A urinary tract infection (UTI) is an inflammatory reaction of the urinary tract’s outer layer of tissue in response to infective microorganisms. Most commonly these organisms are bacteria, but rarely in immunocompromised individuals it can be fungal. UTIs are classified as complicated or uncomplicated. Complicated UTIs imply the presence of other factors that hamper the effectiveness of therapy. Some of these factors include, for example, structural or functional abnormalities of the urinary tract (i.e., urinary strictures, enlarged prostate, etc.,); indwelling catheters; or infections due to resistant organisms. In most cases, UTIs in men are considered complicated. 

Symptoms of UTIs include dysuria (painful or difficult urination), urinary frequency, urinary urgency, pain above the pubic bone area, or pain to the flank areas below the rib cage. In some cases, you may also experience fever and urethral discharge. Other signs you may also notice are voiding hesitancy, incomplete emptying, or nocturia (frequent night time urination). In addition, UTIs may also present with signs of prostatitis (prostate infection) such as rectal or perineal pain. 

Aging contributes to UTI occurrence in men and they rarely develop in men before age 50. UTIs are usually a result of infective organisms gaining access to the urinary tract and not being effectively eliminated. They then ascend up the tract via the urethra. They’re usually of an intestinal origin therefore E. Coli is usually the most common organism found in men and women. Men more frequently have UTIs that are also associated with other organisms such as Enterococcus, Staphylococcus, Pseudomonas, Candida, etc. 

Bacteria gain access to the urinary tract system multiple times a day. The body’s defensive mechanisms attempt to distort the balance between the severity of the invading organism and the ability of the body to defend itself. One of the defensive mechanisms is the strength of the urine flow. Studies in men show that impaired urine flow due to, for example, an enlarged prostate, urinary stones, or urethral strictures play a major factor in contributing to UTIs. And as we get older the incidence of these problems increases. Young men, although less frequently, also experience UTIs due to structural or functional abnormalities. Increased risk factors such as anal intercourse or intercourse with multiple partners with vaginas that are colonized with pathogenic organisms may also result in UTIs. 

There are multiple ways to evaluate for possible UTIs. Here at The Y Factor, we start by collecting a thorough history of your symptoms, we proceed with a physical exam, and we determine what tests are necessary. We may start preliminary treatment on your first visit or wait on results to target therapy more specifically. We also follow-up to make sure the problem was eliminated because we know that some bacteria can be very difficult to treat. And in some cases we evaluate further, especially when we see recurrence of UTIs.

If you experience any of the above signs or symptoms stop by and see one of our providers at one of our five locations across the Greater Houston area. We have the experience to properly assess and treat UTIs in men.  

References:

Abraham SN, Miao Y. The nature of immune responses to urinary tract infections. Nat Rev Immunol. 2015 Oct;15(10):655-63. 

Barnes RC, Roddy RF, Daifuku R, et al. Urinary-tract infection in sexually active homosexual men. Lancet. 1986 Jan 25;1(8474):171-3.

Griebling TL. Urologic diseases in America project: trends in resource use for urinary tract infections in men. J Urol. 2005 Apr;173(4):1288-94.

Hummers-Pradier E, Kochen MM. Urinary tract infections in adult general practice patients. Br J Gen Pract. 2002 Sep;52(482):752-61.

Krieger JN, Ross SO, Simonsen JM. Urinary tract infections in healthy university men. J Urol. 1993 May;149(5):1046-8.

Ruben FL, Dearwater SR, Norden CW, et al. Clinical infections in the noninstitutionalized geriatric age group: methods utilized and incidence of infections. The Pittsburgh Good Health Study. Am J Epidemiol. 1995 Jan 15;141(2):145-57.

Schaeffer AJ. Infections of the urinary tract. In: Walsh PC, ed. Campbells’ urology, 8th ed. Philadelphia, PA: Saunders; 2002.

Stamm WE, Hooton TM. Management of urinary tract infections in adults. N Engl J Med. 1993 Oct 28;329(18):1328-34.

Benancio Martinez Jr is a certified Family Nurse Practitioner and one of the newest integral parts of the Y Factor team. Benancio is the medical provider in charge of the Northpointe location and brings to the Y Factor 10 years of nursing experience obtained through the emergency departments of the VA and Kingwood medical centers, as well as clinical experience in family practice, hematology, and oncology.