Urethral syndrome is defined as symptoms suggestive of a lower urinary tract infection but in the absence of significant bacteruria with a conventional pathogen

Pathogen

A pathogen gignomai "I give birth to") or infectious agent — colloquially, a germ — is a microbe or microorganism such as a virus, bacterium, prion, or fungus that causes disease in its animal or plant host...

. There are other non-infective causes that should be considered such as trauma, allergies

Allergy

An Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid...

, and anatomical features like diverticula and post surgical scarring.

Presentation

Most women will give a history of chronic recurrent UTI

Urinary tract infection

A urinary tract infection is a bacterial infection that affects any part of the urinary tract. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine. The main causal agent is Escherichia coli...

s but the cultures seem to not show any conventional bacterial growth, and pyuria (more than 5 WBC per HPF) is absent. There may also be a history of these episodes often being related to sexual intercourse

Sexual intercourse

Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which a male's penis enters a female's vagina for the purposes of sexual pleasure or reproduction. The entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails...

.

It is not fair to say that urethral syndrome is not due to infection because many physicians believe that it is due to a low grade infection of the Skene's gland

Skene's gland

In human anatomy , the Skene's glands are glands located on the anterior wall of the vagina, around the lower end of the urethra. They drain into the urethra and near the urethral opening and may be near or a part of the G-Spot...

s on the sides and bottom of the urethra

Urethra

In anatomy, the urethra is a tube that connects the urinary bladder to the genitals for the removal of fluids out of the body. In males, the urethra travels through the penis, and carries semen as well as urine...

. At least symptoms often respond to antibiotic

Antibiotic

An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...

s. The Skene's glands are embryologically related to the prostate gland in the male, thus urethral syndrome may almost be a type of chronic prostatitis

Prostatitis

Prostatitis is an inflammation of the prostate gland, in men. A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits in the United States.-Classification:...

in a woman.

Treatment

Treatment of acute urethral syndrome is antibiotics just the same as treatment for a UTI. For chronic urethral syndrome a long term, low dose antibiotic treatment is given on a continuous basis or after intercourse each time if that seems to be prominent in relationship to symptoms occurring.

As a hormonal imbalance may also be considered a source for urethral syndrome, horomone replacement therapy and oral contraceptive pill (birth-control pills) are also used to treat the symptoms of this condition.