Causes of UTI in men: it’s complicated!

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What causes UTI in men? Is there a link between UTI and prostatitis? To find out, I spoke to my friend Dr. Paul Turek (The Turek Clinics) an internationally renowned urologist. In spite of being a decorated professional with many awards and dozens of years of experience, Dr. Turek is down-to-earth and very easy to talk to and doesn’t mind getting his hands dirty…both literally and figuratively.

This is what I’ve learned:

UTI in men: It’s not you, and it’s not me! It’s just complicated…

Statistically, every 4th woman will experience a UTI in her lifetime. In yet another shocking turn of events, men have it easy in the UTI arena as well!  UTIs in men are rarer. Men’s urethra is on average eight inches long; so ladies, when your next date says that: “it’s 8 inches long” technically he’s not lying.  According to Dr. Turek, size does indeed matter…male’s urethra is eight inches longer than their female counterparts and therefore serves as a great first line of defense from harmful bacteria.

Furthermore, for men, unlike women, it takes much more than exposure to E. coli during intercourse to develop a UTI. Basically, a lot of things need to go wrong in order for bacteria to ascend to the bladder.

Every case of UTI in men is considered “complicated.”  This means UTI in men need to be thoroughly evaluated, and not just treated with an antibiotic. “While it’s not always clear why some women get a UTI, in men you could normally find the reason during an evaluation” says Dr. Turek.  Dr. Turek urges men to avoid home remedies and seek a physician’s help if one believes he’s experiencing symptoms of a UTI.

Physicians would normally collect a urine sample and check lower (urethra and prostate) and upper urinary tract (kidney, bladder) in search for any of the following:

  • Stones or tumors that obstruct normal urine flow
  • Malformations or birth defects
  • Prostate enlargement

In most cases a thorough examination is enough to establish a reason for UTI. If no whoopsys are found, your physician might then deliver the most devastating blow to your sex-life…yes, you guessed correctly! He could possibly ask you to start wearing a condom during vaginal intercourse (and if you’re really lucky, during anal too) to reduce or eliminate bacterial contamination during your future sexual entanglements.

Prostatitis is a risk factor for UTI in men

Clinical studies are not conclusive when it comes to establishing reasons for prostatitis, but we know that chronic bacterial prostatitis is a risk factor for UTI in men. Moreover, for patients with chronic bacterial prostatitis recurrent UTIs might be the only symptom they’ll ever experience.

The prostate gland surrounds the urethra just below the bladder and two ejaculatory ducts connect them together. Therefore, bacterial infection can easily travel between prostate and urinary tract. Also, when the prostate becomes enlarged, it presses on the urethra, causing obstruction of urine flow, diminished urinary stream, and sometimes complete urinary obstruction that can predispose you for a UTI. Unfortunately, effective treatment of chronic bacterial prostatitis may be difficult and requires prolonged antibiotic therapy (to learn more check out Dr. Turek’s article in Medscape about prostatitis).

“Since most of male UTI have underlying anatomic reasons, therefore probiotics are probably less important in preventing UTI in men than in women”, speculated Dr. Turek.

Just The Tip?

The most important tips Dr. Turek gives men are: 1) daily hygiene! “Basically, wash your penis well to prevent a whole bunch of problems, including cancer, especially if you are not circumcised.”  2) drink a lot of fluids as “this keeps stones away and bacteria from dividing, and 3) empty regularly “as river water is cleaner than pond water.”

 

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