2023-05-11 16:05:09
Urinary tract infections are much more common in women than in men. Indeed, it is considered that half of women will suffer from at least one symptomatic episode during their lifetime. For his part, the man would only be concerned in 2 out of 10 cases.
Professor Aurel Messas, urological surgeon in Paris: Men rarely encounter such a problem before the age of 50. A urinary tract infection can be a sign of the development of a prostate adenoma, inflammation of the prostate (prostatitis) or a narrowing of the urethral canal (urethral stricture).
L’male urinary tract infection is defined by the presence of pathogenic bacteria in the urine associated with certain characteristic symptoms. “It can be frequent and / or pressing urges to urinate, difficulty or pain in urination, pain in the lower abdomen or back and sometimes a feverish state”, underlines the expert .
The infection can affect any organ of the urinary tract: the prostate (prostatitis), the urethra (urethritis), the bladder (cystitis), the testicle (epididymitis) or the kidney (pyelonephritis, pyelitis). Usually, kidney damage is the result of bacteria migrating through the urinary tract.
What can cause a urinary tract infection in men?
Urinary tract infections result from the intrusion of pathogenic germs into the urinary tract. Generally, it is usually the bacterium Escherichia coli which normally resides in the digestive tract and enters the urinary meatus to infect the urinary tract. “It is also for this reason that urinary tract infections are more frequent in women since they have a urethra (which connects the bladder to the outside) shorter than that of men. The entry of bacteria into the bladder is therefore facilitated”, emphasizes Professor Aurel Messas.
In case of hospitalization, other germs are often responsible for a urinary tract infection. These are mostly Gram negative (klebsiella, proteus, pseudomonas, etc.) and more rarely Gram positive cocci.
Let us add that the infection of the urethra (urethritis) can also be the consequence of infections sexually transmitted to bacteria Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis or even at herpes virus.
Urinary tract infection in men: what risk factors?
In men, urinary tract infection is rare before the age of 50. It is favored by certain factors such as:
- A benign prostatic hyperplasia with obstruction, common in men over 50;
- Any other cause of acquired urinary tract obstruction like a prostate cancer, urethral stricture, urinary stones… ;
- Recent instrumental maneuvers (such as a permanent or transient probe in place) ;
- A recent surgery ;
- Structural abnormalities (such as bladder diverticulavesico-ureteral reflux, urethral valves, delayed bladder maturation, urethral duplications, etc.);
- Neurological disorders that interfere with normal urination (such as spinal cord injury) ;
- A fecal or urinary incontinence ;
- A immunosuppression ;
- And diabetes ;
- A recent urinary tract infectionof the history of recurrent urinary tract infections ;
- And recent antibiotic treatment.
Urinary pain, urges, fever… What are the symptoms of a urinary tract infection in men?
A urinary tract infection in men is manifested by:
- and frequent urination ;
- of the cravings to urinate;
- a difficulty draining completely his bladder;
- difficulty urinating;
- a feeling of burning while urinating;
- passing small amounts of urine;
- a cloudy, smelly urine ;
- of the pain during ejaculation ;
- a mild fever (less than 38°C). Fever should prompt vigilance. It may be a sign that the infection has moved up to the kidneys.
What are the possible complications of a urinary tract infection in men?
Without treatment, a urinary tract infection in men is likely to become complicated:
- of one pyelonephritis : Bacteria can travel up the ureter to reach the kidney. This risk is greater in the event of immunosuppression, diabetes, urinary stones or malformation of the urinary tract.
- a severe general infection (sepsis) ;
- of one prostate abscess ;
- of resistant relapses.
Urinary tract infection in men: is it serious?
Aurel Messas, urological surgeon: A urinary tract infection in men is a benign condition. However, when symptomatic, it is best to consult a doctor. Indeed, it can be the sign of another disease of the urogenital system such as a prostatic adenoma, a stenosis of the urethra, urinary stones or even a tumour.
Diagnosis: how to detect a urinary tract infection?
If in doubt, the use of a dipstick reagent is used to detect a urinary tract infection. It is frequently performed in medical practice. It makes it possible to diagnose cystitis by the detection in the urine of leukocytes (white blood cells) and/or nitrites. However, a negative test does not necessarily mean that there is no infection. The doctor can therefore prescribe a urine analysis (ECBU) to look for the causal germ.
How to prevent a urinary tract infection in men?
In order to avoid the occurrence of a urinary tract infection, it may be recommended to:
- drink at least 1.5 liters of water a day;
- not refraining from urinating;
- completely emptying the bladder at the time of urination;
- maintain good hygiene of the private parts by using a pH-neutral and unscented soap;
- urinate quickly following intercourse to partially eliminate germs;
- prefer cotton underwear;
- avoid tight pants, which can cause chafing on the genitals;
- drink cranberry juice.
If the episodes of cystitis are repeated several times a month or in a particular context, the doctor may prescribe a preventive antibiotic treatment.
Aurel Messas: If the urinary tract infection is the consequence of an adenoma of the prostate, it should be detected and treated (by taking Permixon® initially, or even alpha-blockers if necessary). In general, the best prevention involves the management of the factor favoring urinary tract infection.
Treatments: what antibiotics are prescribed for a urinary tract infection in men?
In a man, urinary tract infection is very often associated with inflammation of the prostate (prostatitis). The doctor waits if possible for the result of the ECBU before prescribing an antibiotic adapted to the causal bacterium. The antibiotics used are most often fluoroquinolones or a cephalosporin by injection. The duration of treatment varies from 2 to 4 weeks. It is advisable to respect the dosage and the duration prescribed by the doctor.
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