title: Management strategies for idiopathic urethritis.
abstract: BACKGROUND
  Williams and Mikhael (1971) described idiopathic urethritis (IU) as a self-limiting condition that affects boys aged 5-15 years, with symptoms of urethrorrhagia, dysuria and haematuria. However, a proportion of boys will remain symptomatic for several years, and may develop urethral stricture (Poch et al., 2007; Palagiri et al., 2003). There is no universally effective treatment for IU, although various strategies have been employed.
  
  
  OBJECTIVE
  To review the presentation and long-term outcomes of boys with IU, and present the efficacy of management strategies that have been utilised.
  
  
  METHODS
  A retrospective review was performed of all boys with IU. It was based on clinical and cystoscopic findings for presentation, medical history, management and clinical progress.
  
  
  RESULTS
  Fifty-four boys were included, with a median age of 11 years (range 5-15 years) at presentation. The median duration of symptoms was 18 months (range 2-132 months). The median follow-up was 18.5 months (range 1-120 months). Seven (13.0%) boys had early urethral stricture at initial cystourethroscopy, and one (1.9%) developed stricture during follow-up. Thirty-six boys (66.7%) had previous circumcision and four (7.4%) had meatal stenosis. Eight (14.8%) had previous hypospadias repair.
  
  
  CONCLUSIONS
  Whilst 50% of boys with IU do not require any specific treatment, those with severe/unremitting symptoms may benefit from a trial of urethral steroids or short-term urethral catheterisation. The mechanisms of benefit from these modalities are unclear and they require further evaluation.
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK. Electronic address: lucy.henderson@doctors.org.uk.
authors.forename: L
authors.initials: L
authors.lastname: Henderson
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK. Electronic address: paul.farrelly@cmft.nhs.uk.
authors.forename: P
authors.initials: P
authors.lastname: Farrelly
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK. Electronic address: alan.dickson29@btinternet.com.
authors.forename: A P
authors.initials: AP
authors.lastname: Dickson
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK. Electronic address: anju.goyal@cmft.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Goyal
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D019468:Disease Management; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014526:Urethritis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
keywords: Haematuria; Idiopathic urethritis; Short-term catheterisation; Steroid instillation; Urethral stricture; Urethrorrhagia