The urethral syndrome: myth or reality? A commentary

Although most urologists will agree that dealing with patients suffering from the multiple symptom complex commonly called the urethral syndrome is often time consuming, its origin and treatment continue to generate debate. This essay proposes that entrapment of sensory nerves in the wall of the urethra by fibrosis leads to an abnormal response of Barrington's reflex II, which, in turn, leads to the urethral syndrome. Periurethral fibrosis occurs following trauma, infections, and pelvic irradiation therapy. The urethral syndrome, the author concludes, is therefore based on recognized anatomical factors. The recommended treatment is urethral dilation accompanied by hot sits baths and short courses of Sulfamethoxazole-Trimethoprim. Long-term drug therapy is to be avoided.