What is urinary tract infection in men?

Urinary tract infection is an overgrowth of bacteria in the urethra (the small tube within the penis that drains urine from the bladder), bladder, or kidneys. It can last a long time and, if left untreated, can cause permanent damage.

How does it occur?

The infection rarely occurs before age 50. Men older than 50 may have an infection but no symptoms. Urinary tract infection is common in elderly and institutionalized men.

It is usually associated with an enlarged prostate or use of a catheter to drain the bladder. It may also occur in younger men, especially if a kidney stone is also present.

An enlarged prostate can cause a urinary tract infection by preventing the urine from draining completely. A less common cause is urethral stricture, which is when the urethra becomes narrower because of scar tissue forming inside it.

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. Urinary tract infection is less common in men than in women because in men the urethra is long, making it difficult for bacteria to spread. Bacteria can also spread from another part of the body through the bloodstream. Bacteria can cause various disorders, including:

• prostatitis (inflammation of the prostate gland)

• urethritis (inflammation of the urethra), usually caused by sexually transmitted diseases

• pyelonephritis (infection of the kidney), which is rare in men but can be serious

• cystitis (infection of the bladder), which is more common in elderly men.

What are the symptoms?

The symptoms of urinary tract infection 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 (low back pain can be associated with prostatitis and mid-back pain with pyelonephritis).

How is it diagnosed?

The doctor will determine whether you have a urinary tract infection by taking your medical history and examining you, including examining the prostate through a rectal exam. The doctor may also order lab tests of the urine and discharge from the urethra and prostate gland.

Unless the doctor knows the cause of your infection, he or she may need to follow all urinary tract infections with further studies such as:

• 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 the doctor can see the urethra and bladder through a viewing tube inserted after anesthesia into the urethra.

How is it treated?

Urinary tract infection is treated with antibiotics. The doctor may also prescribe a drug for burning and discomfort.

For most urinary tract infections, the symptoms go away within 24 hours after treatment begins. However, it is especially important to finish all antibiotics to prevent recurrence of urinary tract infection.

How can I take care of myself?

If you have the symptoms of a urinary tract infection, follow the treatment prescribed by your doctor. In addition, follow these guidelines:

• Maintain good personal cleanliness.

• Drink plenty of fluids.

• Empty your bladder completely when you urinate.

For a fever:

• If you have a fever above 100 degrees F (37.8 degrees C), stay in bed. After your temperature has fallen below 100 degrees F (37.8 degrees C), become as active as you comfortably can.

• Ask your doctor 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. Either 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 periodically to make sure there is no irritation or burning.

If symptoms persist or change for the worse, or if you develop new symptoms, call your doctor.

How can I avoid getting a urinary tract infection?

To prevent recurrence of a urinary tract infection, be sure to take the full course of treatment your doctor prescribes. In addition:

• Drink plenty of fluids daily.

• Empty your bladder often and completely.

• Choose sexual partners wisely and always use condoms.

• Urinate after sex to flush out bacteria.

• If you are uncircumcised, maintain good foreskin hygiene.