Urinary tract infection (UTI) in men rarely occurs before 50 years of age.
Often associated with abnormal structure or function of the urinary tract (complicated UTI).
Catheter-associated UTI is the most common cause of nosocomial infection.
Imaging of the urinary tract is recommended for men with persistent haematuria, voiding dysfunction without a clearly identifiable cause such as benign prostatic hyperplasia (BPH), failure of initial therapy, or signs of upper tract infection.
Treatment with a fluoroquinolone antibiotic is generally appropriate in men as they are likely to have a UTI classified as complicated. Asymptomatic bacteriuria does not require treatment except before urological procedures.
UTI is an inflammatory reaction of the urinary tract epithelium in response to pathogenic micro-organisms, most commonly bacteria.
History and exam
Key diagnostic factors
- presence of risk factors
- suprapubic pain
- costovertebral angle pain
Other diagnostic factors
- enlarged prostate
- tender prostate
- rectal/perineal pain
- urethral discharge
- benign prostatic hypertrophy
- urinary tract stones
- urological surgery, instrumentation
- urethral strictures
- age >50
- previous UTI
- anal sex
- vaginal sex
- recent hospitalisation
1st investigations to order
- dipstick urinalysis
- urine microscopy
- urine culture
- Gram stain
Investigations to consider
- CT renal tract
- plain x-ray kidneys, ureters, and bladder (KUB)
- intravenous urogram (IVU)
asymptomatic bacteriuria before urological procedure
not severe and tolerating oral therapy
severe or not tolerating oral therapy
- Benign prostatic hypertrophy (BPH)
- Guidelines on urological infections
- Urinary tract infection: diagnosis guide for primary care
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