This leaflet only deals with urine infections in men. It does not deal with sexually transmitted infections such as chlamydia which can affect the urethra and cause similar symptoms. See separate leaflets called ‘Cystitis in Women’, ‘Cystitis – Recurrent Infections in Women’ and ‘Urine Infection in Children’.
Understanding the urinary tract
There are two kidneys – one on each side of the abdomen. They make urine which drains down the ureters into the bladder. Urine is stored in the bladder and is passed out through the urethra from time to time when we go to the toilet.
What is a urine infection and what causes it?
Most urine infections are caused by bacteria (germs) that come from your own bowel. They cause no harm in your bowel, but can cause infection if they get into other parts of your body. Some bacteria lie around your anus (back passage) after you pass a stool (faeces). These bacteria sometimes travel to your urethra and into your bladder. Some bacteria thrive in urine and multiply quickly to cause infection.
A urine infection is often called a urinary tract infection (UTI) by doctors. When the infection is just in the bladder and urethra, this is called a lower UTI. If it travels up to affect one or both kidneys as well then it is called an upper UTI. This can be more serious than lower UTIs as the kidneys can become damaged by the infection.
How common are urine infections?
Urine infections are rare in men aged under 50. They become more common in older men. About 3 in 100 men in their 60s, and about 1 in 10 men in their 80s, will have a urine infection. (Urine infection is much more common in women. This is because, compared with men, their urethra is shorter and opens nearer the anus.)
Why do some men get urine infections?
In many cases the infection occurs for no apparent reason. There is no problem with the bladder, kidney, prostate, or defence (immune) system that can be identified. In some cases, an underlying problem can increase the risk of developing a urine infection. These include the following:
- An enlarged prostate may stop the bladder from emptying properly. Some urine may then pool in the bladder. Bacteria are more likely to multiply and cause infection in a stagnant pool of urine. (See separate leaflet called ‘Prostate Gland Enlargement’ which discusses prostate enlargement in more detail.)
- Bladder or kidney problems may lead to infections being more likely. For example, kidney stones or conditions that cause urine to pool and not drain properly. This includes having a urinary catheter.
- A poor immune system increases the risk of having any infection, including urine infections. For example, if you have AIDS or are taking chemotherapy.
What are the symptoms of a urine infection?
- Infection in the bladder (cystitis) usually causes pain when you pass urine, and you pass urine more frequently. You may also have pain in your lower abdomen, your urine may become cloudy, bloody or offensive-smelling and you may have a fever (high temperature).
- Infection in the kidneys may cause pain in a loin (the side of the abdomen over your kidney), a high fever, feeling sick, vomiting and feeling generally unwell.
In some elderly men, the only symptoms may be a recent onset of confusion or just feeling generally unwell, even without any actual urinary symptoms.
Are any tests needed?
A urine sample can confirm the diagnosis and identify the bacterium causing the infection. Further tests are not usually necessary if you are otherwise well and have a one-off infection. However, your doctor may advise tests of your kidney, prostate, or bladder if an underlying problem is suspected (such as an enlarged prostate or a kidney problem).
An underlying problem is more likely if the infection does not clear with an antibiotic, or if you have:
- Symptoms that suggest a kidney is infected (and not just the bladder).
- Recurring urine infections. For example, two or more in a three-month period.
- Had problems with your kidney in the past, such as kidney stones or a damaged kidney.
- Symptoms that suggest an obstruction to the flow of urine.
Tests may include a scan of your kidneys or bladder, and/or a look inside your bladder with a special telescope (cystoscopy).
What is the treatment for a urine infection in men?
- A course of an antibiotic will usually clear the infection quickly. You should see a doctor if your symptoms are not gone, or nearly gone, after a few days.
- Paracetamol or ibuprofen will usually ease any pain, discomfort, or fever.
- Have plenty to drink to help prevent dehydration if you have a fever and feel unwell.
What is the outlook?
The vast majority of men improve within a few days of starting treatment. See a doctor if you do not quickly improve. If your symptoms do not improve despite taking an antibiotic then you may need an alternative antibiotic. This is because some bacteria are resistant to some types of antibiotics. This can be identified from tests done on your urine sample.
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