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.

UTIs-Natural Solutions For Prevention

UTIs affect millions of men and women impacting their quality of life and may even affect their kidneys. Fortunately, most of these infections are uncomfortable with symptoms of burning on urination, frequency of urination, and back and pelvic pain. This article will discuss the usefulness of cranberry juice which may serve as an effective treatment to prevent recurrent UTIs.

A recent study reported in American Journal of Obstetrics and Gynecology, Aug. 2015 showed that cranberry pills (two capsules twice daily, equivalent to two 8-ounce servings of cranberry juice daily) cut the rate of UTIs in half.

Also there is supplement, D-mannose, can also help to reduce recurrent UTIs. Another study found good results from a combination of cranberry and d-mannose.

D-mannose is filtered through your kidneys and concentrated in your bladder and coats the bacteria causing the infections and renders them unable to stay in your urinary tract.

More than 90 percent of all UTIs are caused by Escherichia coli (E. coli), which is normally found in your intestinal tract. Problems only arise when this ordinary bacterium is present in high numbers in places where it shouldn’t be—like your urinary system.

Although antibiotics are an effective means of eradicating bacteria within the urinary tract, antibiotics need to be used with caution. Antibiotics are not selective and they kill the pathogenic bacteria in the urinary tract but also kill the good bacteria within the gastrointestinal tract. As a result, the bacteria develop resistance to antibiotics and with the removal of bacteria from the gastrointestinal tract there is a risk of other infections such as vaginal infections, fungal infections and side effects like diarrhea.

Bottom Line: UTIs are so very common and affect millions of American men and women. Cranberry juice and D-mannose may be a solution to preventing recurrent infections. If you have any questions about recurrent UTIs, speak to your physician.

Urinary Tract Infections (UTIs) in Women

Perhaps one of the most common infections in all women and young girls are UTIs.  Nearly 50% of all women will experience a UTI during their lifetime.

Urinary tract infections (UTIs) are very common in the U.S. In fact, UTIs are the second most common type of infection in the body and are the reason for more than 8 million visits to the doctor each year. About 50% of all women will develop at UTI during their lifetime.

Most UTIs involve the bladder (cystitis) are not serious, but some can lead to serious problems like kidney infections. The most common care or treatment for a UTI is antibiotics. Signs of a UTI involve pain or burning when you pass urine, urine that looks cloudy or smells bad, pressure in your lower abdomen, and an urge to go to the bathroom often. You can get a UTI at any age, but there are peak times in life when they are more common.

Many women report UTIs following sexual activity. Another peak time for UTIs in women is after menopause. This is because of lower vaginal estrogen levels. Lower estrogen levels make it easier for bacteria to grow. A woman’s urethra or the tube from the bladder to the outside of the body is very short, about two inches in length compared to man’s urethra which is 8-10 inches long. This short length makes it easy for bacteria to enter a woman’s bladder. The opening of a woman’s urethra is near the rectum and vagina which happen to be two common places where bacteria dwell.

Prevention of UTIs in women may be as simple as instructing women to wipe from front to back following urination and bowel movements. This helps cut the chance of spreading bacteria from the anus to the urethra.

For women who notice more UTIs after sexual activity, I will often recommend that women take a low dose antibiotic shortly before or right after sexual activity.

Bottom Line: UTIs are common in women.  Most of these infections are not serious and can be treated with a short course of antibiotics.  For women with chronic or repeated infections, low dose antibiotics may be helpful.

Urinary Tract Infections (UTIs)– A Primer

Urinary tract infections are one of mankind and womankind’s most common maladies. Most of these infections are a source of irritation and bother but if left untreated can cause significant kidney damage. This blog will discuss this common condition and what can be done to prevent and treat common UTIs

A UTI is when bacteria gets into your urine and travels up to your bladder. UTIs cause more than 8.1 million visits to health care providers each year. About 40% of women and 12% of men will have symptoms of at least one UTI during their lifetime.

The urinary tract makes and stores urine, one of the waste products of your body. Urine is made in the kidneys and travels down the ureters to the bladder. The bladder stores the urine until it is emptied through the urethra, a tube that connects the bladder to the skin, when you urinate. The opening of the urethra is at the end of the penis in a male and in front of the vagina in a female.
The kidneys are a pair of fist-sized organs in the back that filter liquid waste from the blood and remove it from the body in the form of urine. Kidneys balance the levels of many chemicals in the body (sodium, potassium, calcium, phosphorous and others) and check the blood’s acidity. Certain hormones are also made in the kidneys. These hormones help control blood pressure, boost red blood cell production and help make strong bones. The ureters are two tubes that carry the urine down to the bladder.

Normal urine has no bacteria in it, and the one-way flow helps prevent infections. Still, bacteria may get into the urine from the urethra and travel up into the bladder.

Signs of UTI
When you have a UTI, the lining of the bladder and urethra become red and irritated just as your throat does when you have a cold. The irritation can cause pain in your belly and pelvic area and may make you feel like urinating more often. You may even try to urinate but only get a few drops and/or feel some burning as your urine comes out. At times, you may lose control and wet yourself. You may also find that your urine smells bad or is cloudy.
Kidney infections often cause fevers and back pain. These infections need to be treated at once because a kidney infection can quickly spread into the bloodstream and cause a life-threatening health issue.

Causes of UTI
Large numbers of bacteria live in the rectal area and also on your skin. Bacteria may get into the urine from the urethra and travel into the bladder. They may even travel up to the kidney. But no matter how far it goes, bacteria in the urinary tract can cause problems.
Just as some people are more prone to colds, some people are more prone to UTIs. Men are less likely to get a UTI.
Some factors that can add to your chances of getting a UTI are:
Body Factors
Women who have gone through menopause have a change in the lining of the vagina and lose the protection of estrogen that lowers the chance of getting a UTI. Some women are genetically predisposed to UTIs and have urinary tracts that make it easier for bacteria to cling to them. Sexual intercourse can also affect how often you get UTIs.
Birth Control
Women who use diaphragms have also been found to have a higher risk when compared to those who use other forms of birth control. Using condoms with spermicidal foam is also known to be linked to greater risk getting of UTIs in women. Women are more prone to UTIs because they have shorter urethras than men so bacteria have a shorter distance to travel to reach the bladder.
Abnormal Anatomy
You are more likely to get a UTI if your urinary tract has an abnormality or has recently had a device (such as a tube to drain fluid from the body) placed in it. If you are not able to urinate normally because of some type of block, you will also have a higher chance of a UTI.
Anatomical abnormalities in the urinary tract may also lead to UTIs. These abnormalities are often found in children at an early age but can still be found in adults. There may be structural abnormalities, such as outpouchings called diverticula, that harbor bacteria in the bladder or urethra or even blockages, such as an enlarged bladder, that keep the body from draining all the urine from the bladder.
Immune System
Issues such as diabetes (high blood sugar) also put people at higher risk for UTIs because the body is not able to fight off germs as well.
Can UTIs be Prevented?
There are steps women can take to avoid UTIs:
1 Urinating after sex may lower the risk of UTI by flushing out bacteria that may have gotten into the urinary tract during intercourse.
2 Certain forms of birth control, such as spermicidal foam and diaphragms, are known to increase the risk of UTIs in women. Check with your health care provider about other types of birth control.
3 Drink plenty of fluids to keep well hydrated.
4 Don’t put off urinating when you need to and don’t rush to finish. Holding in urine and not draining your bladder fully can increase your risk of UTIs.
Wipe from front to back to keep bacteria around the anus from getting into the vagina or urethra.

Bottom Line: UTIs are a common condition that affects millions of men and women. this blog will hopefully provide you suggestions for preventing UTIs. For more informatiion call your doctor.

Using Hormone Therapy To Reduce Recurrent UTIs in Women

Women often experience recurrent UTIs after menopause. The cause is often a result of reduced estrogen levels that is so common after menopause. This blog will discuss the use of topical estrogens to reduce the frequency to recurrent urinary tract infections.

Topical hormone replacement therapy (HRT) was associated with a lower incidence of urinary tract infections (UTIs) compared with both oral HRT or even no HRT.

UTIs are a frequent problem among postmenopausal women necessitating antimicrobial use, and resistance is increasing. Every year, 8–10% of postmenopausal women have 1 episode of a urinary tract infection; of these, 5% will have a recurrence in the next year.

Studies have demonstrated use of oral estrogens does not reduce the incidence of UTIs, but topical HRT reduced the number of UTIs in two small studies.

To determine whether a difference existed in incidence of UTIs in women 60–75 years of age, a study compared the number of UTIs per patient per year over 1 year in 3 groups of postmenopausal women: topical HRT, systemic HRT, and control (n=75 per group).
Women aged 60–75 years with a history of UTI (n=448) were identified from retrospective charts (2011–2013). Patients were excluded if they were taking antibiotics for UTI prophylaxis, treated with antibiotics for reasons other than UTI for 2 or more weeks, were on both topical and systemic HRT, or on chronic methenamine hippurate.
The number of UTIs per patient per year was significantly different among the 3 groups. There was a significant difference between topical HRT and systemic HRT, and topical HRT and control, but not systemic HRT and control. The control group had an average of 1.24 UTIs per patient per year, compared with 1.01 in the systemic group and 0.65 in the women who used topical estrogen replacement.

Bottom Line: Topical estrogens may be beneficial when other preferred agents cannot be utilized.

Do’s and Don’ts of Douching-It May Cause Your UTI

I am 56 y\o female with recurrent urinary tract infections. I have been douching for many years and I was told by my urologist that the douching may be the culprit of my UTIs. Is that true?

Douching clears out the normal good bacteria of the vagina, which can upset the balance of bacteria in the vaginal area and make it easier to get UTIs. Allowing that bacteria to stay inside the vagina is a natural way to protect yourself from UTIs. Therefore, if you are prone to recurrent UTIs, then I suggest you deep six the douching.

What can you do to prevent UTIs?

Keep yourself hydrated. One of the best ways for preventing UTIs is to stay well hydrated, Drinking water can flush out bacteria from your bladder and lower your chances of getting a UTI.

I recommend urinating after sexual intimacy. Sexual activity may massage bacteria from the vagina into the urethra, the tube from the bladder to the outside of the body, which can then multiply and create an infection. Urinating after sex will expel the bacteria in the urethra and prevent the bacteria’s access to the bladder.

Drinking cranberry juice also seems to make it harder for bacteria to infect the urinary tract. Cranberry juice contains active compounds that are not destroyed by the digestive system after people drink them, but instead work to fight against bacteria, including E. coli, which is the most common bacteria causing UTIs. It appears that cranberry juice seems to prevent bacteria from sticking to the bladder wall.
Urinate frequently as holding urine probably can increase risk of having UTIs.

Wear cotton underwear. Bacteria grows in a moist, warm environment, so it’s a good idea to wear cotton underwear and clothes that aren’t too tight to allow air to flow and to keep the area dry. Avoid tight fitting jeans and exercise clothing.
See a doctor for persistent symptoms. If you don’t get better quickly with these non-medical suggestions or you have more than 3-4 infections per year, then it is time to obtain a medical opinion.

Bottom Line:
UTIs are a common malady affecting nearly every woman at some time during her adult life. There are several suggestions provided in this blog that you can do to decrease your likelihood of recurrences.

FAQ From My Patients

I am frequently asked questions by my patients and the answers may be of interest to you. If you have any questions that you would like me to answer, please write me at nbaum@neilbaum.com. to your good health.

I am a 60 yr. woman with recurrent urinary tract infections. I was told to drink cranberry juice. Is that effective?
Studies have documented that within eight hours of drinking cranberry juice, the juice could help prevent bacteria from developing into an infection in the urinary tract. Previous studies have suggested that the active compounds in cranberry juice work to fight against bacteria, including E. coli. Naturopaths believe in the medicinal value of cranberries. My own experience with hundreds of patients is that cranberry juice helps but you must drink 4-6 glasses a day, which is also a lot of sugar. So I suggest the cranberry juice pills. Anyone who suspects they have an infection should see a doctor, but drinking cranberry juice may be an easy, inexpensive way to help keep E. coli at bay.
I have chronic prostatitis. Is zinc helpful for this condition?
Zinc plays an important role in maintaining and improving prostate health. While zinc is found in every organ, tissue and cell in the human body, in males, the prostate has more zinc than any other tissue except bone.
As men get older, they tend to exercise less and their diets change as well, often causing them to fall short of the recommended daily allowance of zinc. Men who don’t have significant levels of zinc in their diets tend to have higher instances prostatitis. They also have higher prostate cancer rates.
The recommended daily allowance for men is 11 milligrams. Zinc is found in many popular foods, including meat and poultry, as well as oysters, beans, nuts, crab, lobster, whole grains, fortified breakfast cereals and dairy products.

My urologist told me that I have a varicocele. Will this cause me to have a problem with infertility?

Yes it may. Varicoceles are enlarged varicose veins that occur in the scrotum. They are fairly common, affecting 15 out of 100 men overall and one of the most common causes of male infertility because the heat from the dilated veins affect sperm production. Varicoceles occur most often in the left testicle. A varicocele repair is done to improve male fertility and is accomplished on an outpatient basis with improvement in the sperm producing in 3-4 months after the procedure.

I had radiation therapy for prostate cancer and now have a loss of my sex drive. What is the cause?
Men who receive radiation therapy for prostate cancer often receive injections to lower the testosterone level to decrease the growth of the cancer. Testosterone is responsible for the sex drive or libido. Often the testosterone level will return to normal after the medication is discontinued after the radiation therapy. In some instances men can receive testosterone one year after radiation if the PSA level stays at a low level. I suggest you have a discussion with your urologist about the use of testosterone in men with prostate cancer.

Urinary Tract Infections-Help Without Medication

Urinary Tract Infections Are One of the Most Common Maladies affecting women and is a source of pain, discomfort, and inconvenience. There are several action steps that most women can take to help reduce the frequency of these infections.
There are several simple, do-it-yourself techniques that may prevent a urinary tract infection. Some may work some of the time, or only in some women. But, because they carry no side effects, they certainly are worth trying to prevent the often painful and bothersome symptoms the infection can bring.
Here are some steps you might consider if you have more than 3-4 infections a year.

• Drink plenty of fluids – the equivalent of six to eight 8-ounce glasses of liquids – every day to flush bacteria out of your urinary system.
• Make sure you’re getting vitamin C in your diet, either through food or supplements. Vitamin C, or ascorbic acid, makes your urine acidic, which discourages the growth of bacteria.
• Drinking cranberry juice may also produce the same effect. Cranberry tablets are a more concentrated form of cranberry juice without the sugar content.
• Urinate every two to three hours whether you have the urge or not. Keeping urine in your bladder for long periods gives bacteria an opportunity to grow.
• Avoid using feminine hygiene sprays and scented douches. They also may irritate the urethra.
If you suffer from urinary tract infections more than three times a year, your health care professional may suggest one of the following therapies to try to prevent another recurrence:
• See you doctor about a low dosage of an antibiotic medication, such as trimethoprim/sulfamethoxazole or nitrofurantoin, taken daily for six months or longer
• If you infections occur after sexual intimacy, a single dose of an antibiotic medication taken after sexual intercourse.
Bottom Line: Recurrent urinary tract infections impact millions of American women. A few of these steps can probably reduce the frequency of these infections. If you have any questions, check with your doctor.

Deciding Upon the Prime Cut- The Circumcision Decision

No descriptor required!

Parents often ruminate about the decision to circumcise their young baby boys. Certainly if you are of the Jewish faith, there is no question that you will consider cicrcumcision for your new baby boy. For non-Jews, and non-Moslems, the decision is much more difficult.

New evidence is out that circumcision reduces the risk of sexually transmitted diseases. A review of current medical research points out that the medical benefits of circumcision outweigh the risk of the procedure. Circumcised infants are 90
% less liekly than uncircumcised infants to develop urinary tract infections. Later in life, the circumcised boys are at a lower risk of contracting HIV, herpes, penile cancer, and human papilomavirus, which when passed to female partners, can cause cervical cancer. The serious complicaitons occur in only about 0.2 percent of baby boys who under the operation.

Bottom Line: The circumcision decision is often difficult for most parents to make. I suggest you speak to your pediatrician and obstetrician about the “prime cut.”

Cranberry Juice for Bladder Infections: not just folklore

Cranberry-containing products may be more than just a folk remedy for urinary tract infections (UTIs). A recent article from Archives of Internal Medicine concludes that cranberry-containing products offer women protection against UTIs, particularly those prone to recurrent infections.

Researchers studies over 1,600 men, women, and children of different populations including the elderly; the hospitalized; those with neuropathic bladder, spinal cord injuries, or multiple sclerosis; and pregnant women. Most of the trials (10) were conducted in North America; the remainder were conducted in Finland, Italy, and the United Kingdom.

Cranberry-containing products used in the studies took on different forms and dosages.  Cranberry juice contains P a substance that has the ability to inhibit Escherichia coli from adhering to the lining of the bladder and the urethra, the tube that transports urine from the bladder to the outside of the body. The studies looked at cranberry juice as well as capsules or tablets.

The authors of the review concluded that cranberry-containing products are most protective against UTIs in women with recurrent infections. They also may offer protection to women in general, including those who are pregnant, and to children and other populations, but heterogeneity across the trials made interpretation difficult.

Interestingly, the studies showed that the cranberry juice was more effective than capsules or tablets, but the investigators noted that could be because women who drink cranberry juice are better hydrated. They also found that dosing at least twice daily seems necessary to achieve benefit.

Bottom Line: If you have recurrent urinary tract infections, daily cranberry juice may just be the tonic you need to decrease these infections.