Keep on getting a UTI or feel like it has never gone away? Urinary problems in men can be hard to diagnose.
Men get UTIs too
Men, women and children get UTIs but urinary problems can be hard to diagnose in men. You know your body best, so do be aware of and question, the information your doctor provides if you think they are missing an infection.
Talking to your doctor
No detail is too small when visiting the doctor about urinary problems. We suggest you write down a list of symptoms and take them with you to your appointment. For example, an unusual smell, abnormal amounts of ‘foam’, or persistently darker urine than usual may seem unimportant to you, but to a doctor these can be the characteristic symptoms required to diagnose a given condition. Other signs to look out for and mention to your GP include:
- a weak or intermittent urinary stream
- terminal dribbling
- incomplete emptying
- urgency incontinence
- nocturia – getting up at night to urinate
- post‑urination dribbling
- pain or a stinging sensation in the urethra or penis whilst urinating or post urination.
- Pain radiating into the rectum
One major fear is that of a physical exam, especially when it relates to intimate parts of the body. A physical exam is likely to occur, so prepare yourself ahead of time for it. Do not be afraid to ask for a male doctor when making your appointment (indeed, some surgeries will insist on matching gender when an appointment relates to potential conditions that require genital exams). A chaperone is also acceptable, and in some cases encouraged.
However, a doctor may not wish to examine you in certain conditions; in these cases, do not be afraid to ask for one if you feel it necessary or would like to put your mind at rest. For example, younger men that present urinary symptoms will likely be assumed to not have prostatic issues and thus a doctor will likely not perform an exam. This doesn’t exclude their presence entirely, so should you have any doubt it is recommended that you ask for the exam to be performed anyway.
One key point when testing and treating men with chronic UTI is that bacteria may be harboured in the the prostate rather than the bladder.
It’s also worth knowing that some UTI-like symptoms may not be caused by a urinary tract infection but may be due to a sexually transmitted disease such as chlamydia, herpes, gonorrhoea or a fungal infection such as candida or thrush. Mycoplasma or ureaplasma can also cause urethritis like symptoms.
If you are in any doubt ask your GP or local Sexual Health Clinic for examinations and tests.
Urinary tract infections in men that just don’t go away
Although painful and distressing most are short-lived. But if you keep on getting a UTI or feel like it’s never really gone away you could have chronic infection.
Chronic UTI often starts when a simple infection is left untreated or fails to get better with standard treatments. Read about how and why chronic UTI develops.
Needing to pee all the time, pain when you pee, passing tiny amounts of urine, bladder and urethral pain, pain in your belly, back and legs, difficulty passing urine, problems with incontinence. The symptoms of chronic UTI are similar to acute infections but they vary from person to person.
Currently there’s just not enough research to understand why some people never experience a UTI, why some people have one or two infections and why some people develop chronic infections.
The symptoms of chronic UTI are, frustratingly, not exclusive to the condition – they are common to a number of other lower urinary tract (LUTS) health conditions as well. This can often result in other avenues being explored for diagnosis first by your GP, leading to chronic UTIs being diagnosed by exclusion of other conditions, all the while allowing the UTI to develop further.
Other LUTS conditions that are investigated in men include:
- detrusor muscle weakness or overactivity
- prostate inflammation (prostatitis)
- prostate cancer
- neurological disease
I feel like I have a UTI but my tests are negative
Sound familiar? Unfortunately the standard tests used to diagnose UTIs – dipstick tests and mid-stream urine cultures (MSUs) – miss about half of infections. The figure is likely to be even higher for chronic infections.
But some doctors are more likely to rely on test results than on the symptoms their patients are describing and rule out infection as a cause.
No test is perfect, as they all have different ‘sensitivity levels’. A relatively low concentration of bacteria may fall below the sensitivity limit of a given test, but still be concentrated enough to have a profound effect on the patient. As a result, UTIs are best diagnosed with a combination of tests, physical examinations and symptom analysis.
How do I talk to my GP about chronic urinary tract infections?
Unfortunately currently guidelines for GPs don’t even mention chronic UTI. We know it can be difficult to explain all this and describe your symptoms in a short doctor’s appointment.
Write down all your symptoms as we outlined above and take them with you to your appointment.
Your doctor may well investigate if your UTIs are related to your prostate. But if these investigations come back negative ask your GP to consider chronic UTI.
No detail is too small when visiting the doctor about urinary problems. It may help to write down a list of symptoms, no matter how small, and take them with you to your appointment. For example an unusual smell, abnormal amounts of ‘foam’, or persistently darker urine than usual may seem unimportant to you, but to a doctor these can be the characteristic symptoms required to diagnose a given condition.
How do I manage and treat chronic UTI?
This website includes a list of specialists who treat those with recurrent and chronic UTI.
It can take time to find the right combination of treatment or treatments to successfully reduce your symptoms and the infection.
Having a chronic UTI can feel incredibly isolating, but you are not alone. Find support groups to help you.
If you would like to speak to someone, Bladder Health UK run an advice line. One day a week you can speak to a specialist nurse. Call 0121 702 0820.