Das Urethralsyndrom: Fakt oder Fiktion – ein Update

Dreger, Nici Markus; Degener, Stephan; Roth, Stephan; Brandt, Alexander Sascha; Lazica, D.A.

doi:10.1007/s00120-015-3926-9

Cited by 9 publications

(10 citation statements)

References 41 publications

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“…Most of these patients are women aged 20 to 30 years and 50 to 60 years. Contrary to the earlier definition, urethral pain syndrome may also occur in men, but less frequently [6,10]. This condition is more common in Caucasians than other races [5].…”

Section: Urethral Pain Syndromementioning

confidence: 74%

“…The diagnosis implies a specific duration of symptoms, a minimum of six months [5]. The exact etiology is unknown; however, infectious and psychogenic factors, urethral spasms, early IC, hypoestrogenism, squamous metaplasia, as well as gynecological risk factors are discussed [6]. There is now evidence that the microscopic paraurethral glands connected to the distal third of the urethra in the prevaginal space are homologous to the prostate.…”

Section: Urethral Pain Syndromementioning

confidence: 99%

“…This condition is more common in Caucasians than other races [5]. As a result of these nonspecific symptoms, patients with urethral pain syndrome often enter into urological care after long-term suffering and repeated treatment [6,11].…”

Section: Urethral Pain Syndromementioning

confidence: 99%

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Is Urethral Pain Syndrome Really Part of Bladder Pain Syndrome?

Cho

2017

Urogenit Tract Infect

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Urethral pain syndrome is a symptom complex that includes dysuria, urinary urgency, frequency, nocturia, and persistent or intermittent urethral and/or pelvic pain in the absence of proven infection. Bladder pain syndrome is a clinical diagnosis, based primarily on chronic symptoms of pain from the bladder and/or pelvis associated with urinary urgency or frequency in the absence of identified cause for the symptoms. To date, the term, urethral pain syndrome, remains to be unclear in referring to a distinct subgroup of bladder pain syndrome. However, these two syndromes share many similarities, except the organ of pain. This review is intended to summarize the current state of literature with regard to similar pathophysiology and possible interrelations between urethral pain syndrome and bladder pain syndrome.

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Section: Urethral Pain Syndromementioning

confidence: 74%

Section: Urethral Pain Syndromementioning

confidence: 99%

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Is Urethral Pain Syndrome Really Part of Bladder Pain Syndrome?

Cho

2017

Urogenit Tract Infect

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“…The problem of pain in the urethra with unchanged urinalysis, the absence of any other clinical manifestations, and the absence of somatically explainable causes, is complex and ultimately remains unresolved, since the exact pathogenetic mechanisms are not yet fully understood [ 6 , 7 , 8 , 9 ]. Neither are there any clear recommendations for the prevention and treatment of UPS, as a result of which the only effective form of medical care today is symptomatic therapy—involving the continuing intake of strong pain medications, antidepressants, and anticonvulsants [ 4 , 9 ]. In the methodological recommendations on CPP, published under the auspices of the the Moscow Department of Health (dated 14 July 2016), it is noted that there is no specific accepted treatment for UPS [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

New Approaches in the Study of the Pathogenesis of Urethral Pain Syndrome

et al. 2020

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Introduction: Urethral pain syndrome (UPS) is still a pathology in which the diagnosis is formulated as a “diagnosis of exclusion”. The exact pathogenetic mechanisms are not yet fully understood and clear recommendations for the prevention and treatment of UPS are absent. Methods and Participants: A clinical and laboratory evaluation of 55 patients with established UPS included history taking, basic laboratory tests (e.g., complete blood count and clinical urine test), physical examination, uroflowmetry, and cystourethroscopy. Additionally, transvaginal ultrasound (TVUS) with compression elastography and cross-polarization optical tomography (CP OCT) were performed in 24 and 33 patients with UPS, respectively. The control group consisted of 14 patients with no complaints from the urinary system. Results: TVUS showed an expansion in the diameter of the internal lumen of the urethra, especially in the proximal region compared with the norm. Compression elastography revealed areas with increased stiffness (presence of fibrosis) in urethral and surrounding tissues. The performed CP OCT study showed that in UPS, the structure of the tissues in most cases was changed: trophic alterations in the epithelium (hypertrophy or atrophy) and fibrosis of underlying connective tissue were observed. The proximal fragment of the urethra with UPS underwent changes identical to those of the bladder neck. Conclusion: This paper showed that the introduction of new technology—CP OCT—in conjunction with TVUS will allow verification of structural changes in tissues of the lower urinary tract at the level of their architectonics and will help doctors understand better the basics of the UPS pathogenesis.

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“…Previous studies indicate that the syndrome is not due to a single cause but to several complex mechanisms [5]. Low-grade infection, early interstitial cystitis (Painful Bladder Syndrome), urethral spasm, urethral stenosis, inflammation of the paraurethral glands (“female prostatitis”), estrogen deficiency in the urethral mucosa and psychogenic illness, have been investigated as possible causes [5, 10, 11]. Parson et al reported a hypothesis concerning a common pathophysiological pathway behind the symptoms, regardless of etiology.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Urethral Pain Syndrome (UPS) in Sweden

et al. 2019

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BackgroundUrethral Pain Syndrome (UPS) in women is a recurrent urethral pain without any proven infection or other obvious pathology. There are few studies on UPS, and evidence-based treatment is lacking. The primary aim was to study what treatments are used, and to compare the treatment tradition of UPS in Sweden in 2018, with what was used in 2006.MethodsA questionnaire on the treatment of women with UPS was sent to all public gynecology, urology, gynecologic oncology and venereology clinics, and one public general practice in each county in Sweden in 2018. Private practice clinics in gynecology responded to the survey in 2017. Comparisons were made with the same survey sent to gynecology and urology clinics in 2006.FindingsOf 137 invited clinics in 2018, 99 (72.3%) responded to the survey. Seventy-seven (77.8%) of them saw women with UPS and 79.2% (61/77) of these clinics treated the patients using 19 different treatment methods. Local corticosteroids and local estrogens were the methods most used. Treatments were similar in gynecology and urology clinics in 2006 and 2018, although strong corticosteroids had increased in use in the treatment regimens of 2018. More than half of the clinics used antibiotics.InterpretationSince there is no evidence-based treatment of UPS, a wide spectrum of treatments is used, and different specialties use different treatment strategies. Despite the lack of proven infection, a large number of clinics also treated the syndrome with antibiotics. There is thus a need for well-designed randomized controlled clinical trials to find evidence-based treatments of UPS.

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Das Urethralsyndrom: Fakt oder Fiktion – ein Update

Cited by 9 publications

References 41 publications

Is Urethral Pain Syndrome Really Part of Bladder Pain Syndrome?

Is Urethral Pain Syndrome Really Part of Bladder Pain Syndrome?

New Approaches in the Study of the Pathogenesis of Urethral Pain Syndrome

Treatment of Urethral Pain Syndrome (UPS) in Sweden

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