Urinary Tract Infections in Men
Urinary tract infections (UTI) indicate inflammation anywhere within the urinary system. In men it can occur in the kidneys, bladder, prostate or urethra. UTIs are more common in women, but they also affect men, especially in men more than 50 years of age. If UTIs are left untreated, they can result in spread of the infection and cause permanent kidney damage.
Prostate infections are the most common infections in men. Acute prostatitis occurs when bacteria lodge in the prostate and produce symptoms such as fever, chills, difficulty with urination, back pain, or blood in the urine. The treatment is antibiotics for 7-10 days.
Chronic bacterial prostatitis is similar to the acute infection but without the fever or chills. These men also may have painful ejaculation and low back pain. The treatment is also antibiotics but often the medication has to be taken several weeks or even months. Men with chronic prostatitis also may be advised to avoid caffeine, alcohol, spicy foods and chocolate.
In many men, prostatitis occurs without identifying any bacterial culprit. This is called abacterial prostatitis or prostadynia. The symptoms are the same a chronic bacterial prostatitis. The pain and vague urinary problems are a result of spasm or congestion of the pelvic floor muscles or congestion within the prostate gland itself. In most instances, antibiotics are not helpful in treating this condition. The treatment consists of anti-inflammatory medication, muscle relaxants or alpha blockers.
UTIs can also occur after instruments are inserted into the urinary tract such as catheters or tubes as they may transport bacteria from outside of the body to the bladder and prostate gland.
Previous infections such as some of the sexually transmitted diseases may leave scars in the urethra and cause it narrow or stricture. This disrupts the normal flow of urine and may result in infections of the urinary tract.
The diagnosis of a UTI is made with a history, physical examination and a urinalysis and a urine culture. The latter is a test that identifies the offending bacterial and the best antibiotic to treat the infection. Occasionally, additional tests such as a CAT scan and cystoscopy are required.
General measures for treating UTIs in men include increasing the consumption of water. Alkaline substances, such as citrates, taken in water might improve symptoms. By making the urine more alkaline, they make the environment more hostile to bacterial growth and improve the results of antibiotic therapy.
Antibiotics are the mainstay of treatment. Trimethoprim (Trimpex) is currently the first choice for lower UTI , because it is cost-effective, well tolerated and works in 80 per cent of infections. Cephalosporins and quinolones are reserved as second line drugs in patients with lower UTI, but are first choices in patients with signs of kidney infection.
You can prevent UTIs by drinking lots of fluids every day, empty your bladder often and completely, practice safe sex, always use latex or polyurethane condoms, urinate after sex to flush out bacteria, if you are uncircumcised, and wash under the foreskin each time you take a bath or shower.
Although UTIs are aggravating and affect the quality of life of those with the condition, they do not cause prostate cancer, benign enlargement of the prostate, or perhaps more importantly, impotence.
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