Urethral syndrome is where you have symptoms of a urinary tract infection, but a urine test for bacteria comes back low or negative.

The urine test for urinary tract infections looks for red and white blood cells. The white blood cells are what your body responds to inflammation with, so if you have an infection that is causing inflammation, you will have white blood cells in your urine. Your doctor will also do a bacterial petri dish to see what type of bacteria are in your urine, and in what quantities.

This is not an exact science, and rarely do you get precise information back. What it tells you, however, is if you have an infection of some kind. If you have an infection, you do not have urethral syndrome, which is characterised by inflammation of the urethra, but without infection.

Symptoms of urethral syndrome

  • The most common symptom is pain or discomfort while urinating
  • Symptoms of a urinary tract infection – frequency and urgency of urination, a feeling of pressure in the lower abdomen even after relieving your bladder, pain while having sex (dyspareunia), discomfort of the vulva and lower abdominal area

Causes of urethral syndrome

Urethral syndrome can be caused by external causes, and the symptoms may be very local, around the very end of your urethra. It might feel like a low-grade infection. It may be caused by irritation to chemicals found in pads, tampons, soaps or toilet paper. It could be a reaction to condoms, semen, contraceptive devices, or spermicide.

Additionally, it has been observed that women can, like men, suffer prostatitis, since the Skene’s glands in women are the same as the prostate in men. This means inflammation of the prostate (prostatitis) can also occur in women – called Skenitis – causing the sort of symptoms urethral syndrome presents with.

The urethra is the tube that connects the bladder to the external opening where urine is released out of the body. Inflammation of the surrounding organs might also be a factor. Other reasons could be a herpes infection or a spasm in the muscles around the urethra.

It is found that more women than men are affected by this syndrome.

Tests/Diagnosis of urethral syndrome

A urine test will be conducted. At times, a blood test and cystoscopy (using a small telescope, the bladder and urethra are checked) may be conducted. Make sure you are tested for Mycoplasma genitalium

Treatments for urethral syndrome

If your doctor believes the bacteria count in your urine test is enough to give you antibiotics, you most probably will be given a cycle of antibiotics. Most urologists prescribe a urinary tract-targeted pain reliever such as Pyridinium if the patient is in dire pain and discomfort.

If you experience symptoms during and after sex, you may be asked to refrain from sexual activity until your condition is controlled. You may also be given steroid shots in the urethra to control inflammation.

Women of menopausal age sometimes get urethral syndrome because of the drop in their oestrogen levels which in turn creates inflammation and thinning of the area around the urethra and vagina. If this is the case with you, hormone replacement therapy would be an option.

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
Read more about Jessica and My Vagina's origin story.