Robert, a retired 86-year-old man, was outside gardening when he noticed pain in his lower abdomen; and throughout the day, he had difficulty urinating. When he asked his wife about the symptoms, she suggested he might have a urinary tract infection. "I can't have a UTI," he said. "Men don't get UTIs!"
UTIs in men
Contrary to popular belief, men can experience UTIs, as can people of all ages. Men are at a lower risk of UTIs than women due to their anatomy -- the bacteria have to travel farther from where the urine is released, through the duct attached to the bladder (called the urethra).
Being uncircumcised and participating in anal sex can increase men's risk of developing a UTI. There is not nearly as much research on UTIs in men, but their treatment looks fairly similar to that of women, said Stanford primary care physician Kim Chiang, MD. "The biggest difference in treatment is that antibiotics are often given for seven days rather than three to five days, and the antibiotic choice may be different as well."
"The variation in treatment is due to the difference in the anatomy of the urinary tract system in men versus women - men have longer urethra, which typically makes it more difficult for bacteria to travel far enough to cause an infection," Chiang explained. "If a man were to get a UTI, then the bacteria is presumably more virulent and may require a longer duration of treatment than for UTIs in women."
Older adults can get UTIs
In older adults, UTIs are one of the most common bacterial infections.
Although many older adults experience UTIs, they can be overdiagnosed and overtreated, which can lead to poor health outcomes or the overuse of antibiotics, said Stanford physician Randall Stafford, MD, PhD. This is because many older adults have symptoms similar to UTIs due to other issues, such as overactive bladders or enlarged prostates, Stafford said. Therefore, it is important for health care providers to confirm the diagnosis with a urine culture to avoid misinterpreting the symptoms.
One common belief is that change in mental status or falls in the elderly could indicate a UTI; however, these are not reliable predictors, Stafford said.
For women after menopause, vaginal estrogen cream is a proven prevention technique for UTIs. However, how this prevents UTIs is not completely clear.
Children can get UTIs
Five-year-old Samantha had been wetting the bed and waking up to use the bathroom multiple times per night. Then, she developed a fever. After she was unable to attend her first day of kindergarten, Samantha's parents brought her to the pediatrician's office, where she was diagnosed with a UTI.
UTIs are difficult to diagnose in children, so health professionals almost always collect and test a urine sample. It is common for children to have bladder and bowel dysfunction, such as difficulty urinating and passing stools, which are risk factors for recurrent UTIs. Children with a UTI can develop scarring on the kidney, which can lead to later urological issues.
Pregnant women can get UTIs -- without symptoms
Irene, a 40-year-old mother of three, was very familiar with the routine prenatal care at her OB-GYN appointment. But at one of the visits, she was concerned to learn that for the first time, she was experiencing asymptomatic bacteriuria, or the presence of bacteria in the urine, in her first trimester.
From 2% to 7% of pregnant women have asymptomatic bacteriuria, which is a bacterial infection in the urine that is not accompanied by any symptoms. Without treatment, this can develop into a UTI or a kidney infection.
Potential complications for pregnant women with UTIs are low birthweight for their babies and/or preterm birth, yet this association has not been fully established. Therefore, all pregnant women should be screened for an infection early in their pregnancy to prevent any complications. In addition, treatment options have to be tailored because not all antibiotics are safe to take during pregnancy.
For other people, treatment may not be needed, Chiang said. "Asymptomatic bacteriuria generally does not require treatment, except for special cases, such as pregnancy or prior to a planned urological procedure," she said.
It is important to note that UTIs can happen in anyone, so be sure to pay attention to any symptoms, such painful, frequent or sudden urination, and seek care from a health care professional when needed.
This is the sixth post in the series Understanding UTIs. The goal of this seven-part series is to provide easy-to-understand, scientifically grounded information about UTIs. Patients referenced are composites, compiled from actual patient experiences.
Joanna Langner is a graduate student in Community Health and Prevention Research at Stanford who is interested in health disparities and women's health. She wrote this series with the support of Randall Stafford, MD, PhD, professor of medicine and director of the Program on Prevention Outcomes and Practices, and Kim Chiang, MD, clinical assistant professor of medicine.
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