Dysuria in Women-Waters et al. IIRMM 757dysuria is commoner in women who have had children (Waters, 1969) whereas age-adjusted mean systolic and diastolic blood pressures decrease with the number of children (Miall and Oldham, 1958).Fifty-three (1-8°,') of the women seen during the initial screening survey dated their first attack of dysuria' to childhood. A oomparison of symptoms in these women ;with those who had dysuria only in adult life suggests that their symptoms are more severe and more frequent and that they are more likely to consult a doctor (Table IV). After standardizing for age there is no evidence that their plasma urea, plasma creatinine, or blood pressure is different when compared with women who have never had dysuria. There is, however, evidence of a significant impairment of renal concentrating power. Loss of renal concentrating power is one of the earliest signs of chronic pyelonephritis, and the present finding suggests that dysuria in childhood is associated with kidney damage. The fact that women who report dysuria in childhood are significantly younger than the rest of the population could be the result of a higher mortality, but more probably this trend is simply an effect of memory.Thus dysuria in women is unlikely to lead to impairment of kidney function but may be associated with higher than average blood pressure levels. In view of the large number of women with dysuria the present findings are on the whole reassuring, but they do not exclude the possibility that a few women with dysuria may develop kidney damage. There is no evidence of such a group in the numbers examined. Women with histories of dysuria in childhood, however, do show evidence of a decreased renal concentrating power, which suggests that in childhood this symptom is associated with kidney damage which persists into adult life.

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