Urinary tract infections (UTIs) in men

Urinary tract infections (UTIs) are common, especially in those with female anatomy due to the shorter urethra. Those with male anatomy tend to have a lower incidence because of their urethra is longer.

UTIs are relatively uncommon in individuals with male anatomy who are under the age of 50. However, the incidence of these infections tends to increase with age, becoming more prevalent in older individuals.

The exact reasons for the occurrence of these infections are not entirely clear, but it is believed that they often result from bacteria from the bowel entering the urinary tract. This can happen, for example, during sexual activity or if one wipes from back to front.

Claire Harris, registered nurse in our 24/7 Health Support Team, for members, explores the possible causes and treatment options for UTIs, as well as how to help prevent them.

Causes of a UTI?

There are several factors that can contribute to the development of a UTI. These may include anatomical abnormalities, or the presence of certain medical conditions that affect the urinary system.

As previously mentioned, sexual activity and hygiene practices can also play a role in increasing the risk of infection. Other potential causes include:

• a weakened immune system,
• an enlarged prostate gland,
• the presence of a urinary catheter,
• bladder conditions that hinder complete emptying of the bladder,¹
• diabetes.²

Types of UTIs

UTIs can be classified into two main types:

• Lower UTI: These affect the bladder and urethra (the tube that carries urine out of the body).
• Upper UTI: These occur when the infection travels up to affect one or both kidneys and the connecting tubes.³

Lower UTIs can sometimes spread to the kidneys, leading to more severe symptoms such as back pain and fever. In such cases, it is essential to seek urgent medical attention.

Symptoms of a UTI

Common symptoms of a lower UTI may include:

• Stinging or burning sensation during urination.
• Increased frequency and urgency of urination.
• Incomplete bladder emptying.
• Sharp pain in the lower abdomen.
• Cloudy or foul-smelling urine, which may also contain blood.

In some elderly individuals, the only symptoms may be a recent onset of confusion or just feeling generally unwell or unsteady, even without any actual urinary symptoms.⁴

While lower UTIs are generally not serious, it is important to consult a doctor if symptoms worsen, persist after a few days, or if you frequently experience UTIs.

If you have recurrent urinary infections (defined as two or more infections in six months or three or more infections in a year), your GP may refer you to a urologist for further investigation.

Treatment options for UTIs

A GP typically prescribes a short course of antibiotics to halt the progression of the infection and may send a urine sample to a laboratory for analysis. Depending on the results, your GP may adjust your antibiotic prescription.

Over-the-counter medications are available at pharmacies to help alleviate the symptoms of UTIs, and non-prescription painkillers may be taken if it is safe for you to do so.

Symptoms should begin to improve within three to five days; however, it is crucial to complete the entire course of prescribed medication and stay well-hydrated.

If symptoms persist, worsen, or return, you should contact your doctor.

How to help prevent UTIs

To help prevent UTIs, consider the following self-help tips:

• Stay well-hydrated by drinking two to three litres of water daily.
• Urinate regularly and ensure complete bladder emptying.
• Urinate soon after sexual intercourse.
• Maintain good personal hygiene and avoid perfumed bath products or gels.
• Wipe from front to back after using the toilet.
• Wear cotton underwear and avoid tight-fitting clothing.
• Consider alternative contraception methods instead of spermicide-coated condoms or diaphragms.

Sometimes preventive antibiotics are recommended to prevent recurrent UTIs. These are usually given daily at a low dose for several months. The antibiotics are often rotated to prevent antibiotic resistance from occurring. The antibiotics used include nitrofurantoin, trimethoprim, cefalexin and amoxicillin.⁵

If you suspect you have a UTI and experience symptoms that do not resolve, consult your GP for further advice.

References

1. What causes a urine infection in men? – Patient Info
2. Urinary tract infections – Diabetes.co.uk
3. Urine infection in men – Patient Info
4. Symptoms of a urine infection in men – Patient Info
5. Preventing a urine infection in men – Patient Info