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For males, the upper urinary system is made up of the kidneys and ureters. While the lower urinary system is made up of the bladder, prostate and urethra.
The 2 biggest differences of the male urinary system from the females’ are
- In males, there is a walnut sized organ called the prostate just below the bladder and
- The urethra that brings the urine from the bladder out of the body is much longer in the male due to the presence of the penis.
It is, in fact, uncommon for younger men to have a UTI, simply because the urethra is longer and that is a form of natural protection against bacteria climbing up the urinary system. It is estimated that women are at a 30 times higher risk of getting UTI than men.
Causes of UTI in males
Some of the causes of male urinary tract infection includes :
- Prostate enlargement ( either by Benign prostate hyperplasia or prostate cancer )
- Urethra tightening - that could be due to previous surgeries, scopes or infections
- Recent instrumentation - meaning medical instruments has been inserted into the urinary tract such as a urine catheter or a scope
- Urinary stones
- Sexually transmitted infection such as chlamydia or gonorrhoea
- Poor immune system due to diabetes or HIV
Statistically, the number 1 cause of urinary tract infection in men above 50 is benign prostate hyperplasia whereas the top cause of Urinary tract infection in men below 50 is usually sexually transmitted disease.
Symptoms of UTI in males
Men with lower urinary tract infection may present with symptoms of
- Burning sensation during urination
- Increased urgency to urinate
- Frequent sensation of needing to pass urine
- Cloudy, smelly urine
- Blood in urine
- Pain in the lower abdominal area
- Penile discharge
And if this infection spreads upwards to the urinary system, it can lead to an upper urinary tract infection.
The patient can have additional symptoms of
- Fever and chills
- Pain in the upper back and sides
- Nausea and vomiting
- Extreme feeling of unwell.
Diagnosis and Treatment
Male Urinary tract infection must be properly investigated and treated. In addition, the underlying cause of the infection must be sought out.
Some of the initial physical examinations and investigations includes :
- A digital prostate examination : based on the feel and size of the prostate, we can make an educated guess if this patient has prostate infection or if the prostate is enlarged. In certain situations, doctors may even be able to detect a prostate cancer.
- Urine dipstick : these are very convenient tests that can be done in the clinic with results obtained within 5-10 minutes. This allows doctors to confirm the diagnosis of urinary tract infection on the spot.
- Urine Formed Element Microscopic Examination (UFEME) and urine cultures. These tests are done and sent to the laboratory for visual confirmation of the urine infection and for identification of the bacteria that is causing the infection.
- Urine PCR ( polymerase chain reaction ) to detect sexually transmitted bacteria like chlamydia and gonorrhoea.
These bacterias cannot be grown on urine cultures and a PCR test is needed to identify them.
Following which, patient will be placed on the appropriate antibiotics before refering them to Urologists for further investigations.
As you have learnt - urinary tract infection in men are uncommon and can be complicated. If you are a guy and you do have symptoms of UTI, please see your doctor as soon as possible to have it investigated and treated. Otherwise, complications may likely happen
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)