Urinary tract infection (UTI) in men | Pokenga pūaha mimi

Most urine infections in men are caused by bacteria (bugs) from your bowel. Bacteria don’t cause any problems in your bowel but can be harmful if they get into other parts of your body. Bacteria left around your back passage (anus) after you poo (pass faeces) can get into your urethra and bladder and multiply to cause infection.

Because urinary tract infections (UTIs) are less common in men, there’s more likely to be an underlying problem, such as a problem with your bladder, urethra or prostate that stops you from passing pee or emptying your bladder completely.

Things that can increase the risk of men getting a UTI include:

• being over 60 years of age
• problems with the structure of your kidneys, ureters, bladder or urethra
• an enlarged prostate
• having a urinary catheter
• having unsafe sex
• radiation therapy which can irritate the lining of the bladder.
• a poor immune system, diabetes or kidney failure
• kidney problems, such as kidney stones
• having had a previous UTI
• having a condition that makes it difficult to fully empty your bladder, such as constipation.

A sexually transmitted infection (STI), such as chlamydia, may cause inflammation of the bladder (cystitis) and symptoms similar to a UTI.

Symptoms of a UTI include:

• pain or burning during, or immediately after, peeing – this is called dysuria
• needing to pee more often than usual during the night – this is called nocturia
• pain in your lower tummy (abdomen)
• feeling the need to pee more often
• needing to pee without much warning
• urine that smells bad or looks cloudy or reddish.

Symptoms of a kidney infection (pyelonephritis), can include the symptoms listed above as well as pain in your loin (the side of your lower back over your kidney), fever, feeling or being sick (vomiting), or feeling generally unwell.

Older men may have no urinary symptoms or fever. Often the only symptoms are being more muddled, sleepier, having accidental urine leakage (incontinence) poor appetite, or feeling generally unwell. Confusion and sleepiness can put older adults at risk of falls.

If you have UTI symptoms you should see a healthcare provider. You may have a lower UTI (cystitis or urethritis) or you may have another condition, such as a sexually transmitted infection (STI), prostatitis or a kidney infection.

To diagnose a urinary tract infection (UTI), your healthcare provider will examine you and ask questions about your symptoms and general health. Sometimes that might be enough to diagnose a UTI. They may ask you for a urine sample to find out what bacteria is causing the infection. 

If your healthcare provider suspects an underlying problem, or if you’ve had more than one UTI, other tests may include blood tests, checks for sexually transmitted infections (STIs), examination of your prostate gland and scans of your bladder or kidneys.

Lower urinary tract infections (UTIs), such as bladder infections (cystitis), are treated with antibiotics to relieve your symptoms, get rid of the infection and reduce the risk of it spreading to your kidneys and causing pyelonephritis. It's important to finish the whole course of treatment even if you start to feel better before you’ve taken all of your antibiotics. 

If a urine sample is being tested, antibiotics can be started while you’re waiting for the results.

If your symptoms continue for more than 2 days after starting treatment, or you get worse, see your healthcare provider as soon as possible in case you need a different antibiotic or the infection has spread to your kidneys. An upper UTI or kidney infection needs to be treated urgently with antibiotics which may need to be given intravenously (through a vein in your arm). Read more about the treatment for kidney infections. 

If you have recurrent UTIs (you keep getting them), or you’re at higher risk of complications, you may be prescribed a low-dose antibiotic to take for a few months. How long you need to take the antibiotic depends on how often you get the UTIs. Read more about recurrent UTIs. 

• Take your antibiotics as prescribed. Take the full course of treatment.
• Take paracetamol or ibuprofen (if it's safe for you) for pain.
• Drink plenty of water so you don't get dehydrated. This helps to flush out the bacteria.
• Some people find that drinks such as coffee, alcohol, fizzy drinks and very acidic juices (eg, orange juice) can make bladder symptoms feel worse. So you may choose to reduce or avoid them while you're uncomfortable.
• Some people try products that make their urine less acidic (called urinary alkalinisers such as Ural) to ease urinary discomfort. Urinary alkalinisers don't treat the infection and there is some concern that they may reduce the effect of some antibiotics commonly used to treat UTIs. Talk to your healthcare provider to see if this treatment is right for you.     

• Drink plenty of fluids to avoid dehydration.
• Don't 'hold on' if you feel the urge to pee.
• Try to empty your bladder fully when you pee. Try sitting when you pee or peeing twice to make sure your bladder is empty.

Symptoms of a urinary tract infection (UTI) usually improve within a few days of starting antibiotic treatment. If your symptoms don’t improve you may need a different antibiotic or you may be referred to a urology specialist for further investigation.

However, a lower UTI may spread to your kidney (pyelonephritis) or prostate gland (prostatitis) and cause more serious symptoms.

Most men don’t get further UTIs, but if you get 1or 2 more within a 6-to-12-month period, these should be investigated to try and find out if there’s an underlying cause.