Urinary Tract Infections in Men

Although men can get cystitis, more common is prostatitis — inflammation of the prostate gland which affects half of men and is sometimes called ‘male cystitis’.

Symptoms include pain when urinating, frequent urination and the urgent need to pass water, cloudiness or blood in the urine and pain in the abdomen, groin or lower back. Sometimes it causes sexual problems such as low libido and erectile dysfunction.

Prostatitis is diagnosed by ruling out other conditions that could be causing symptoms, such as cancer. A doctor may give you a physical examination, order urine and blood tests and sometimes a scan of your urinary tract and prostate to check for underlying issues.

In about 10 per cent of cases it can be down to bacterial infection. This type comes on quickly and can cause a high fever, chills, muscle aches and joint pain, as well as pain in the perineum and around the base of the penis and difficulty passing urine.

In severe cases, a man may need antibiotics for four to six weeks, or even longer.

The quinolone class of antibiotics, Cipro and Levaquin, are most effective at treating infections of the prostate gland.

The most common type of prostatitis is not caused by bacteria at all. Chronic prostatitis without bacterial infection, also known as chronic pelvic pain syndrome (CPPS) is diagnosed when men complain of pain around their back passage and discomfort passing urine — yet tests reveal no bacteria in the urine.

Chronic pelvic pain syndrome may be caused by scar tissue left after a bacterial infection has resolved — this can stimulate nerves which continue to send signals to the brain that there is inflammation.

New evidence suggests it may be down to chronic spasms in the pelvic floor. Treatment for CPPS includes alpha blockers, which can help by relaxing the bladder neck and the muscle fibers within the prostate.

Some patients seem to benefit from Cialis, used to treat erectile dysfunction, in doses of 5 mg per day which can also improve sexual function. Botox injections into the prostate have been used to reduce muscle spasms. And physical therapy to relax the pelvic floor muscles has been shown to help.

Frequent sex and masturbation are sometimes cited as ways to reduce the pain of prostatitis, but that this is probably a myth.

For some men, surgical removal of the prostate is worth considering only as a last resort.

Bottom Line: Urinary tract infections are common in middle aged and older men.  Most of the men with UTIs can be successful treated with antibiotics.

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