Prostatitis

Urinary Tract Infections (UTIs) in Men

Anyone who has ever had a urinary tract infection (UTI) knows well how uncomfortable and embarrassing they can be.

A urinary tract infection (UTI) is an infection of any part of your urinary system — your kidneys, ureters, bladder, and urethra The bacteria, (usually Escherichia coli) are mostly responsible for UTIs and can gain entry via urethra or reach urinary system via blood.

UTI’s are much more common in women, but men can also develop them.

Usually, urine doesn’t contain bacteria, as the one-way flow helps prevent infections. However, bacteria can get into the urine through the urethra and travel up into the bladder, resulting in infection.

This article will discuss what causes a urinary tract infection in men, the symptoms you should watch out for, and the treatment options available.

What causes a urinary tract infection?

Several factors can cause UTI’s in men, and it may be a sign of a significant underlying problem.

urinary tract infection

Benign Prostatic Hyperplasia (BPH)

Men are most at risk of developing a UTI when the flow of urine is slowed or blocked.

A common occurrence of this is prostate enlargement (BPH). As men age, the prostate gland naturally enlarges, and the growing prostate gland gradually presses against the urethra and restricts urinary flow. The bacteria can gain entry from the urethra and into the bladder.

The urine-filled bladder facilitates the growth of bacteria that can then ascend to involve ureters or can disseminate into the blood, resulting in septicemia.

Prostatitis

Another common cause of UTI is prostatitis, which is when the prostate becomes inflamed.

It is one of the most common prostate health problems in men, with an estimated 50% of men experiencing the symptoms at some point during their lifetime.

Acute prostatitis (a type of bacterial prostatitis) is usually caused by the same bacteria that cause urinary tract infections (UTIs). A recurrent urinary tract infection can also increase your risk of prostatitis

Catheter

Another factor that can cause a UTI is the use of urinary catheters. A catheter is a hollow tube, which is passed into the bladder via external urethral opening to drain urine.

UTI occurs when bacteria in a catheter bypass the body’s defense mechanisms and enter the bladder. The risk of developing a further infection increases; the longer the indwelling catheter is in place.

Sexually transmitted diseases

Urethritis also may be caused by microorganisms including gonorrhea and Chlamydia that are transmitted through sexual contact.

UTIs are given different names, depending on where they occur. For example:

  • A bladder infection is called cystitis.

  • A urethra infection is called urethritis.

  • A kidney infection is called pyelonephritis.

Symptoms of a urinary tract infection

If you start to experience any of the following symptoms, you should visit your doctor for diagnosis and treatment.

  • Painful urination /burning with urination (dysuria).


  • Frequent urination/ sudden urge to urinate.


  • Difficultly bladder emptying.


  • Urinary incontinence.


  • Abdominal pain/ pelvic pain.


  • Strong-smelling urine.


  • Blood in the urine.


  • Back pain, or groin pain.


  • Fever or chills.


  • Pain during sexual intercourse.


  • Fatigue.

Who is at risk of urinary tract infections

Some people can be more prone to developing urinary tract infections than others. Risk factors include:

  • People with diabetes mellitus: Diabetes and other diseases that impair the immune system, increase the risk of urinary tract infections.


  • Women: as touched upon, women are at a higher risk of developing UTIs, due to their urethra being much shorter than men’s. As a result, there is less of a distance for bacteria to travel. Post-menopausal women are, particularly at risk.


  • Those using urinary catheters: for those unable to urinate unassisted, a catheter may be used. This can increase the risk of a urinary tract infection.


  • Blockages in the urinary tract: Kidney stones or prostate enlargement can obstruct the urinary passage, increasing the risk of infection.

Complications of a urinary tract infection

If left untreated, a urinary tract infection in men can result in a number of complications, including:

  • Urethral narrowing (stricture) in men with recurrent infections.


  • Kidney infections can result in long-lasting kidney damage.


  • Sepsis, a life-threatening condition.

Diagnosing a urinary tract infection

If you are experiencing symptoms associated with a urinary tract infection, you should contact your doctor. Your doctor will review your symptoms and may perform the following tests:

Urine sample: One of the first steps is to provide a urine sample, which will then be sent to the lab for analysis to look for white blood cells, red blood cells, or bacteria.

Urine culture: a urine culture sometimes follows a lab analysis (urinalysis) of the urine. This urine test tells your doctor what bacteria are causing your infection, helping to decide which means of treatment will be most effective.

CT Scan: If urinary tract infections are a frequent problem, your doctor may carry out a CT scan or an MRI to check for any abnormalities.

Cystoscopy: If UTI’s are a recurring problem, your doctor may use a cystoscope (a thin tube with a lens) to see inside your urethra and bladder.

Treatment for a urinary tract infection

Antibiotics

If you are diagnosed with a urinary tract infection, your doctor will usually prescribe a course of antibiotics. Depending on the type of antibiotic your doctor prescribes, you will take the pills either five to seven or more days.

Drugs commonly recommended for simple UTIs include:

  • Trimethoprim/sulfamethoxazole (Bactrim, Septra, others).

  • Fosfomycin (Monurol).

  • Nitrofurantoin (Macrodantin, Macrobid).

  • Cephalexin (Keflex).

  • Ceftriaxone.

If you have an uncomplicated urinary tract infection, then antibiotics will generally clear it up.

In the case of complicated urinary tract infection or kidney infection, your doctor may prescribe fluoroquinolone medicine, if no other treatment options exist. This is in rare cases, as the side effects of this medication are severe.

However, increasing rates of antibiotic-resistant infections, including those of the urinary tract, due in part to medically unnecessary prescriptions, have increased the need for antimicrobial stewardship when treating UTI in clinical practice.

It is important to note that antibiotics can have side effects. Some of the most common ones include:

  • Nausea and vomiting.

  • Diarrhea.

  • Loss of appetite.

  • Stomach pain.

  • Bloating.

Lifestyle

Home remedies to try that may ease symptoms and help prevent urinary tract infections.

  • If you develop a urinary tract infection, it is advised to drink plenty of water, to help flush waste from the system. Medical professionals recommend that you drink 6 to 8 glasses of water per day.


  • Probiotics can help keep free from harmful bacteria. Probiotics called lactobacilli may help with treating and preventing UTIs. Probiotic supplementation can also restore the loss of healthy bacteria in your gut microflora caused by antibiotic treatment. This would lower the risk of a bacterial infection recurrence


  • If you are experiencing pelvic pain, then the heating pad may help to relieve the pain.


  • Supplements such as vitamin C, beta-carotene, and zinc can help to boost the immune system, lowering the likelihood of developing an infection.


  • Some anecdotal evidence suggests that cranberry juice can help prevent bladder infections. Studies on the effectiveness of cranberry juice for UTIs have had mixed results. According to one review, cranberry juice contains compounds that may prevent E. coli cells from attaching to cells in the urinary tract.

Conclusion

Most people will develop a urinary tract infection at some point in their life. Although it can leave you feeling frustrated and uncomfortable, the good news is that they are generally very treatable. If you start to experience symptoms, it is important to see a doctor.

Sources

  1. Gharbi Myriam, Drysdale Joseph H, LishmanHannah, Goudie Rosalind, Molokhia Mariam, Johnson Alan P et al. Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study BMJ 2019; 364 :l525
  2. den Heijer, C, van Dongen, M, Donker, G, Stobberingh, E. (2012). Diagnostic approach to urinary tract infections in male general practice patients: a national surveillance study. British Journal of General Practice. 62 (604), p1.
  3. Ziyadi, S, Bastan, P, Homayouni, A, Mohammad-Alizadeh-Charandabi, Mallah, F. (2015). Chapter 63: Probiotics and Usage in Urinary Tract Infection. In: Watson, R, Preedy, V Probiotics, Prebiotics, and Synbiotics. USA: Academic Press. p827-830.
  4. Lipsky, BA. (1989). Urinary tract infections in men. Epidemiology, pathophysiology, diagnosis, and treatment.. Annals of Internal Medicine. 110 (2), p138-50.
  5. Hummers-Pradier E, Ohse AM, Koch M, Heizmann WR, Kochen MM.. (2004). Urinary tract infection in men.. International journal of clinical pharmacology therapeutics . 42 (7), p360-6.
  6. Gharbi M, Drysdale J, Lishman H, Goudie R, Molokhia M, Johnson A et al. Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study BMJ 2019; 364 :l525

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