Urinary tract infections in men
Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- dysuria
- urgency
- frequency
- suprapubic pain
- costovertebral angle pain
Other diagnostic factors
- hesitancy
- nocturia
- enlarged prostate
- tender prostate
- rectal/perineal pain
- fever/rigors
- urethral discharge
Risk factors
- benign prostatic hypertrophy
- urinary tract stones
- urological surgery, instrumentation
- urethral strictures
- age >50
- previous UTI
- catheterisation
- anal sex
- vaginal sex
- recent hospitalisation
- uncircumcised
Diagnostic investigations
1st investigations to order
- dipstick urinalysis
- urine microscopy
- urine culture
- Gram stain
Investigations to consider
- CT renal tract
- ultrasound
- plain x-ray kidneys, ureters, and bladder (KUB)
- intravenous urogram (IVU)
Treatment algorithm
asymptomatic bacteriuria before urological procedure
not severe and tolerating oral therapy
severe or not tolerating oral therapy
Contributors
Authors
Timothy J. Benton, MD
Regional Chairman
Residency Program Director
Associate Professor
Department of Family and Community Medicine
Texas Tech University Health Sciences Center
Permian Basin Campus
Odessa
TX
Disclosures
TJB declares that he has no competing interests.
Peer reviewers
Catherine DuBeau, MD
Professor of Medicine
Dartmouth Hitchcock Medical Center
Lebanon
NH
Disclosures
CD is a member of the American Geriatrics Society Revision Panel for the Beers criteria for potentially inappropriate medications in older persons; planning committee, speaker, and manuscript co-author for the American Urogynecological Association State of the Science on OAB and cognition; and co-investigator, RELIEF trial (botulinum toxin for refractory overactive bladder in older women, funded by PCORI.
Richard Viken, MD
Professor of Family Medicine and Chairman of the Department of Family Medicine
University of Texas Health Sciences Center
Tyler
TX
Disclosures
RV declares that he has no competing interests.
Robert Pickard, MD, FRCS (Urol)
Professor of Urology
Institute of Cellular Medicine
Newcastle University
Newcastle upon Tyne
UK
Disclosures
RP declares that he has no competing interests.
Differentials
- Benign prostatic hypertrophy (BPH)
- Prostatitis
- Pyelonephritis
More DifferentialsGuidelines
- Guidelines on urological infections
- Urinary tract infection: diagnosis guide for primary care
More Guidelines
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