tissue during fetal development; thus when one becomes inflamed, the inflammation may spread to the adjoined areas.
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