Urology Clinic DRHC Dubai
Urethral pain syndrome mostly in aged females is a less well-defined entity and scientific studies are few. Positive diagnostic signs are urethral tenderness or pain on palpation and a slightly inflamed urethral mucosa found during endoscopy. Hypotheses about the etiology include concealed infections of the periurethral glands or ducts, according to the anatomical description by Huffman and estrogen deficiency.
In clinical practice, the diagnosis of urethral pain syndrome is commonly given to patients who present with the symptoms of dysuria (with or without frequency, nocturia, urgency and urge incontinence) in the absence of evidence of urinary infection.
The absence of a urinary infection may cause diagnostic problems. Dysuria is pain or discomfort experienced in association with micturition. The classical symptom of a burning sensation in the urethra during voiding caused by infection is well known. Biochemical testing and microbiological culture of urine is important in assessing lower urinary tract symptoms and has been reviewed in some detail in the elderly.
This is regrettable because studies have shown that significant pyuria is a nearly universal indicator of urinary tract infection, although it is not specific for differentiating cystitis from urethritis, particularly urethritis due to Chlamydia trachomatis. Women with pelvic floor dysfunction sometimes describe similar symptoms, as do post-menopausal women, in whom trauma is associated with estrogen deficiency, loss of lubrication and vaginal dryness.
Detailed micturition history and local Gyn.Physical examination, Urethro-cystoscopy, Extended urine cultures, and Antibiotics, and alpha-blocker trials can help as a therapeutic test. Uroflow as the primary test and even pressure flow studies Urodynamic in resistant cases and if treatment has no effect refer to a pain team to get some help.
There is no consensus on treatment. Management may require a multidisciplinary approach. Various modalities including antibiotics, alpha-blockers, acupuncture and laser therapy have been proven successful. Local estrogen creams proved to be helpful plus the others.
DRHC offers urinary flow tests in DRHC Dubai urology clinic
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