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Urinary Tract Infection (UTI) in Men

Urinary Tract Infection (UTI) in Men

Historically, men have focused less on their overall and urologic health than women, often until a problem presents with symptoms that refuse to be ignored any longer. This phenomenon is something I have written extensively about over the years, mainly because early detection of any condition offers the highest chances of curative treatment. So, this Men's Health Month is a great time to discuss and focus on urinary tract infections (UTIs). Though the condition is far more common in women, UTIs do occur in men, especially those over 70. 

For most men who experience UTI, they typically fall into one of five categories:

  1. Bladder infection: Cystitis
  2. Prostate infection: Prostatitis
  3. Urethral infection: Urethritis 
  4. Kidney infection: Pyelonephritis 
  5. Testicular infection: Epididymitis/orchitis.

Cystitis and prostatitis are often the most common culprits of UTI in men, while Urethritis, Pyelonephritis, and epididymitis occur less frequently.

Though the penis is not prone to UTI, people with prior urethral infection or trauma can develop stricture in the urethra, which is located inside the penis. Strictures can cause a urine flow block, leading to infection, including UTI.  

The symptoms of UTI in men are generally the same as those experienced by women and may include one or more of the following:

-Burning with urination

-Urinary urgency

-Urinary frequency

-Cloudy urine that may have an unusually foul odor

-Pain in the bladder or kidney area

-Pain in the perineal area (in men, this is the area between the anus and bulb of the penis)

-Discharge from the urethra

-Blood in the urine

-Fever

Though less common than the symptoms described above, some additional UTI signs for men to watch out for include: pain in the lower abdomen, back pain, a slow urinary stream, and painful ejaculation.

In many instances, when a man develops a UTI, it is because of an underlying urological problem. Especially when the underlying urological problem is unaddressed, it can predispose a man to get more UTIs. Therefore, the doctor must do a workup and determine the root cause of the first UTI, then treat the underlying problem.  

The symptoms of an enlarged prostate, bowel problems, bladder cancer, and general pelvic pain disorders are sometimes misdiagnosed as UTIs. The doctor must perform a urine culture test if they suspect the UTI is from the bladder, kidney, or prostate.  

Some underlying issues or risk factors that may lead to UTI in men include:

-Diabetes

-Spinal disorders that cause bladder muscle dysfunction

-Urethral stricture disease

-Enlarged prostate

-Incomplete bladder emptying

-Kidney stones

-Bladder stones

-Unprotected anal or vaginal intercourse

-Occupations that require men to sit for prolonged periods (drivers, lawyers, computer programmers, etc.)

Many people (and not only men) tend to think that UTIs aren't serious. But left untreated, there are plenty of dangerous complications that UTI can present specifically in men, including: 

-Infection that spreads from the bladder to the kidneys

-Incontinence

-Abscess formation in the prostate or testes, which requires surgery to treat

-Renal failure

-Long-term damage to the urinary tract

Thankfully, UTIs, especially when caught and treated early, can be treated with culture-directed antibiotics, and especially by treating the underlying condition which led to the infection in the first place.

 There is plenty a man can do to reduce his risk of developing UTI, including:

-Don't hold urine for prolonged periods

-Avoid constipation by drinking fluids, eating fruits and vegetables, and minimizing caffeine intake

-Avoid sitting for prolonged periods (sitting can increase the risk of prostatitis)

-Have frequent sexual activity to release semen that builds up in the prostate and seminal vesicles 

-Use condoms if having anal intercourse

-See a specialist and undergo treatment if the prostate is enlarged

-Stay well hydrated 

For most men, UTI is uncommon. So, if it is experienced more than once, the UTI may be the tip of the iceberg sitting on top of a more complicated problem that must be discovered and expertly treated. A man experiencing recurrent UTI should see a specialist who understands the importance of and has experience determining and treating the underlying cause.