Urinary Tract Infection in Men

What is urinary tract infection in men?

Urinary tract infection (UTI) is an overgrowth of bacteria in the urethra, bladder, kidneys, or prostate gland. It can last a long time and, if left untreated, can cause permanent damage.

How does it occur?

Men rarely get urinary tract infections before age 50, but they are common in older men. Men older than 50 may have an infection but no symptoms.

Urinary tract infection usually happens in older men who have an enlarged prostate or when a catheter is used to drain the bladder. In younger men it may be associated with a kidney stone.

Bacteria usually cause a urinary tract infection by spreading on the skin from the rectum into the urethra and then to the bladder or kidneys. Bacteria can also spread from another part of the body through the bloodstream into the urinary system. Urinary tract infection is less common in men than in women because the male urethra is long, making it difficult for bacteria to spread to the bladder.

An enlarged prostate can cause a urinary tract infection by preventing the urine from draining out of the bladder completely. A less common cause is urethral stricture, which is when the urethra becomes narrower because of scar tissue forming inside it. (The urethra is the small tube in the penis through which urine passes.)

Bacteria can cause various types of infections in the urinary tract, including:

• prostatitis (infection of the prostate gland)
• urethritis (infection of the urethra), usually caused by sexually transmitted diseases
• cystitis (infection of the bladder), which is more common in elderly men
• pyelonephritis (infection of the kidney), which is rare in men but can be serious.

What are the symptoms?

The symptoms of urinary tract infection may include:

• pain and discomfort (burning) when urinating
• frequent and urgent need to urinate (especially at night)
• urethral discharge (a clear fluid or small amount of pus from the penis, more common with sexually transmitted diseases)
• abdominal pain
• fever
• blood in the urine
• back pain (prostatitis may cause low back pain while a kidney infection may cause mid-back pain).

How is it diagnosed?

Your health care provider will ask about your symptoms and medical history. Your provider will examine you, including an exam of the prostate with a rectal exam. Your provider may also order lab tests of the urine and discharge from the urethra and prostate gland.

For serious or repeated infections, you may need:

• an ultrasound, a technique that produces images of soft tissues and fluids
• IVP (intravenous pyelography), which gives x-ray pictures of the urinary system
• cystoscopy, a procedure in which your health care provider can see the urethra and bladder through a viewing tube inserted (after anesthesia) into the urethra.

How is it treated?

UTIs are treated with antibiotics. Your health care provider may also prescribe a drug for burning and discomfort.

For most UTIs, the symptoms go away within 24 hours after you begin treatment. Make sure you finish all of the antibiotic to prevent recurrence of the infection.

How can I take care of myself?

If you have the symptoms of a urinary tract infection:

• Follow the treatment prescribed by your health care provider.
• Maintain good personal cleanliness.
• Drink plenty of fluids.
• Empty your bladder completely when you urinate.
• Keep your follow-up appointment with your provider, if recommended.

For a fever:

• If you have a fever above 100°F (37.8°C), stay in bed. After your temperature has fallen below 100°F, become as active as you comfortably can.
• Ask your health care provider what you should take to control your fever.
• Keep a daily record of your temperature.

For cramps or abdominal pain, you may want to use a hot water bottle or an electric heating pad on a low setting. Never put anything hot directly on your skin. Put on a t-shirt and keep it between your skin and the hot water bottle or heating pad, or wrap the hot water bottle or heating pad in a washcloth, towel, or pillowcase. Check your skin to make sure there is no irritation or burning. Don't fall asleep while you are using the heating pad.

Call your health care provider if:

• You keep having symptoms.
• Your symptoms get worse.
• You develop new symptoms.

How can I avoid getting a urinary tract infection?

To help prevent a urinary tract infection:

• Drink lots of fluids every day.
• Empty your bladder often and completely.
• Practice safe sex. Always use latex or polyurethane condoms.
• Urinate after sex to flush out bacteria.
• If you are uncircumcised, wash under the foreskin each time you take a bath or shower.