Idiopathic urethrorrhagia in boys.

During a 11-year period 21 toilet-trained, prepubertal boys were seen with blood spotting on the undershorts (urethrorrhagia) between voidings. Most patients presented in the winter and spring months as opposed to the summer and fall months. The median age at presentation was 7 years. The most frequent presenting system, in addition to urethrorrhagia, was dysuria. Laboratory and radiographic studies were frequently normal, although red blood cells were seen microscopically in 57 per cent. Bacterial cultures were always negative. Symptoms persisted for as long as 8 years (median between 6 and 12 months). The etiology of this symptom complex in these cases is unknown but is thought to be an infectious agent. Strictures developed in 3 patients, all of whom had had prior endoscopy. In none of the 6 patients in whom cystoscopy was omitted did a stricture develop. Inasmuch as endoscopy is unnecessary to rule out serious lesions that might mimic idiopathic urethrorrhagia, its use on a routine basis in these patients does not seem warranted.