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Urinary tract infections in men

Última revisão: 19 Sep 2025
Última atualização: 10 Sep 2025
10 Sep 2025

US and European guidance recommends updated classifications for UTI in men

​Updated guidelines for the classification of UTI have been published in 2025 by the Infectious Diseases Society of America (IDSA) and the European Association of Urology (EAU) to reflect a shift from the traditional “uncomplicated” and “complicated” to one that no longer automatically defines UTI in men as complicated.

The IDSA now defines all uncomplicated UTIs, in both men and women, as an infection confined to the bladder, while all complicated UTIs in both sexes are those that extend beyond the bladder; thus treating male UTIs based on the extent of infection, rather than labeling all as complicated. The IDSA felt this update was needed to better align with clinical practice and to become more congruent with the available data on male UTI. The prior version of the IDSA UTI guidelines omitted UTI in men from their recommendations but given the aging US population it was recognised that UTI in men is a salient issue, and that evidence to support guidance for this population has improved.

The EAU has also moved away from the terms “uncomplicated” or “complicated” in its most recent guidance, and now proposes classification of UTIs in both sexes as either “localized” (cystitis) or “systemic” (involving fever or other systemic signs of infection).

Fonte original da atualização

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • dysuria
  • urgency
  • frequency
  • suprapubic pain
  • costovertebral angle pain
Detalhes completos

Outros fatores diagnósticos

  • hesitancy
  • nocturia
  • tender prostate
  • rectal/perineal pain
  • fever/rigors
  • urethral discharge
Detalhes completos

Fatores de risco

  • benign prostatic hypertrophy
  • bladder stones
  • urologic surgery, instrumentation
  • urethral strictures
  • age >50 years
  • previous urinary tract infection (UTI)
  • catheterization
  • anal sex
  • vaginal sex
  • uncircumcised
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • dipstick urinalysis (U/A)
  • urine microscopy
  • urine culture
  • Gram stain
Detalhes completos

Investigações a serem consideradas

  • CT renal tract
  • ultrasound
Detalhes completos

Algoritmo de tratamento

Inicial

asymptomatic bacteriuria before urologic procedure

AGUDA

not severe and tolerating oral therapy

severe or not tolerating oral therapy

Colaboradores

Autores

Rashmi S. Licht, MD

Clinical Associate Professor

Department of Surgery (Urology)

Brown University

Providence

RI

Declarações

RSL declares that she has no competing interests.

Agradecimentos

Dr Rashmi S. Licht would like to gratefully acknowledge Dr Timothy J. Benton, previous contributor to this topic.

Declarações

TJB declares that he has no competing interests.

Revisores

Catherine DuBeau, MD

Professor of Medicine

Dartmouth Hitchcock Medical Center

Lebanon

NH

Declarações

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

Declarações

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

Declarações

RP declares that he has no competing interests.

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Principais artigos

Infectious Diseases Society of America. Complicated urinary tract infections (cUTI): clinical guidelines for treatment and management.​ 2025 [internet publication].Texto completo

European Association of Urology. Guidelines on urological infections. Mar 2025 [internet publication].Texto completo

Nicolle LE, Gupta K, Bradley SF, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2019 May 2;68(10):e83-e110.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

    • Benign prostatic hypertrophy (BPH)
    • Prostatitis
    • Pyelonephritis
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Complicated urinary tract infections (cUTI): clinical guidelines for treatment and management
    • Guidelines on urological infections
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Urinary tract infections in men

    Mais Folhetos informativos para os pacientes
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