尿道综合征又称为尿频-排尿困难综合征,多见于女性,有明显的排尿困难,尿频,但无发热、白细胞升高等全身症状。多次尿细菌培养菌落计数<105/ml;尿中可以有红细胞、白细胞,但增多不明显,未达到诊断菌尿标准,一般<10个/HP。尿道综合征的诊断依据为:
尿道综合征的诊断是建立在全面了解病史,详细体格检查,并作各种相应的实验室及影像学检查,如中段尿培养、腹部平片、尿路造影等,在排除器质性疾病后才能确立。
诊断第一步必须排除尿路感染, 因为二者最易相互误诊,尿路感染诊断的确立主要依靠尿细菌学检查即真性细菌尿的发现。真性细菌尿是指有尿感症状时,一次清洁中段尿定量细菌培养菌落计数 ≥105/ml,或无尿感症状时,二次清洁中段尿定量细菌培养菌落计数≥105/ml,且菌种相同;或膀胱穿刺尿有细菌生长者。
假如无真性细菌尿,诊断第二步还必须进一步排除有无泌尿系的特殊感染:如真菌、结核菌、淋球菌、厌氧菌、L型细菌、衣原体和支原体等。真菌感染常发生于人体免疫功能低下的基础上,或大剂量广谱抗生素应用后。
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