UTI in Men
Compared to women, Urinary tract infections in men are uncommon. This is due to the longer length of urethra and dryness of the urethral opening (called meatus). Prostatic secretions have antibacterial properties and hence these may prevent urinary tract infections. Non-circumcision is also a risk factor for UTI. The commonest organism is E coli.
UTI is common if there is an anatomic abnormality, obstruction, instrumentation of the urinary tract or prior surgery. In men after 50 years of age, prostatic enlargement can make a person prone to UTI.
As in the case of women, the infections of the urinary tract may involve urethra, bladder or kidney or a combination of all of them. In addition, the prostate gland can also be infected.
Symptoms are similar to those in women. However, infections of the prostate can give rise to fever and pain in the perineum (the area between anus and scrotum).
Diagnosis of UTI is by its symptoms, physical examination and laboratory tests. The prostate is tender on digital examination of the rectum.
Urine shows increased pus cells, nitrate test is positive and midstream urine culture shows >105 bacteria /ml of urine. In case of recurrence, if no cause is apparent, tests are done to ascertain anatomical details of the urinary tract.
Treatment is started empirically. In case of no or poor response in 2-3 days, the drugs are modified based on culture results.