Acute uncomplicated cystitis and pyelonephritis in men
- Thomas M Hooton, MD
Thomas M Hooton, MD
- Professor of Medicine
- University of Miami Miller School of Medicine
Acute cystitis refers to infection of the bladder (lower urinary tract); it can occur alone or in conjunction with pyelonephritis (infection of the kidney – the upper urinary tract). Acute cystitis and pyelonephritis in men will be reviewed here. Issues related to prostatitis are discussed separately. (See "Acute bacterial prostatitis" and "Chronic bacterial prostatitis".)
Acute cystitis and pyelonephritis in women and asymptomatic bacteriuria are discussed separately. (See "Acute uncomplicated cystitis and pyelonephritis in women" and "Acute complicated cystitis and pyelonephritis" and "Urinary tract infections and asymptomatic bacteriuria in pregnancy" and "Approach to the adult with asymptomatic bacteriuria".)
Symptomatic urinary tract infection is much less common in men than in women. This is due to longer urethral length, drier periurethral environment (with less frequent colonization around the urethra), and antibacterial substances in prostatic fluid.
It has been conventional to consider all UTIs in men as complicated, since the majority occur in infants or the elderly in association with urologic abnormalities, such as bladder outlet obstruction (eg, due to prostatic hyperplasia) or instrumentation (table 1). However, acute uncomplicated UTIs occur in a small number of men between 15 and 50 years of age. Risk factors associated with these infections include insertive anal intercourse and lack of circumcision .
ACUTE CYSTITIS AND PYELONEPHRITIS
Cystitis is an infection of the bladder (lower urinary tract), which can occur alone or in conjunction with pyelonephritis (infection of the kidney - upper urinary tract) or prostatitis. The incidence of symptomatic UTI in young healthy adult men is much lower than that in women; approximately five to eight UTIs occur per year per 10,000 young to middle-aged men [2,3].
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- ACUTE CYSTITIS AND PYELONEPHRITIS
- Clinical manifestations
- - Urinalysis
- - Urine culture
- Additional evaluation
- Differential diagnosis
- - Cystitis
- Antibiotic choice
- Duration of therapy
- - Pyelonephritis
- - Follow-up
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS