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Urinary tract infection – A guide for men

UTI in men, Urinary tract infection in men, UTI symptoms, Causes of UTI, UTI causes in Men
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Most of us are familiar with the term Urinary Tract Infection or UTI. It is a condition that is more commonly associated with women. While women are more prone to developing urinary tract infections, men can also develop UTIs. In this article, Dr Shalabh Aggrawal – leading urologist and andrologist in Gurgaon answers common questions about urinary tract infections or UTI in men, their symptoms, treatment and preventive measures. 

What is urinary tract infection or UTI? 

The male urinary system or urinary tract comprises of the kidneys, ureters, bladder, urethra and prostate gland. It is responsible for removing waste from the body and expelling it in the form of urine. Infections in any of these body parts are referred to as urinary tract infections. It is caused by bacteria that can get inside the urinary tract. 

If the infection is limited to the bladder and urethra (the lower part of the urinary tract), it is referred to as a lower UTI or cystitis. In more severe cases, the infection can spread to rest of the urinary tract, impacting the bladder and the kidneys. This is known as pyelonephritis. It is much more serious and can cause irreversible damage to the kidneys. 

Why are UTIs more common in women as compared to men?

The male urinary tract has a longer urethra as compared to women, which makes the passage of bacteria much more difficult. Hence, women are more prone to developing UTIs. The proximity of the anus to urethra also increases the risk of developing UTI in women. 

What causes UTI in men?

UTIs are caused by bacterial buildup in any part of the urinary tract. 

Infections in the urethra are called urethritis. It is most commonly caused due to sexually transmitted infections such as chlamydia or gonorrhoea. Other types of infections are less common as urine sterilises the urethra before it can get infected. 

Bladder infections are less common in men due to the length of their urethra. Infections in the prostate is called prostatitis. It can be due to bacteria from the bladder or bloodstream. In severe cases, kidneys can also get affected. 

What are the risk factors of UTI?

Some men may have a higher risk of developing urinary tract infections. The risk factors of UTI include:

  • Enlarged prostate: Benign prostatic hyperplasia or PH is a noncancerous increase in the size of the prostate gland. It can cause an obstruction in the flow of urine, increasing the risk of UTI. 
  • Practicing unsafe sex: Engaging in unprotected sexual intercourse with multiple partners can put you at the risk of contracting sexually transmitted infections such as gonorrhoea and chlamydia. These are some of the most common causes of UTI in men. Anal sex is also known to increase the risk of UTI as it exposes the urethra to bacteria. 
  • Kidney stones: Kidney stones are hard deposits of minerals and salts that are formed in the kidneys. While small stones do not cause any significant problem, larger stones or more number of stones can block the flow of urine and increase the risk of UTIs. 
  • Diabetes: Diabetes is a metabolic disorder that can result in several health conditions such as cardiovascular disease, nerve damage (neuropathy) etc. Diabetic patients are also more prone to developing infections including UTIs. 
  • Urethral Stricture: Urethral stricture refers to any abnormal narrowing of the urethra. Any blockage in urine flow is one of the most significant risk factors of UTIs. 
  • Use of urinary catheter: Urinary catheters are long thin tubes which are inserted into the bladder through the urethra in order to drain out urine. If care is not taken and hygiene is not maintained, it can expose the urethra to bacteria resulting in UTIs. 
  •  Urinary incontinence: This refers to the inability to control the urge to urinate. 
  • Age: Studies show that UTIs are less common in younger men and its incidence increases significantly in men ageing over 50 years. 
  • Obesity: Obesity and overweight are complex disorders associated with a number of health conditions including heart disease and diabetes. Patients who are obese or overweight are more prone to developing infections due to underlying complications and a compromised immune system. 
  • Lifestyle: Insufficient hydration can increase the risk of UTIs (less urine to sterilise the urinary tract) as well as kidney stones. It is important to maintain at least 2 litres of water intake in a day. This may need to be increased in summers. 

Also, read: Everything you need to know about prostate enlargement: Benign prostatic hyperplasia

What are UTI symptoms?

Signs and symptoms of UTI in men include:

  • Frequent need to urinate (especially if you have to wake up at night to urinate)
  • Strong urge to urinate 
  • Burning or discomfort during or right after urination 
  • Cloudy urine with a strong odour 
  • Haematuria or blood in the urine 
  • Difficulty in urinating
  • Feeling full even after urinating 
  • Low-grade fever

Diagnosing this condition in elderly patients may be challenging, especially if the patient is unable to express his/her issues due to age-related conditions such as dementia. In such cases, the patient may exhibit fever and confusion. 

How is a UTI diagnosed?

UTI is diagnosed on the basis of the patient’s medical history. The doctor will make a detailed note of all your symptoms and assess your risk of developing UTIs. Your urine sample will be tested for bacteria to confirm the diagnosis. If this is a recurrent problem, further tests may be done to identify the root cause. 

How is UTI treated?

Like any bacterial infection, UTI is also treated with antibiotics. The doctor may also recommend pain medication in case of severe discomfort. 

How can UTIs be prevented?

Some causes of UTI may not be preventable. But with a little care, the risk of developing it can be reduced significantly. Preventive measures for UTI include:

  • Hydrate yourself as required. Alcohol, caffeinated or sugary drinks are not suitable for hydration as they can irritate the bladder and exacerbate the symptoms. 
  • Urinate after sexual intercourse
  • Perform Kegel exercises to strengthen pelvic floor muscles to prevent issues like urinary incontinence. 
  • Do not delay urination if you feel the urge. 

When should you worry about a UTI?

Seek immediate medical attention if:

  • You are not able to urinate or are passing very little urine
  • You have a high fever with or without chills 
  • You have pain in your back or side that is increasing in intensity

UTIs are seldom a cause of worry. However, recurrent or severe UTIs do need medical attention at the earliest. You can meet Dr Shalabh Aggrawal at the CK Birla Hosptial Gurgaon for treatment of all urological problems. 

Also, read: Guide to identifying UTI and managing its risk