Gittes R F, Nakamura R M
Department of Surgery, Scripps Clinic and Research Foundation, La Jolla, California, USA.
West J Med. 1996 May;164(5):435-8.
The cause of the female urethral syndrome has previously been obscure, as it has been associated by definition with a lack of objective findings but a plethora of subjective complaints of retropubic pressure, dyspareunia, urinary frequency, and dysuria. There is now strong evidence that the microscopic paraurethral glands connected to the distal third of the urethra in the prevaginal space are homologous to the prostate. They stain histologically for prostate-specific antigen and, like the prostate, are subject to both infection and cancer. The most important aspect of recognizing this microscopic "female prostate" as an anatomic feature is that its infections may completely explain many cases of the urethral syndrome. Further, the diagnosis is not elusive if trained clinicians palpate for localized and objective paraurethral tenderness through the anterior vagina wall to one or both sides of the urethra. Treatment parallel to that for male prostatitis is usually rewarded by the elimination of symptoms and the objective finding of the loss of tenderness of the paraurethral glands. As with prostatitis, the localized problem often recurs. It is time to alert primary care physicians to this disorder and to eliminate the widespread practice of treating affected women with either invasive urethral dilation or tranquilizers.
女性尿道综合征的病因以前一直不明，因为根据定义，它与缺乏客观发现相关，但却有大量诸如耻骨后压力、性交困难、尿频和尿痛等主观症状。现在有强有力的证据表明，在阴道前间隙中与尿道远端三分之一相连的微小尿道旁腺与前列腺同源。它们在组织学上对前列腺特异性抗原呈阳性染色，并且与前列腺一样，易受感染和发生癌变。将这种微小的“女性前列腺”视为一种解剖学特征，其最重要的意义在于其感染可能完全解释许多尿道综合征病例。此外，如果训练有素的临床医生通过阴道前壁触诊尿道一侧或两侧以发现局部和客观的尿道旁压痛，诊断并不困难。与男性前列腺炎类似的治疗通常会使症状消除，并且尿道旁腺压痛消失这一客观表现也会出现。与前列腺炎一样，局部问题常常复发。现在是时候提醒初级保健医生注意这种疾病了，并且要消除对患病女性进行侵入性尿道扩张或使用镇静剂的普遍做法。
