Urinary Tract Infections (UTIs) In Men

UTIs are just a problem for young women.  Although UTIs are more common in young women, men, too, are not immune to infections of the urinary tract.  One of the most common infections in middle age and older men are urinary tract infections.

Older men (such as, men 70 years and older) are at somewhat higher risk for UTIs because of problems going to the bathroom and/or emptying the bladder. Older post-menopausal women are also at a greater risk for UTIs due to lower amounts of vaginal estrogen, which can change the vaginal climate. The normal flora, ‘good bacteria,’ are looked at as ‘good’ because they kill off other types of bacteria that can cause UTIs. Good bacteria can only grow in slightly acidic vaginal climates and this needs some estrogen. Systemic estrogen replacement options like pills and skin patches do not help with this problem, but vaginal estrogen therapy can be helpful for certain individuals. Talk to your doctor to see if this is a choice for you.

Often, older adults can help stop UTIs by staying hydrated, using the bathroom and getting routine health exams to screen for health problems like high blood sugar that puts you at higher risk for getting a UTI. If you or a loved one wears adult diapers, it’s very important to keep the genital area clean and to change them often.

Other Groups at High-Risk for UTIs

People with high blood sugar and vesicoureteral reflux are at higher risk of getting a UTI. Vesicoureteral reflux is when urine goes backwards from the bladder toward the kidney. Over time, this reflux of infected urine may raise a person’s risk for kidney damage. Vesicoureteral reflux is usually seen in children with UTIs compared to adults. Additionally, some patients with kidney stones and indwelling catheters may also be a higher risk for getting a UTI. An indwelling catheter is a hollow tube that is placed into the bladder through the urethra and left inside your body. The catheter drains urine from your bladder into a bag outside of your body. A catheter-associated UTI happens when bacteria enter the urinary tract through the catheter and cause an infection.

How UTIs are Diagnosed

In most cases, if you think you have a UTI, you should visit a health care provider and give a urine sample for testing. A urinalysis is a test that looks for white blood cells, red blood cells, bacteria, and or other chemicals such as nitrites in your urine. A proper urinalysis can pinpoint an infection and a urine culture can help your health care provider choose the best antibiotic for treatment. It is vital to get a urinalysis and culture performed to make sure you have an infection and require care. Use of antibiotics when not needed, can be tricky, and can lead to greater rates of bacterial antibiotic resistance.

It should be noted that some individuals get a urinalysis result that shows bacteria, but the individuals are not having any symptoms of a UTI. This event is common in older adults. If the individual has bacteria in their urine, but has no symptoms, treatment is not right. Treatment should be given to individuals who have bacteria and associated UTI symptoms.

In closing, it should be noted that studies on cranberry juice and linked supplements are mixed. Some studies show that cranberry supplements can be helpful and other studies show that they don’t help stop UTIs before they happen. Be sure to read about the pros and cons of cranberry products, and decide if they’re right for you. For now, practice these tips to lower your risk of getting a UTI.

Tips for Preventing UTIs

1. Drink plenty of water.
2. Urinate often.
3. Don’t hold it.
4. Keep your genital area clean.
5. Empty your bladder before and after sex

 

Bottom Line:  UTIs are common in men and women.  Men after age 70 are at a risk for UTIs.  The symptoms are burning on urination, frequency of urination, passing cloudy urine, and even blood in the urine.  The diagnosis is easily made with a physical examination, a urine exam, and occasionally other imaging studies.  Treatment with antibiotics is usually effective.

More FAQs From My Patients

I have a high cholesterol level. Is there anything I can do to lower the cholesterol level besides medications, i.e., statins?
Yes, there are cholesterol lowering foods that are effective and have absolutely no side effects. These include:
Soluble fiber of 25gms each day is helpful and good for the colon as well. Good sources of soluble fiber include legumes such as peas and beans; cereal grains such as oats and barley and vegetables and fruits such as carrots, apples, and dried plums (prunes).
Nuts to the rescue. Although nuts are high in fat, the fats are predominantly monounsaturated and polyunsaturated, which are known to decrease LDL cholesterol levels or bad cholesterol. By eating a daily helping of nuts — about 2.4 ounces — results in an average 5% reduction in total cholesterol concentration. Nuts that will help lower LDL cholesterol levels include almonds, walnuts, peanuts, pecans, macadamias and pistachios.
Plant sterols and stanols, plant compounds that are structurally similar to cholesterol, partially block the absorption of cholesterol from the small intestine. They lower levels of LDL cholesterol without adversely affecting high-density lipoprotein (HDL or “good”) cholesterol levels. Plant sterols and stanols, plant compounds that are structurally similar to cholesterol, partially block the absorption of cholesterol from the small intestine. They lower levels of LDL cholesterol without adversely affecting high-density lipoprotein (HDL or “good”) cholesterol levels.
So you can begin by decreasing your consumption of red meat, butter, and high cholesterol containing seafood such as crayfish (heaven forbid!) shrimp and lobster and try these other non-medical options. If these do not work, then talk to your doctor about medication.

I am thinking of having a vasectomy. Is there any risk of erectile dysfunction or impotence?
No, you have nothing to worry about. A vasectomy ONLY prevents the sperm from entering into the ejaculate or seminal fluid. It does not affect the testosterone level or the ability to engage in sexual intimacy. If your erections are good before the vasectomy, they will remain just like they were prior to the vasectomy. So it is safe to proceed with the “prime cut”!

I am a man 78 years of age. Do I need to have a PSA test for prostate cancer?
No, the American Cancer Society and the American Urological Association do not recommend screening for prostate cancer with the PSA test in men more than 75 years. Cancer screening tests — including the prostate-specific antigen (PSA) test to look for signs of prostate cancer — can be a good idea in younger men between 50-75 but not in men over age 75. A normal PSA test, combined with a digital rectal exam, can help reassure you that it’s unlikely you have prostate cancer. But getting a PSA test for prostate cancer is not be necessary for men 75 and older.

I am 40 years of age and ate some red beets. My urine turned red. Is that normal after consuming red beets?
Usually red urine after red beet consumption is a result of a pigment, betalain, in the red beets and is nothing to worry about. However, if the red persists more than 24 hours after consuming the beets, then it is important to see your physician and have a urine examination. When the red color persists, this is referred to as hematuria. Hematuria is a clinical term referring to the presence of blood, specifically red blood cells, in the urine. Whether this blood is visible only under a microscope or present in quantities sufficient to be seen with the naked eye, hematuria is a sign that something is causing abnormal bleeding in the patient’s genitourinary tract. For more information on hematuria, please go to my website: http://neilbaum.com/articles/hematuria-blood-in-the-urine

When Your Pee Changes Color

Most of us are uncomfortable talking about our waste products, urine and feces.  However, changes in the color and odor may signify disease that can be treated or prevented.  This article will review causes of discoloration of urine and when there is a change in the odor of urine. 

For hundreds of years doctors have looked at urine as a barometer of what is happening in the body.  The urine can tell what you have been eating, how much fluid you are consuming, and what diseases you may have.  Early doctors even tasted the urine of their patients in order to diagnose their medical conditions.  Fortunately, we have made progress and a simple urinalysis can make this determination in seconds.                   

Urine is an important part of the body’s regulation process. Its job is to remove the extra water and wastes that the kidneys filter out of the blood. The urine is there primarily to get rid of toxins or things that would otherwise build up in the body that would be bad for the body.

When you notice that your urine has changed color, or there’s a strange odor emanating from the toilet, the cause might be something as harmless as what you had for dinner such as asparagus. It also might be a sign of a more serious condition, such as an infection or cancer. 

Color Changes

Urine normally varies from pale yellow to deep amber, depending on the concentration of the urine, which is determined by the amount of fluid you consume. Darker urine is usually a sign that you’re not drinking enough water.   Correction is as simple as consuming more liquids, especially water. 

The opposite is also true. If your urine is very pale, it means that you’re either drinking a lot of fluid, or you’re taking a diuretic or water pill which is a drug that forces the body to eliminate excess water.

Urine can turn a rainbow of colors, and an unusual hue isn’t necessarily cause for alarm. Certain medications can turn the urine fluorescent green or blue, the carotene in carrots can tint it orange, and vitamins can give it a yellow hue.  Pyridium, a medication, which is used to treat burning on urination, will turn the urine orange-red.

Seeing red is typically a sign that there is blood in the urine, but before you panic, know that a little blood can produce a dramatic color change. Just like a drop of food coloring will add color to a large volume of food or fluids, it only takes one drop of blood to turn an entire toilet bowl red.

Red urine is usually an ominous sign and can indicate an infection or maybe even cancer.  Red blood is a real warning sign and should prompt you to see your doctor or urologist, a doctor who specializes in disease of the kidneys and bladder.

Odor Changes

Urine normally doesn’t have a very strong smell. If your urine has a foul odor, you could have an infection or urinary stones, which can create an ammonia-like odor. Diabetics might notice that their urine smells sweet, because of excess sugar.

Some foods can also change urine odor. Asparagus is among the most notorious. What people are smelling when they eat asparagus is the breakdown of a sulfur compound called methyl mercaptan (the same compound found in garlic).

How Often Do You Need to Go?

How often you need to go can be as important an indicator of your health as the color or smell of your urine. Most people take bathroom breaks about six to eight times a day, but you might go more or less depending on how much fluid you drink. If you’re constantly feeling the urge to go and it’s not because you’re not drinking extra fluid, causes can include:

Overactive bladder  (when you gotta go, you gotta go!), urinary tract infection, Interstitial cystitis (painful urination without an infection), prostate gland enlargement, and diabetes. 

The opposite problem, not going to the bathroom enough, can occur when there is a blockage or infection. Or, it can be the result of bad bathroom habits. Some people — especially teachers, surgeons, and anyone else who doesn’t have time for regular bathroom breaks throughout the day — tend to hold it in.

Delaying urination can also cause problems.  The bladder can develop a chronic over-distension and will not empty completely.  As a result urine is left in the bladder and can be a source for developing a urinary tract infection.

Develop good bathroom habits.

Drink whenever you’re thirsty, but certainly increase your fluids before going outside in the hot summer sun or before exercising. 

If you’re getting up during the night to use the bathroom, stop drinking three to four hours before bedtime. Limit caffeine, which can irritate the lining of the bladder. Also watch your intake of alcohol, which can have an effect similar to a diuretic.

Finally, don’t hold it in. Don’t delay answering the call of the rest room.  Your bladder will thank you.

Bottom Line:  Pay attention to the color and odor of your urine.  If there is a change, contact your physician.

Let’s Get To The “Meat” of the Matter-Red Meat and Bladder Cancer

Already linked with an increased risk of cardiovascular disease and certain cancers, including cancer of the pancreas, red meat was found by a team of US researchers to be a possible cause of bladder cancer.

For the study, scientists assessed the intake of nitrates, nitrites and other components found in red meat, in some 300,00 men and women aged 50-71 year, in eight US states, and its relation to cancer.

The study participants were followed up for up to eight years. During that time, 854 were diagnosed with cancer of the bladder.

For those who can’t do without their bacon-cheeseburger, some good news: scientists found no associations between beef, bacon, hamburger, sausage or steak and bladder cancer.

But they did observe a positive association for red meat cold cuts and bladder cancer.

The culprits in the cold cuts are nitrates and nitrites which are added to meat when it is processed to preserve and enhance color and flavor.

The scientists found that people whose diets were high in nitrites had a nearly a 30 percent greater chance of developing bladder cancer than those who consumed the lowest amount of either compound.

What’s the bottom line: If you are at risk for bladder cancer or you have had bladder cancer, I suggest that you restrict your intake of red meat and cold cuts.  Your bladder will thank you!