Although urinary tract infections (UTI) are much more common in females, I have decided to talk about the UTI in males. I have observed that with the increase in awareness, various opportunities have opened up for women to discuss menstruation or intimate hygiene.
I was lucky to be a part of the Menstrual Hygiene Management Campaign, where I explored both sides of the coin. Although there is a lot more to grow in this direction as well, men are far behind women when it comes to discussing their ‘privates’. You can easily find young girls talking about their periods or genital infection to their friends (including male friends) but ever noticed that guys never talk about any issues? Or are they ‘naturally protected’?
Well, that could be partly true (More on this, later). However, I have observed the hesitancy in male patients in the hospitals as well. Either they would present too late or they are reluctant to talk to a ‘female doctor’. Even a 70-year-old man was waiting at his home for the Fournier gangrene (rapidly progressing infection of the scrotum that leads to tissue death) to spread before he visited the hospital. I don’t blame them for that; this is the culture that we have grown in, where a man’s dignity depends on his ‘performance’.
So let us break the ice, and start the conversation.
Disclaimer: This post is not suggesting any diagnosis or treatment options. If you have any symptoms, please visit your physician. This post intends to spread awareness.
What is UTI?
The Urinary tract extends from the renal pelvis to the urethra. So, infection of any of the organs that are components of this tract will come under UTI (Urinary Tract Infection), e.g. infection of the prostate, infection of the urethra etc.
As I said earlier, men have relatively less UTI as compared to women. Let me explain to you why?
- Men have a longer urethra which makes it difficult for the infections to travel.
- The male urethra is separated from the rectum (a common source of infection) by several centimetres which protect the urethra from the intestinal microbes.
The same reasons make urinary infection in men ‘complicated’ as compared to females. How?
As males are naturally less prone to infection, getting a UTI might be due to some anatomical anomaly which is ‘complicated’ because it might require an intensive management plan.
The next important question – Are all ‘healthy’ (considering, absence of other illnesses or anomalies) men at equal risk of getting UTI?
Let us divide males into two age groups –
a. > 50 years old
b. < 50 years old
The elderly males are more likely to get UTI. Why?
- Let me give a well-known example, Benign Prostatic Hyperplasia (enlargement of the prostate gland) is a common issue in elderly males. As the prostate gland surrounds the urethra, its hypertrophy will block the passage of urine. The stasis of urine will provide a ground for bacteria to proliferate.
- This age group is more likely to have other comorbid conditions like diabetes which favours infection proliferation.
- Frequent catheterisation (artificial passage for the urine) is more common in elderly, promotes bacterial growth.
Maybe you are a 25 years old male who is thinking – Is my age group safe from UTI?
(“Nobody is safe in this world” – said, 2020)
Males in the younger age group are relatively at a lesser risk but there are multiple factors which determine that. For instance, a 24-year-old who is on steroid therapy is higher risk compared to his peers. Also, keeping into account that there are various sexually transmitted infections (STI) that can lead to UTI, the younger population is at a higher risk to get the latter infections.
What puts a man at risk?
- Immune deficiency (e.g. HIV, immunosuppressive therapy for psoriasis or rheumatoid arthritis).
- Comorbidity (e.g. diabetes).
- Anatomical anomalies (e.g. stricture of the urethra).
- Catheterisation (e.g. old age patient who can not control bladder).
- Sexually transmitted infection (e.g. chlamydia, gonococci).
- Being uncircumcised.
- Anal intercourse (the urethra gets exposed to faecal flora).
What are the signals that indicate you should take a doctor’s opinion?
- Burning while urinating.
- Urgency (you are unable to wait for the bathroom to get vacant).
- Hesitancy (incomplete emptying of the bladder).
- Blood in urine.
- Change in colour of the urine or cloudiness.
- Tenderness of the prostate.
- Pain during or after ejaculation.
- Urethral discharge.
- Fever or chills.
- Weakness and fatigue.
- Pain at the sides of your abdomen.
A medical professional will best evaluate your signs and symptoms. Do not be your doctor, nope!
What can you do to prevent urinary tract infections?
- Use barrier contraceptives (condoms) during sex.
- Pee and wash your genitals before and after sex.
- If uncircumcised, clean the area under the foreskin regularly.
- Wipe from front to back after using the toilet. (if you wipe from back to front, you increase the chance of exposing the urethra to gut bacteria.)
- Drink adequate amount of water.
- Don’t hold your urine.
- Do not wear tight-fitting and synthetic undergarments.
Please note that fever can be a symptom for various ailments; having any of the above symptoms does not guarantee a urinary tract infection. Therefore, you require an expert opinion to proceed further. Similarly, the preventive measures are helpful but not a substitute for treatment. Prevention protects you from getting a disease, but if you have already acquired the infection then a more structured management plan is needed.
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