A Clinical Study on Female Urethritis

Lee, Jhy Bok; Lee, Hak Song

Abstract

Female urethritis is a relatively common clinical entity which lesion is mainly limited only in urethral mucosa and causes urinary symptoms including frequency, urgency and dysuria, and non-urinary symptoms. i. e. lumbago, discomfort in the lower abdomen. This is sometimes referred as urethritis cystitis syndrome since symptoms arising from urethritis are similar to those from cystitis. Female urethra is frequently subjected to trauma from sexual relation and childbirth and to bacterial infection since the urethral meatus is very close to germ bearing genitalia and the anus, and easily bathed with vaginal discharge and fecal substances. Infection of urethral glands is a factor causing stubborn female urethritis resistant to ordinary treatment with antibiotics, sulfa-drugs and irrigation. Avulsion and resection of the glands are only choice of treatment in such cases. 233 cases of unselected female urethritis seen at the urological clinic during the period April 1. 1958 to November 30, 1960 were studied. Female urethritis has been observed more frequently in the age groups of 21-30 and 31-10 (11.6% and 30.0% respectively) and the incidence is very low in the age groups under 10 and over 61 (1.3 % and 2.2% respectively). Common urinary symptoms arc frequency. 63%, pain on urination. 37.3%; tenesmus, 3l.7%; urgency, 31.3%; and retardation on urination, 17.6%. Non-urinary symptoms are suprapubic dull pain, 26.5 %; and lumbago. 18.0%; and ten patients present considerable dyspareunia. Of 229 cases having cystoscopic examination. 121 cases (54.1%) had normal bladder, 83 had trigonal infection and 66 had trabeculation and cellule formation which was interpreted as lower urinary tract obstruction. Of 41 cases having pan-endoscopic examination, 26 revealed hyperemic and erythematous urethral mucosa, 9 showed edema, 8 had irregular and narrowing bladder neck, 6 had dilatedtortuous vessel. 5 instances of polyp or pseudopolyp and 5 cases of urethral infiltration were also observed. Physical urethral tests including urethral tenderness test, shaft and catheter test were applied to 24 cases. 7 positive and 2 questionably positive urethral tenderness test. 13 unilaterally positive, 1 bilaterally and 6 questionably positive shaft test and 18 unilaterally and 6 bilaterally positive catheter test were obtained. Agreement between shaft test and catheter test was obtained in 11 cases (same side) and in 6 cases (bilateral catheter test and unilateral shaft test). Of 136 cases in which urinalysis was performed, 91 cases or 67% were normal and of 91 vaginal smear 65 cases or 71.0% were normal. 159 patients received medical and local treatment less than one week to nine months and the following results were obtained: 47 complete cure (29.6%), 64 improvement(40.2%), 15 no improvement (9.4%) and 33 unknown(20.8%)