Urinary Tract Infection in Men

Urinary Tract Infection in Men

Article
Men's Health
Sexual Health
+2
Contributed byMaulik P. Purohit MD MPHDec 25, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • UTI (Men)
  • UTI in Men

What is Urinary Tract Infection in Men? (Definition/Background Information)

  • A Urinary Tract Infection (UTI) in Men is an infection that occurs within the urinary tract system, which consists of the urethra, bladder, ureter, and kidneys, as well as the prostate and testicles
  • The infection is named after the location in the urinary tract, where it occurs:
    • Infection of the ureter is urethritis
    • Infection of the bladder is cystitis
    • Infection of the prostate is prostatitis
    • Infection of the testicles is orchitis
    • Infection of the epididymis is epididymitis
    • Infection of the kidneys is pyelonephritis
  • Urinary Tract Infection is generally caused by a microbe, such as bacteria. Men are at a decreased risk of developing a UTI than women, because of the anatomical structure of the male urinary system
  • The infection can occur more frequently with increasing age, due to a blockage in the urinary tract, having a bladder catheter, or with a decreased immune system
  • The signs and symptoms of Urinary Tract Infections in Men include fever, frequent urination, and a burning sensation while urinating. A diagnosis for the condition can include a complete physical exam with urine and blood tests
  • Urinary Tract Infections in Men are commonly treated with antibiotics (when the infection is caused by bacteria), which can bring about positive outcomes within 48 hours
  • However, severe complications can occur if the condition is left untreated such as the spread of the infection to the kidneys or to the bloodstream

Who gets Urinary Tract Infection in Men? (Age and Sex Distribution)

  • Urinary Tract Infections in Men generally affect adult men over the age of 50 years
  • The infection also occurs in men below the age of 50 years; however, the prevalence is low (at 5 per 10,000)
  • Men of all races and ethnicities are equally susceptible to UTIs

What are the Risk Factors for Urinary Tract Infection in Men? (Predisposing Factors)

The risk factors for developing Urinary Tract Infections in Men include:

  • Age: Men over the age of 50 years are at an increased risk of developing UTI, generally due to enlargement of the prostate gland
  • Blockages in the urinary tract, such as caused by kidney stones, which impair the flow of urine
  • Uncircumcised males have a higher risk for UTI than circumcised males
  • Sexual intercourse with infected individuals can result in the spread of pathogen from one individual to another; anal sex
  • Urinary bladder catheter placement (or use) can disrupt the normal flow of urine, which help wash away the microbes. A urinary bladder catheter is usually used for various medical conditions to facilitate urine outflow
  • Weakened immune system due to the use of certain medications or the presence of HIV
  • Having poorly-controlled diabetes
  • Congenital and acquired structural abnormalities of the kidney and urinary bladder

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Urinary Tract Infection in Men? (Etiology)

  • Urinary Tract Infections in Men are usually caused due to infection by bacteria such as Escherichia coli, Klebsiella, Pseudomonas, or Staphylococcus
  • The infection can spread from the urethra through the urinary tract and reach the bloodstream from the kidneys
  • Rarely, fungus and other parasites can also cause UTI in Men

What are the Signs and Symptoms of Urinary Tract Infection in Men?

The signs and symptoms of a Urinary Tract Infection in Men may include:

  • Painful or difficult urination (dysuria)
  • Changes in urinary frequency
  • Changes in consistency, smell, or color of the urine
  • Fever and chills

Additional signs and symptoms may arise depending on the location of the infection which includes:

  • Urethra infection (urethritis) causing discharge from the urethra
  • Prostate infection (prostatitis) resulting in pain near the anus or groin region
  • Epididymis infection (epididymitis) with pain and swelling of the scrotum
  • Testicular infection (orchitis) with pain and swelling of the testicles
  • Bladder infection (cystitis) leading to:
    • Abdominal discomfort
    • Pelvic pressure
  • Kidney infection (pyelonephritis) causing:
    • High fever
    • Back and side pain (near the ribs)
    • Episodes of chills with shivering
    • Nausea and vomiting 

How is Urinary Tract Infection in Men Diagnosed?

Diagnostic methods that a physician may use to help diagnose Urinary Tract Infections in Men include:

  • A complete physical examination with a detailed medical and surgical history
  • Rectal examinations to evaluate the state of the prostate
  • Laboratory testing through tests such as:
    • Urine analysis, such as a dipstick test
    • Urine cultures to detect the pathogen causing the infection
    • Blood tests 
  • Intravenous pyelogram (IVP), which is a series of x-rays using contrast dyes to detect abnormalities in the urinary tract
  • Ultrasonography to detect kidney stones 

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Urinary Tract Infection in Men?

The complications from a Urinary Tract Infection in Men could include:

  • Urinary discomfort
  • Shrinking of the testicles
  • Infertility
  • Kidney infections that could lead to kidney failure
  • Spread of infection to the bloodstream, leading to sepsis

How is Urinary Tract Infection in Men Treated?

The treatment of Urinary Tract Infection in Men depends on many factors including the:

  • Location of infection
  • Species of bacteria (or pathogen) causing the infection

Common treatments for UTIs in Men include:

  • Oral or IV antibiotics to specifically target the bacteria causing the infection, such as ampicillin, amoxicillin, and ciprofloxacin
  • Surgery to repair twisting of the epididymis, if necessary
  • Surgery to repair damaged portions of the kidneys: Congenital or acquired conditions of the kidney can cause abnormal kidney structure that can lead to increased risk for developing infection

Some infections are known to be self-limiting and get better without any treatment.

How can Urinary Tract Infection in Men be Prevented?

The following factors may help prevent Urinary Tract Infections in Men or reduce the risk for an infection:

  • Drinking large amounts of water to increase urination, which can help flush bacteria from the urinary tract
  • Emptying the bladder after intercourse
  • Maintain cleanliness and hygiene, especially before and after sexual activities
  • Having safe sex, such as by using condoms and avoiding multiple partners
  • Avoiding holding-in of the urine regularly: Postponing urination when there is an urge to urinate can cause pooling of urine within the bladder. Such pooling over a prolonged period of time can create an environment for favorable bacterial growth
  • Keeping diabetes (blood sugar levels) under control
  • Sexual partners may also have to be treated for infections
  • Individuals with poor immune system have to be additionally careful as they are higher prone to infections

What is Prognosis of Urinary Tract Infection in Men? (Outcomes/Resolutions)

  • In general, the prognosis for Urinary Tract Infections in Men is excellent, if treatment is begun immediately on onset of symptoms
  • UTI symptoms typically disappear after 48 hours, however if the infection is localized to the kidneys, it make take up to a week to become better
  • In some rare cases without proper treatment, UTI can spread, causing fatal kidney damage and blood infections
  • In some cases, the condition resolves on its own without any treatment

Additional and Relevant Useful Information for Urinary Tract Infection in Men:

  • The most common cause of Urinary Tract Infection is E. coli bacterium, which can be found in the intestines
  • In some cases, antibiotics may increase one’s risk of developing UTI by promoting the growth of antibiotic-resistant bacteria.
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Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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