Urinary Tract Infections in Men

Millions of urinary tract infections develop in men each year. And even though such infections in men are less common than in women, it's still important to recognize the symptoms and get treatment quickly. Infections of the urinary system (the kidneys, ureters, bladder and urethra) can be very serious, and even life-threatening. 

Causes of Urinary Tract Infection (UTI)

Urine is normally sterile, but under certain circumstances, bacteria (often E-coli that live in the colon) can move into the urethra, causing an infection called urethritis. The infection may move up the system to the bladder (called cystitis) or to the kidneys (pyelonephritis).

• Microorganisms called chlamydia and mycoplasma can both be transmitted sexually. When this happens, both partners have to be treated for the infection.


• Men with abnormalities of the urinary tract, such as kidney stones or an enlarged prostate, are more prone to urinary infection.


• Men who have a catheter or tube placed in the bladder are more susceptible to infection.


• Men with diabetes or any disease that suppresses the immune system are more prone to

Symptoms of Urinary Tract Infection in Men

Although some men who have a UTI do not have any symptoms, most men will experience some or all of the following symptoms:

• Frequent urge to urinate but the amount of urine passed is often small
• Painful, burning feeling in the area of the bladder or urethra during urination
• Fatigue
• Fever (this often means that the infection has moved into the kidney)
• Cloudy or milky urine. Blood may also be present, in which case the color will be reddish
• Offensive-smelling urine
• Nausea and even vomiting may occur in kidney infections
• Back pain

Diagnosis of UTI

Your doctor will ask you for a urine sample and will send it to be tested for bacteria. Further tests, such as an intravenous pyelogram (IVP), ultrasound, or cystoscopy may be required to detect the cause of urinary infections especially if they recur or do not respond to the medication your doctor orders.

Treating a Urinary Tract Infection

Antibioticsc such as ciprofloxacin, levofloxacin, sulfamethoxazole with trimethoprim are typically prescribed to kill the bacteria that is causing the infection. It's important to take the full course of antibiotics as prescribed by your doctor, even if your symptoms appear to clear up before you're finished.

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Managements of Erectile Dysfunction

Male sexual dysfunction includes erectile dysfunction (ED), decreased libido, anatomical abnormalities (e.g., Peyronie disease), and ejaculatory dysfunction. ED, defined as the inability to achieve erections firm enough for vaginal penetration, affects millions of men in the United States. The Massachusetts Male Aging Study showed that the prevalence of ED increased by age: approximately 50% of men experienced ED at age 50, and nearly 70% at age 70.

Causes

The causes of ED may be results of disturbance in erectile physiology include hormonal, vascular, psychological, neurological, and cellular components. Testosterone is primarily responsible for maintaining sexual desire (libido) so hypogonadism is associated with ED.

Other hormonal causes of ED include hyperthyroidism and prolactinomas

Psychogenic erections, triggered by fantasy or visual stimulation, are mediated by sympathetic input from the thoracolumbar chain (T11-L2).

 Reflex erections are caused by tactile stimulation and are mediated by the parasympathetic nervous system (S2-S4).

 Overall, parasympathetic signals are responsible for erection, and sympathetic signals are responsible for ejaculation.

Risk factors

 Men with diabetes, hypertension, and coronary artery disease are at Increased risk of ED. Also improves in obese men who lose weight through diet and exercise

Medical Management

·         Phosphodiesterase Type 5 (PDE-5) Inhibitors:  The first lines of therapy for most men with ED are

o   Sildenafil (Viagra)

o   Vardenafil (Levitra)

o   Tadalafil (Cialis).

·         Intraurethral Alprostadil is effective in men of all ages who have various causes of ED and is inserted into the tip of the penis with an applicator

·         Intracavernosal Penile Injections a triple-therapy combination of alprostadil, papaverine, and phentolamine cause relaxation of cavernosal smooth muscle and penile blood vessels, and phentolamine antagonizes a adrenoreceptors

·         Hormonal therapy with   testosterone available for injection, skin patch, topical gel, or buccal oral tablets.

Nonmedical Treatments

Other treatments for ED include topical vacuum pump devices, surgically inserted inflatable penile implants and psychological counseling are used in ED treatments.

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