The urethra is the tube that empties urine from the bladder. Urethral syndrome is a long-term problem that causes swelling or irritation of the urethra that is not due to an infection. The symptoms feel similar to a urinary tract infection. Urethral syndrome may get better as you get older, but it can be a life-long problem.
Women have urethral syndrome much more often than men. A woman’s urethra is short (about 1 and 1/2 inches long). Its opening is just above the vagina and not far from the anus (rectal area).
What is the cause?
Usually a cause of the symptoms cannot be found. Urethral syndrome may be caused by irritation of the genital area from:
Spasms of the muscles around the urethra
Rubbing or pressure from tight clothing or sex
Physical activity such as bicycle riding
Irritants such as soap, body powder, and spermicides
Dyes or perfumes in toilet tissue and feminine hygiene products, such as pads, tampons, and sprays
Nerve problems caused by diseases such as diabetes or herpes
Lack of the female hormone estrogen that causes the tissues around the opening of the vagina and urethra to get thinner and drier after menopause
What are the symptoms?
Symptoms may include:
Pain and discomfort in the lower belly
Feeling the need to urinate often
A feeling that your bladder is never empty
Pain when you urinate
Pain during sex
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:
Blood or urine tests.
Urodynamic tests, which shows how well your bladder can store and release urine.
Cystoscopy, a procedure which uses a slim, flexible, lighted tube with a tiny camera to look into the urethra and bladder.
How is it treated?
Your healthcare provider may prescribe medicine to help you have less pain when you urinate.
If you are a woman who has reached menopause and you are not taking estrogen, prescription estrogen vaginal cream may help prevent tissue thinning and dryness.
If sexual activity brings on your symptoms, your provider may prescribe medicine to relieve pain or an antibiotic. You may need to avoid having sex until your symptoms go away.
If the urethra has become narrower, you may not be able to empty your bladder completely. Your provider may dilate the urethra to widen the opening and make it easier to urinate. You may be given steroid shots in and around the urethra to decrease inflammation.
Kegel exercises can help strengthen the muscles that support your bladder, vagina, uterus, and rectum. You use these muscles when you urinate, have bowel movements, and during sex. Your healthcare provider can teach you how to do Kegel exercises.
How can I take care of myself?
Follow the full course of treatment prescribed by your healthcare provider. In addition:
Drink plenty of fluids each day. The fluids help flush the bladder and the rest of the urinary tract.
Avoid caffeine, chocolate, and alcohol. It may also help to avoid foods that are acidic or spicy, such as citrus fruit, hot mustard, hot peppers, and salsa.
Keep the genital area clean, using a mild cleanser and water.
Urinate before and after sex.
Wipe from front to back after urination. Use toilet tissue that is not colored or perfumed.
Avoid activities, chemicals, or other irritants that cause redness, burning, or itching in the genital area. This includes strong soaps, bubble bath, bath oils or other perfumed bath products, feminine hygiene sprays, douches, scented tampons, sanitary napkins, or panty liners.
Ask your provider:
How and when you will hear your test results
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
How can I help prevent urethral syndrome?
In addition to taking the above steps, it may help to:
Wear underwear that is all cotton or has a cotton crotch. Pantyhose should also have a cotton crotch. Cotton keeps your body cooler than nylon. Change underwear and pantyhose every day.
Avoid tight clothes in the genital area, such as control-top pantyhose and tight jeans.
Avoid bicycling often or for long periods of time, especially if you have a long-nose bicycle seat.
Use a lubricant if you have mild pain during sex. Glycerin or water-based vaginal lubricants, such as K-Y jelly, can help lessen pain during sex. (Petroleum jelly, like Vaseline, is not recommended.) Avoid scents, colors, or flavors in condoms.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-12-05 Last reviewed: 2014-12-08
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Urethral Syndrome in Women: References
Osman, N, Chapple, C. (2014). Fowler’s syndrome–a cause of unexplained urinary retention in young women? Nat Rev Urol. 11(2):87-98.
Del Mar, C. (2010). Urinary tract infections in healthy women: a revolution in management? BMC Fam Pract. 11:42. doi: 10.1186/1471-2296-11-42
Maskell, R. (2010). The natural history of urinary tract infection in women. Med Hypotheses. 74(5):802-6.