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Revised: June 7, 1998

Spotlight on Research: Female Urethral Syndrome: An infection of the female prostate glands?!

(Written by Jill Osborne) Researchers Ruben Gittes, MD and Robert Nakamura, MD, of the Scripps Clinic and Research Foundation, have turned the female urology community on it’s ear with their publication “Female Urethral Syndrome: A Female Prostatis” in the May 1996 issue of WJM. Their studies have conclusively proven that women do indeed have a set glands, the paraurethral glands, which, in the past ten years, have been proven to be homologues of the male prostate. In the abstract for their research project, they state "The most important aspect of recognizing this microscopic ‘female prostate’ as an anatomical feature is that it’s infections may completely explain many cases of the urethral syndrome."

Is this new? Actually, these glands were first described in 1672 by Regeneri de Graaf. In the late 1940’s and 1950’s, researcher Huffman was the first to describe the paraurethral glands in detail. In post mortem tissue exams, he consistently found inflammation in and about this area... and went on the record to say that an infection of these glands "play and important role in nonspecific urethritis." Unfortunately, the research community at the time wasn’t receptive to this line of research. It wasn’t until the past decade Huffman’s theories have been validated by the use of new staining procedures which have proven that the paraurethral glands are indeed homologous to the male prostate. As such, it is easy to surmise that, like the male prostate, these may become infected.

Where are they? The microscopic paraurethral glands are found alongside the outer two thirds of the urethra.

How is this diagnosed in women? These researchers choose not to diagnose by exclusion. Much like the rectal examination of the prostate in men, they rely on a careful assessment of the tenderness of the glands through the vaginal wall to discover the presence of inflammation and infection. It seems to be no coincidence that IC researchers have documented similar distal vaginal tenderness.

Treatment Options: Drs. Gittes and Nakamura based much of their treatment based upon the treatment of men with prostate infections, specifically the use of “tissue-penetrating” antiobiotics. They state that because of the “inaccessibility and presumed stagnation of the glands” the treatment may require long term treatment with antiobiotics to achieve a cure. Progress of the treatment is assessed again via a vaginal re-examination. They further state that, like prostatitis, relapses may occur. (For more info on the antiobiotics discussed, please have your physician refer to the text of the article).

What does this mean for IC patients? We don’t have any official comments from the IC research community. In fact, this article was obtained via the Prostatis Foundation. However, many IC patients have expressed frustration with the multiple diagnoses they have received and have speculated about any relationship between a diagnosis of IC versus one of urethral syndrome. While some doctors have expressed opinions that the syndromes are unrelated, others believe that urethral syndrome may be a milder form of IC.

Of special interest is the use of antiobiotics to treat this condition. With much “pro and con” discussion on the internet about the research of Dr. Durier, Domingue and Paul Fugazzotto, Ph.D., this study seems to support their research premise that IC may be bacterial in origin. The downside, of course, is that the use of repeated antiobiotics DOES promote the development of resistant bacterial strains and dramatic side effects in some patients. Because of this, patients should never self administer random antiobiotics without their physicians approval.

As a patient who has long had anterior vaginal tenderness, I found this publication to be one of the most exciting in the past year. If you, the reader, are interested in reading more about this line of research, you can find the article in the May 1996 issue of WJM- Vol. 164, No. 5 (pages 435-438) Your comments would be greatly appreciated.

©1996 - The IC Network
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