Microbiology of the Female Urethra and Adjacent Areas

Abstract

The diagnosis of the urethral syndrome is a diagnosis of exclusion, made in women who have classical symptoms of urinary tract infection, but in whom no infection is found when freshly voided midstream urine (MSU; also known as VB2) is examined by conventional bacteriological techniques. However, some women who appear ‘uninfected’ by standard tests nevertheless have significant numbers of polymorphonuclear cells in their urine, and recent studies have indicated that more sophisticated microbiological investigation of both urine and urethra sometimes reveals infections in these pyuric women which otherwise go unrecognised. This suggests that a more critical microbiological appraisal of patients with the apparent urethral syndrome is needed, in order to define accurately the true syndrome; that is, patients with frequency and occasional dysuria in the absence of any infection of the upper or lower urinary tract.