Urinary Tract Problems in Men

man in hospital gown holding urine sample
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Bladder and urinary problems can strike men of any age and for any number of reasons. The urinary tract is the system that removes waste and excess fluid from the body in the form of urine. In order for normal urination to occur, all parts of the system need to work together in coordination.

This includes, in descending order, the kidneys, the ureter (which connects the kidneys to the bladder), the bladder, and the urethra (through which urine leaves the body through the penis). If any of these organs are damaged, infected, or diseased, the system can break down and manifest with characteristic urinary symptoms.

Here are six of the most common urinary tract problems affecting men.

Decreased Urine Output

Decreased urine output is the result of the constriction or blockage of the channels through which urine exits the body. It may be caused by dehydration, an enlarged prostate, or medications such as diuretics ("water pills"), anticholinergics, and certain antibiotics. Less commonly, decreased urine output can be a result of blood loss, a urinary tract infection (UTI), or a traumatic injury.

Bladder Stones

Bladder stones occur almost entirely in men. Contrary to popular belief, they are are not the same thing as kidney stones and are far less common. Bladder stones are caused by a high concentration of urine in the bladder which can trigger the formation of hardened crystals. Bladder stones can block the downward flow of urine and irritate the lining of the bladder. Symptoms include pain, blood in the urine (hematuria), painful urination (dysuria), and the frequent urge to urinate (urinary urgency).

Stress Urinary Incontinence

While more common in women, stress incontinence can occur in men when the muscles meant to control hold the urine become weak and cause the unintentional loss of urine. Stress incontinence can happen when a physical activity or movement—such as coughing, sneezing, laughing, or lifting heavy objects—places stress on the bladder.

Bladder Cancer

Bladder cancer is the fifth most common type of cancer in the United States and one which develops primarily in the epithelial lining of the bladder. Hematuria, dysuria and urinary urgency are the three most common symptoms of bladder cancer. Men, older adults, Caucasians, and people with a family history of bladder cancer are at greatest risk.

Urethritis

Urethritis is the inflammation of the urethra. It can be caused by bacteria and viruses, including sexually transmitted ones. Men ages 20 to 35 are at highest risk, especially those with multiple sex partners and a history of risky behaviors (including condomless sex). If you have urethritis, you may experience a burning sensation when urinating or have a milky discharge from the penis. In some cases, urethritis can happen for no known reason, a condition referred to as non-specific urethritis (NSU).

Urinary Tract Infection

Around four times as many women get urinary tract infections (UTIs) as men. They are the second-most common infection a person can experience and occur when bacteria enter through the urethra and begin to multiply in the bladder. Symptoms included dysuria, urinary urgency, cloudy and/or foul-smelling urine, pain in the flanks, fever, and malaise. UTIs are more common in older men, particularly those who have experienced damage to the urinary tract (often due to a previous illness or infection) or have a congenital malformation of the urethra.

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Article Sources
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  • Schaeffer, A. and Nicolle, L. "Urinary Tract Infections in Older Men." N Engl J Med. 2016; 374:562-71. DOI: 10.1056/NEJMcp1503950.