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 hematuria, 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 urologic procedures.
UTI is an inflammatory reaction of the urinary tract epithelium in response to pathogenic microorganisms, most commonly bacteria.
History and exam
Key diagnostic factors
- suprapubic pain
- costovertebral angle pain
Other diagnostic factors
- enlarged prostate
- tender prostate
- rectal/perineal pain
- urethral discharge
- benign prostatic hypertrophy
- urinary tract stones
- urologic surgery, instrumentation
- urethral strictures
- age >50
- previous UTI
- anal sex
- vaginal sex
- recent hospitalization
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 urologic procedure
not severe and tolerating oral therapy
severe or not tolerating oral therapy
- Benign prostatic hypertrophy (BPH)
- Guidelines on urological infections
- Diagnosis of urinary tract infections: quick reference guide for primary care
Urinary tract infections in menMore Patient leaflets
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