Urinary Tract Infection (UTI) in Males Clinical Presentation: History, Physical Examination, Prostatitis Syndromes (2024)

Author

John L Brusch, MD, FACP Corresponding Faculty Member, Harvard Medical School

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Burke A Cunha, MD Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Acknowledgements

Bryan P Blair, MD Staff Physician, Department of Urology, Naval Medical Center at Portsmouth

Disclosure: Nothing to disclose.

David S Howes, MD Professor of Medicine and Pediatrics, Section Chief and Emergency Medicine Residency Program Director, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

David S Howes, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physicians-American Society of Internal Medicine, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Klaus-Dieter Lessnau, MD, FCCP Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital

Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Sepracor None None

Mark Jeffrey Noble, MD Consulting Staff, Urologic Institute, Cleveland Clinic Foundation

Mark Jeffrey Noble, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Kansas Medical Society, Sigma Xi, Society of University Urologists, and Southwest Oncology Group

Disclosure: Nothing to disclose.

M Tyson Pillow, MD Assistant Director of Medical Education, Ben Taub General Hospital Emergency Center; Assistant Professor, Baylor College of Medicine

M Tyson Pillow, MD is a member of the following medical societies: Air Medical Physician Association, American College of Emergency Physicians, American Medical Association, American Medical Student Association/Foundation, Emergency Medicine Residents Association, Society for Academic Emergency Medicine, and Student National Medical Association

Disclosure: Nothing to disclose.

Joseph A Salomone III, MD Associate Professor and Attending Staff, Truman Medical Centers, University of Missouri-Kansas City School of Medicine; EMS Medical Director, Kansas City, Missouri

Joseph A Salomone III, MD is a member of the following medical societies: American Academy of Emergency Medicine, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

Richard H Sinert, DO Associate Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Department of Emergency Medicine, Kings County Hospital Center

Richard H Sinert, DO is a member of the following medical societies: American College of Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Cindy L Tamminga, MD Consulting Staff, Division of Infectious Diseases, Naval Medical Center at Portsmouth

Disclosure: Nothing to disclose.

Urinary Tract Infection (UTI) in Males Clinical Presentation: History, Physical Examination, Prostatitis Syndromes (2024)

FAQs

What is the male presentation of a UTI? ›

Symptoms may include pain (in the perineum, lower abdomen, testicl*s, or penis or with ejacul*tion), bladder irritation, and, sometimes, blood in the sem*n.

What is a physical exam for a male UTI? ›

For men, your doctor will: Evaluate any history of prostate problems. Examine your genitals, lower back, and abdomen. Examine your rectum and rectal area to check for prostate enlargement, growths, or inflammation.

What is the clinical presentation of a UTI? ›

Symptoms of uncomplicated UTIs are typically pain on urination (dysuria), frequent urination (frequency), inability to start the urine stream (hesitancy), sudden onset of the need to urinate (urgency), suprapubic pain or discomfort, bladder spasms, and blood in the urine (hematuria).

How to tell the difference between UTI and prostatitis? ›

While it can be extremely difficult to tell whether you have a UTI or prostatitis without professional diagnostic testing, there are a few signs and symptoms that may make prostatitis the more likely culprit. These include pain and pressure in the perineum, high fever, and an elevated PSA.

What are the signs of UTI in males? ›

Bladder infection in men
  • Frequent urination.
  • Strong, persistent urge to urinate (urgency)
  • Burning or tingling sensation during or just after urination (dysuria)
  • Low-grade fever.
  • Cloudy urine with a strong odor.
  • Blood in urine (hematuria)
  • Trouble urinating, especially if you have a problem with your prostate.

What are the red flags for UTI in men? ›

A lower UTI should be suspected if the man has: Dysuria, frequency, urgency, nocturia, and suprapubic pain. Suprapubic tenderness, odorous or cloudy urine, and haematuria.

How to test for male urinary tract infection? ›

Your health care provider may ask for a urine sample. The urine will be looked at in a lab to check for white blood cells, red blood cells or bacteria. You may be told to first wipe your genital area with an antiseptic pad and to collect the urine midstream. The process helps prevent the sample from being contaminated.

What is the clinical examination for UTI? ›

Examine the woman:

Palpate the abdomen for flank or suprapubic tenderness or an abdominal mass. Consider performing a vulval and pelvic examination (with a chaperone) to assess for an alternative cause of symptoms, such as urogenital atrophy, vulval rash, pelvic mass, or pelvic organ prolapse.

What are the assessment findings of a UTI? ›

Symptoms of uncomplicated UTI are a pain on urination (dysuria), frequent urination (frequency), inability to start the urine stream (hesitation), sudden onset of the need to urinate (urgency), and blood in the urine (hematuria).

What is an unusual presentation of a UTI? ›

Atypical presentation is often cited as one of the causes of diagnostic delays6,7 because typical UTI symptoms and signs, such as dysuria, frequency and costovertebral angle tenderness, are often lacking in patients with delayed diagnosis of UTI.

How to get rid of male UTI? ›

You need to take the full course of antibiotics. Take your medicines exactly as prescribed. Be sure to take all of your antibiotics, which treat the infection. Drink extra water for the next day or two.

What are the clinical details of a UTI? ›

Common symptoms of UTIs include: wanting to urinate more often and urgently, if only a few drops. burning pain or a 'scalding' sensation when urinating. a feeling that the bladder is still full after urinating.

What is the prostatitis syndrome? ›

Prostatitis is a disorder of the prostate gland usually associated with inflammation. Prostatitis often causes painful or difficult urination, as well as pain in the groin, pelvic area or genitals. Bacterial infections cause some but not all cases of prostatitis.

Can ejacul*ting help prostatitis? ›

Of 18 patients who adhered to the recommendations, two (11%) experienced complete relief of symptoms, whereas six (33%) had marked improvement, six had moderate improvement and four (22%) did not benefit. In contrast, three of seven patients who masturbat*d less frequently reported partial improvement.

Can prostatitis go away on its own? ›

Can prostatitis go away on its own? If a bacterial infection is causing prostatitis, it won't go away on its own. You need medication to get rid of the infection. But, if you have CPPS or nonbacterial prostatitis, the inflammation and tenderness may subside without medication.

How do you explain what a UTI feels like to a man? ›

pain and discomfort (burning) when you urinate. discharge from the penis (that is, a clear fluid or small amount of pus from the penis) abdominal pain. fever or chills.

How can a man tell the difference between a UTI and STD? ›

UTI's often have a frequent or urgent need to urinate, a feeling of incomplete bladder emptying, and cloudy, dark, or strange-smelling urine. However, STDs can have additional symptoms that are not present with a UTI. These symptoms include: Pain during intercourse.

What is the first line for male UTI? ›

Adult males with UTI should receive a 10- to 14-day course of antibiotics. Outpatient regimens include a fluoroquinolone, trimethoprim-sulfamethoxazole (TMP-SMZ), minocycline, or nitrofurantoin (should not be given if glomerular filtration rate < 50). Treat the symptom of dysuria with phenazopyridine.

What is the male version of UTI? ›

The category of adult male UTIs includes cases, prostatitis, epididymitis, orchitis, pyelonephritis, cystitis, urethritis, and infected urinary catheters. Because of the male urinary tract's many defenses, any such infections usually are associated with anatomic abnormalities, which often require surgical correction.

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