Urinary Infections in Men
Section snippets
Pyelonephritis
Pyelonephritis refers to inflammation of the kidney and is considered an upper urinary tract infection. Acute pyelonephritis is a clinical diagnosis based on the classic presentation of fever (>100°F); chills; and flank or costovertebral angle pain. These signs and symptoms may be associated with urinary urgency, frequency, and dysuria. However, patients do not always present with classic symptoms. Gastrointestinal symptoms, such as nausea and emesis, may be present. Patients often have a
Uncomplicated Cystitis
Uncomplicated cystitis is uncommon in men. It is far more common in women. By definition, any bladder infection in a man is considered a complicated UTI. However, young men can experience acute uncomplicated cystitis without any underlying structural or functional abnormality. E coli are the most common causative organism, as it is in women.
Clinical presentation varies significantly and can include suprapubic or perineal pain, dysuria, frequency, urgency, and hematuria. In young sexually active
Orchitis and epididymitis
Orchitis and epididymitis can be difficult clinical conditions to recognize, properly diagnose, and treat. By definition, orchitis and epididymitis refer to inflammation of the testis and epididymis, respectively. The source of inflammation could be bacterial, viral, fungal, traumatic, autoimmune, or idiopathic. The clinical presentation of men can range from acute and severe illness to chronic pain. Infectious orchitis may coexist with epididymitis. Bacterial epididymo-orchitis is most
Chlamydia
Chlamydia is the most common bacterial STD in the United States and the most common cause of epididymitis in young men. It is also a common cause of nongonoccocal urethritis. Symptoms typically include dysuria and mucopurulent urethral discharge. Some infections may be asymptomatic.
Diagnosis typically involves obtaining an intraurethral swab for analysis. Swab culture, nucleic acid amplification tests (NAAT), and nucleic acid hybridization tests (NAHT) are used to diagnose C trachomatis. NAAT
Summary
Infections in the genitourinary tract in men can range from acute, life-threatening illnesses to chronic conditions. Clinical presentation, previous history, physical examination findings, and laboratory studies can be used to generate possible diagnoses. Appropriate use of imaging can further aid in identifying potential causes. In the presence of complicating factors or evidence of obstruction of the urinary tract, urologic consultation is recommended for further evaluation and management.
References (9)
Urologic Diseases in America Project: trends in resource use for urinary tract infections in men
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(2005)Urologic Diseases in America Project: trends in resource use for urinary tract infections in women
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Renal and perirenal abscesses in patients with otherwise anatomically normal urinary tracts
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Is percutaneous drainage the new gold standard in the management of emphysematous pyelonephritis? Evidence from a systematic review
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Cited by (22)
Comparison of the clinical characteristics of community-acquired acute pyelonephritis between male and female patients
2021, Journal of Infection and ChemotherapyCitation Excerpt :In Italy, maintenance of indwelling urinary catheters was seen in 38.1% of elderly people registered in home care programs [25]. In addition to BPH and the maintenance of indwelling urinary catheters, history of urinary tract surgery and recent medical procedures, including cystoscopy, transrectal prostate biopsy, and urethral stricture, may also affect the occurrence of UTIs [21,26]. Our study shows that the representative clinical symptoms of APN, such as CVA tenderness and vomiting, were relatively less apparent in male patients, whereas hematuria and azotemia were more common in male patients than in female patients.
Overview on the clinical presentation and indications: Part B
2021, Herbal Medicine in AndrologyAcute Illness in the Athlete
2019, Clinics in Sports MedicineEscherichia coli sequence type 73 as a cause of community acquired urinary tract infection in men and women in Rio de Janeiro, Brazil
2017, Diagnostic Microbiology and Infectious DiseaseCitation Excerpt :ST95 is associated with neonatal meningitis (Alkeskas et al. 2015), and ST73, also a virulent clone, has been described with plasmid-encoded CTX-M genes (Alhashash et al. 2016). UTI in men is uncommon, except when abnormalities or invasive procedures in the urinary tract are present (Lipsky 1989; Raynor and Carson 2011). Nevertheless, isolates of the more pathogenic UPEC phylogenetic group B2 are able to cause infection in men without urinary abnormalities (Johnson et al. 2005).
Infectious disease
2011, Clinics in Sports MedicineCitation Excerpt :A short, 3-day course of treatment is favored for females with uncomplicated infection.48 In addition to requiring both urinalysis and urine culture for workup of cystitis, men require a longer 7-day course of therapy.49 A few small studies have suggested that drinking cranberry juice may decrease the incidence of UTIs.
Biosensor diagnosis of urinary tract infections: A path to better treatment?
2011, Trends in Pharmacological SciencesCitation Excerpt :Urinary tract infection (UTI) is among the most common bacterial infections and poses a significant healthcare burden [1]. Almost 50% of the global population will experience a UTI at some point in their lives, and those who suffer from recurrent, complicated UTI can have more than three episodes of infection per year [2–6]. As the most common healthcare-associated infection, UTI accounts for more than 30% of infections reported by acute-care hospitals [7–9].
The authors have nothing to disclose and report no conflicts of interest.