Treatment of the Urethral Syndrome

  • M. Tasker


The patients to be considered for treatment in this section fall conveniently into pyuric (persistent or intermittent) and apyuric groups according to the definition of the urethral syndrome described above (p. 91). Those patients in whom significant pyuria occurs will be the subject of intensive microbiological investigation in an attempt to isolate the suspected organism and it is recognised that longitudinal studies will be required to obtain positive results in the ‘between infections’ patients (O’Grady et al. 1973). Additionally, Chlamydia trachomatis will be isolated from a number of cases (Stamm et al. 1980) but there will remain a significant minority whose urethral syndrome is associated with a pyuria for which no cause can be found. Patients whose urine never contains white cells constitute the ‘hard core’ of the urethral syndrome and it would appear that infection is unlikely to be implicated as the factor responsible for the symptom complex in these cases (O’Grady et al. 1973).


Irritable Bowel Syndrome Chlamydia Trachomatis Urethral Closure Pressure Bladder Training Urethral Dilatation 
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  1. Asscher AW (1978) Use of antibiotics. Management of frequency and dysuria. Br Med J 1: 1531–1533PubMedCrossRefGoogle Scholar
  2. BMJ (1977) The urethral syndrome. Br Med J 11: 593–594Google Scholar
  3. Buckley RM, McGuckin M, MacGregor RR (1978) Urine bacterial counts after sexual intercourse. N Engl J Med 298: 321–324PubMedCrossRefGoogle Scholar
  4. Caine M, Raz S (1975) Some clinical implications of adrenergic receptors in the urinary tract. Arch Surg 110: 247–250PubMedGoogle Scholar
  5. Carson CC, Segura JW, Osborne DM (1980) Evaluation and treatment of the female urethral syndrome. J Urol 124: 609–610PubMedGoogle Scholar
  6. Charlton CAC, Cattell WR, Canti G, Grottick J, O’Grady FW (1973) The non urethral syndrome. In: Brumfitt W, Asscher AW (eds) Urinary tract infection. Oxford University Press, Oxford, pp 173–177Google Scholar
  7. Farrar DJ, Green NA, Ashken MH (1973) An evaluation of Otis urethrotomy in female patients with recurrent urinary tract infections. Br J Urol 45: 610–615PubMedCrossRefGoogle Scholar
  8. Freeman RM, Baxby K (1982) Hypnotherapy for incontinence caused by the unstable detrusor. Br Med J 284: 1831–1834CrossRefGoogle Scholar
  9. Freeman RM, Guthrie KA (1985) Hypnotherapy for the unstable detrusor: a two year review. Br Med J 290: 286CrossRefGoogle Scholar
  10. Frewin WK (1980) The management of urgency and frequency of micturition. Br J Urol 52: 367–369CrossRefGoogle Scholar
  11. Hinman F (1968) Bacterial elimination. J Urol 99: 811PubMedGoogle Scholar
  12. Hole R (1972) The calibre of the adult urethra. Br J Urol 44: 68–70PubMedCrossRefGoogle Scholar
  13. Holmes DM, Stone AR, Bary PR, Richards CJ, Stephenson TP (1983) Bladder training—3 years on. Br J Urol 55: 660–664PubMedCrossRefGoogle Scholar
  14. Jarvis GJ (1982) The management of urinary incontinence due to primary vesical sensory urgency by bladder drill. Br J Urol 54: 374–376PubMedCrossRefGoogle Scholar
  15. Kaplan WE, Firlit CF, Schoenberg HW (1980) The female urethral syndrome: external sphincter spasm as etiology. J Urol 124: 48–49PubMedGoogle Scholar
  16. Kiesswetter H (1977) Mucosal sensory threshold of the urinary bladder and urethra measured electrically. Urol Int 32: 437–448PubMedCrossRefGoogle Scholar
  17. Maskell R, Pead L, Allen J (1979) The puzzle of “urethral syndrome”: a possible answer? Lancet 1: 1058–1059PubMedCrossRefGoogle Scholar
  18. Maskell R, Pead L, Sanderson RA (1983) Fastidious bacteria and the urethral syndrome: A 2-year clinical and bacteriological study of 51 women. Lancet 11: 1277–1280CrossRefGoogle Scholar
  19. O’Boyle PJ, Parsons KF (1979) Primary vesical sensory urgency: A clinical trial of bromocriptine. Br J Urol 51: 200–203Google Scholar
  20. O’Grady FW, Richards B, McSherry MA, O’Farrell SM, Cattell WR (1970) Introital enterobacteria, urinary infection and the urethral syndrome. Lancet 11: 1208–1210CrossRefGoogle Scholar
  21. O’Grady FW, Charlton CAC, Fry IK, McSherry A, Cattell WR (1973) Natural history of intractable ‘cystitis’ in women referred to a special clinic. In: Brumfitt W, Asscher AW (eds) Urinary tract infection. Oxford University Press, Oxford, pp 81–91Google Scholar
  22. Parkes AC, Boreham P (1980) Cryosurgery for the urethral syndrome: prelimary communication. J R Soc Med 73: 428–430PubMedGoogle Scholar
  23. Powell PH, Feneley RCL (1980) The role of urethral sensation in clinical urology. Br J Urol 52: 539–541PubMedCrossRefGoogle Scholar
  24. Powell PH, George NJR, Smith PJB, Feneley RCL (1981) The hypersensitive female urethra—A cuase of recurrent frequency and dysuria. Paper presented at XIth Meeting of the International Continence SocietyGoogle Scholar
  25. Ravnskov U (1984) Soap is the major cause of dysuria. Lancet 1: 1027–1028PubMedCrossRefGoogle Scholar
  26. Raz S, Smith RB (1976) External sphincter spasticity syndrome in female patients. J Urol 115: 443–446PubMedGoogle Scholar
  27. Rees DLP, Farhoumand N (1977) Psychiatric aspects of recurrent cystitis in women. Br J Urol 49: 651–658PubMedCrossRefGoogle Scholar
  28. Rees DLP, Whitfield HN, Islam AKMS, Doyle PT, Mayo ME, Wickham JEA (1976) Urodynamic findings in adult females with frequency and dysuria. Br J Urol 47: 853–860CrossRefGoogle Scholar
  29. Richardson FH (1969) External urethroplasty in women: Technique and clinic evaluation. J Urol 101: 709–723Google Scholar
  30. Roberts M, Smith P (1968) Non-malignant obstruction of the female urethra. Br J Urol 41: 694CrossRefGoogle Scholar
  31. Smith PJB (1979) The management of the urethral syndrome. Br J Hosp Med 22: 578–587PubMedGoogle Scholar
  32. Smith PJB (1981) The urethral syndrome. Clin Obstet Gynaecol 8: 161PubMedGoogle Scholar
  33. Smith PJB, Powell PH, George NJR, Kirk D (1981) Urethrolysis in the management of females with recurrent frequency and dysuria. Br J Urol 53: 634–636PubMedCrossRefGoogle Scholar
  34. Sonnex TS, Jones RL, Weddell AG, Dawber RPR (1985) Long term effects of cryosurgery on cutaneous sensation. Br Med J 290: 188–190CrossRefGoogle Scholar
  35. Splatt AJ, Weedon D (1977) The urethral syndrome: Experience with the Richardson urethroplasty. Br J Urol 49: 173–176Google Scholar
  36. Splatt AJ, Weedon D (1981) The urethral syndrome: Morphological studies. Br J Urol 53: 263–265Google Scholar
  37. Splatt AJ, Weedon D (1982) The urethral syndrome: Experience with the Richardson urethroplasty. A review after 5 years. Br J Urol 54: 566PubMedCrossRefGoogle Scholar
  38. Stamey TA, Sexton CC (1975) The role of vaginal colonization with enterobacteriaceae in recurrent urinary infections. J Urol 113: 214–217PubMedGoogle Scholar
  39. Stamm WE, Wagner KF, Ansel R, Alexander ER, Turck M, Counts GW, Holmes KK (1980) Causes of the acute urethral syndrome in women. N Engl J Med 303: 409–415PubMedCrossRefGoogle Scholar
  40. Stamm WE, Running K, McKevitt M, Counts GW, Turck M, Holmes KK (1981) Treatment of the acute urethral syndrome. N Engl J Med 304: 956–958PubMedCrossRefGoogle Scholar
  41. Stanton SL (1978) Diseases of the urinary system. Drugs acting on the bladder and urethra. Br Med J 1: 1607PubMedCrossRefGoogle Scholar
  42. Whorwell PJ, Prior A, Faragher EB (1984) Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Lancet 11: 1232CrossRefGoogle Scholar
  43. Van Geelen JM, Doesburg WH, Thomas CMG, Martin CB (1981) Urodynamic studies in the normal menstrual cycle: The relationship between hormonal changes during the menstrual cycle and the urethral pressure profile. Am J Obstet Gynecol 141: 384Google Scholar

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© Springer-Verlag Berlin Heidelberg 1986

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  • M. Tasker

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