How are male and female UTIs different?

While men are much less likely to get UTIs, the symptoms and treatment are very similar

Are urinary tract infections (UTIs) the same in women and men?

UTIs are infections that typically occur in the urethra, the bladder and — in rare and but potentially fatal cases — in the kidneys. UTIs are among the top three most common infections in the world and over 90% of all UTIs happen to women. This has simple anatomical reasons: it’s much easier for bacteria to enter the vagina and move up the urinary tract. In many cases the troublemaking bacteria come from the woman’s own digestive tract. They go from the anus across the perineum (more commonly known as the “dam”) into the vagina. Another common cause of infection is sex, where bacteria enter the vagina with the partner’s penis.

Male anatomy obviously features a much longer distance between the anus and the urethra entry point on the tip of the penis. Moreover, the urethra itself, i.e., the distance to the bladder, is much longer in men. For these reasons, men are very unlikely to catch a UTI by hygiene accidents or even through sex (unprotected anal sex in rare cases can lead to bacterial infection of the male urethra though).

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What are the causes and symptoms of male UTIs?

Male UTIs are most common among men in their 60s and older. One major risk factor is prostatic hyperplasia (prostate gland enlargement), as the enlarged prostate sometimes can pressure the connection point of urethra and bladder, which in turn prevents the bladder from draining all urine. There’s always a “bottom” of urine left the bladder, which can serve as a habitat for bacteria that normally would be flushed out and away each time you pee. This accumulation of bacteria in the long run can trigger a bladder infection.

Other issues that can trigger or worsen the likelihood of getting a prostate-related UTI are: 

  • Chronic dehydration (your bladder doesn’t get flushed often enough)
  • Recent surgery/medical interventions in the urinary tract
  • Diabetes (because bacteria feed on urine polysaccharides) 
  • Fecal incontinence
  • Unprotected anal sex
  • Lack of penis-related hygiene (especially when a man is not circumcised)  

   
The most common symptoms of male UTIs include:

  • Burning pain during urination
  • Urge to urinate frequently
  • Dull, persistent abdominal pain 
  • Dark/cloudy color of urine
  • Blood visible in urine 

If you notice any of these symptoms and they persist for more than 48 hours it’s recommended to seek medical help to check whether you have a UTI. If left untreated, a UTI can cause a kidney infection, which sometimes can be fatal. So, UTIs are always to be taken seriously.

A simple urine test can figure out whether your illness is the work of bacteria and it will also determine which bacteria exactly caused the UTI (in most cases the culprit is the E. coli bacteria). The doctor may also examine your prostate to see whether it is enlarged or otherwise inhibits the proper functioning of your bladder.   

How are male UTIs treated?

Once the urine sample test has identified which bacteria strain is behind your UTI, your doctor will prescribe you one of about a dozen antibiotics that are used for treating UTI. The most common choices for this antibiotics treatment are:

  • Cipro (ciprofloxaxin) 
  • Macrobid (nitrofurantoin) 
  • Keflex (cephalexin) 
  • Monurol (fosfomycyin) 

Unfortunately, E.coli in recent decades have become more and more resistant to mainstream antibiotics. This is why your doctor first has to test your urine before an antibiotic can be prescribed to you. If after 2-3 days of treatment you haven’t felt any improvement yet, see your doctor again. It might be that the current medication isn’t useful and you’ll need to try another antibiotic. 

There are a few things you can do to support your recovery. Most importantly, make sure to always drink plenty of water. The more you have to pee, the more often your bladder and urethra are getting flushed and any bad bacteria taken out. For about two weeks, abstain from alcohol, coffee, caffeine in general, and all citric things like citrus fruits and juices, as these can unnecessarily irritate your bladder and disturb the healing process. Dress warm and dry.

Male UTIs very rarely turn into chronic conditions, but if they do — which would mean you have a UTI 3-4 times a year — the underlying cause needs to be addressed. This often could be some prostate issue that may require surgery or long-term medication, and it needs to be evaluated by an experienced urologist. 

  
References

  1. den Heijer, Casper DJ, et al. “Diagnostic Approach to Urinary Tract Infections in Male General Practice Patients: A National Surveillance Study.” The British Journal of General Practice, vol. 62, no. 604, 1 Nov. 2012, pp. e780–e786, www.ncbi.nlm.nih.gov/pmc/articles/PMC3481519/, 10.3399/bjgp12X658313. Accessed 21 Feb. 2020.
  2. Pujades-Rodriguez, Mar, et al. “Lower Urinary Tract Infections: Management, Outcomes and Risk Factors for Antibiotic Re-Prescription in Primary Care.” EClinicalMedicine, vol. 14, Sept. 2019, pp. 23–31, www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30120-8/fulltext, 10.1016/j.eclinm.2019.07.012. Accessed 21 Feb. 2020.
  3. “Urinary Tract Infection (UTI) in Males: Practice Essentials, Background, Anatomy.” EMedicine, 2 Jan. 2020, emedicine.medscape.com/article/231574-overview. Accessed 21 Feb. 2020.


 

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