Even though women are affected by cystitis significantly more often than men, an inflammation of the urinary bladder (urocystitis or cystitis) can also cause problems for men. Urocystitis is often even more serious in men than in women, as the prostate may also be affected. It is therefore all the more important to know the symptoms of cystitis in men in order to be able to treat it correctly and in good time. Here you can read everything you need to know about cystitis in men.
What is cystitis?
Cystitis belongs to the urinary tract infections (UTI). This refers to an infection – usually bacterial – of the urinary tract. The urinary tract extends from the kidney through the ureters (upper urinary tract) to the bladder and urethra (lower urinary tract). In this context, cystitis affects only the urinary bladder and is usually caused by bacteria of the intestinal flora ascending through the urethra (urethra). In addition to the bladder, the urethra itself (urethritis or urethritis) or the kidneys (pyelonephritis or renal pelvic inflammation) may also be affected by inflammation.
What are the types of urinary tract infections?
There are three types of urinary tract infections, or more specifically, bladder infections:
- Uncomplicated cystitis: By definition, this is an inflammation of the urinary bladder without any functional or anatomical features. That is, the kidneys and urinary tract must be completely normal in function and form. In addition, there must be no renal dysfunction or other concomitant diseases that could promote urinary tract infection.
- Complicated cystitis: All urinary tract infections that do not meet the requirements of an uncomplicated urinary tract infection are considered complicated. In a complicated cystitis, so to speak, physical concomitant circumstances are present.
- Recurrent (recurrent) cystitis: recurrent urinary tract infections are said to occur when there are two or more infections per six months or three or more infections per year.
The cystitis in men – a special case.
Inflammation of the bladder in men occupies a special position in the classification in these categories. Thus, any cystitis in a man – even if he is perfectly healthy – is considered complicated. There are two reasons for this. First, men are less likely to be affected by urinary tract infections because of their long urethra – in women, the urethra is only a few centimeters long, so pathogens can more easily ascend to the bladder. For this reason, it should always be clarified in men whether there are any malformations or diseases that could have promoted the bladder infection. On the other hand, there is a risk that the prostate is also affected by the inflammation.
Causes: How does a man get cystitis?
Bacteria from the intestines are most often responsible for urinary bladder infections. The bacteria rise through the urethra and can then cause infections in the urinary bladder. Most often, the responsible bacteria are Escherichia coli (E. coli), Proteus mirabilis, Klebsiella or Enterococcus. Some of them are also found in the intestines of healthy people, but if they are carried into the urinary tract, they can cause urinary bladder infections. The pathogens do not differ in men and women. In addition, in rare cases, cystitis can also be caused by viruses, parasites or fungi. Theoretically, it is possible to be infected with the pathogens that can cause cystitis. In the actual sense, however, cystitis is not contagious.
Risk factors for cystitis in men
The risk factors for a urinary tract infection are mainly sexual intercourse, anatomical changes in the urinary tract, urinary catheters, and pre-existing conditions such as diabetes:
- Unprotected sexual intercourse can lead to infection with various bacteria, fungi, and viruses. Some of these pathogens can ascend through the urethra and cause cystitis.
- Anatomical changes, such as a narrowing of the urethra, can cause urine to flow more poorly. Urine that remains too long in the bladder is a good breeding ground for bacteria, which can thus multiply and cause cystitis.
- Foreign bodies in the urethra or urinary bladder, for example bladder catheters, also favor a urinary bladder infection, because bacteria can attach to the plastic surface.
- In addition, systemic diseases, for example, diabetes mellitus, can contribute to the development of urinary bladder inflammation. If the blood sugar level is too high, sugar is excreted through the urine. In this “sweet” urine bacteria can multiply very well.
The hypothermia of the urinary tract is rarely to blame for infection. However, cold can favor the ascent of bacteria through the urethra.
Symptoms of cystitis in men
Dysuria, alguria, stranguria, pollakiuria, and hematuria: these foreign words describe the typical symptoms of cystitis, both in men and women, although these signs do not necessarily occur.
- Dysuria describes difficult urination. For example, urination does not start as usual or the stream is weakened or interrupted.
- Alguria describes pain during urination. Pain or a burning sensation when urinating are quite typical symptoms of urinary bladder inflammation.
- Stranguria describes the feeling of constant, painful urination without being able to urinate.
- In a similar direction goes the symptom of pollakiuria. Here, the sufferers have to go to the toilet very often, but can only ever let very small amounts of water. This very frequent urge to urinate is also characteristic of the inflammation of the urinary bladder.
- Inflammation of the urinary bladder may also cause excretion of blood with the urine, which is called hematuria.
The blood in the urine is more precisely an excretion of red blood cells (erythrocytes). Normally, the urine must not contain more than five erythrocytes per microliter. If this is the case, it is called microhematuria. Micro because the blood in the urine cannot be seen, but can only be detected in the laboratory. There is no red coloration of the urine. Blood excretion with red coloration would be called macrohematuria, but this is not typical for cystitis. In addition, so-called suprapubic pain can occur, i.e. pain above the pubic area, which can be triggered in particular by pressure. General symptoms such as fever, chills and malaise occur rather rarely. Usually, symptoms are limited to the urinary tract.
When is a visit to the doctor necessary for cystitis?
If the above symptoms occur, there is an urgent suspicion of a urinary tract infection. Men should always go to a doctor with these symptoms, because a urinary tract infection in men is always considered a complicated urinary tract infection that must be treated. If there is uncertainty about which doctor is the right one, men can first contact their family doctor. If necessary, he can refer them to a urologist or andrologist. Women can avoid an immediate visit to the doctor if mild to moderate symptoms occur for the first time. If the symptoms last longer or occur repeatedly, women should also see a doctor.
Recognizing cystitis in men
Diagnosis of cystitis is made by the doctor with the help of a physical examination and urine tests. During the physical examination, he primarily tests for tenderness over the pubic area. In addition, the doctor usually performs an ultrasound examination of the bladder, kidneys and prostate. In this way, urine stasis, which in the worst case can damage the kidneys, or prostatitis can be ruled out. In addition, he will perform further examinations, if necessary, to determine whether, for example, physical changes such as a narrowing of the urethra or diseases such as diabetes mellitus have caused the cystitis. Especially in the case of recurrent, i.e. chronic, cystitis, a thorough search for the causes should be carried out.
Urine tests for the diagnosis of cystitis
So-called urine sticks are available for urine tests. These are test strips that are briefly dipped into a urine sample. After a few seconds, the result can be read. This tests for white blood cells, red blood cells and nitrite:
- White blood cells (leukocytes) indicate inflammation.
- Red blood cells (erythrocytes) can be detected in hematuria.
- Nitrite is a chemical compound produced by some bacteria from nitrate. If nitrite is detected, it is called a nitrite-positive urinary tract infection. However, this detection is not particularly meaningful, because bacteria can also cause cystitis, which can not produce nitrite.
The detection by urine stix is also “qualitative”. That is, the exact amount of leukocytes, erythrocytes and nitrite contained can not be determined, but only whether these substances are present in the urine at all. However, the advantage of this method is that the examination is quick, inexpensive and can be performed anywhere. More precise information can be obtained by urine analysis in the laboratory. However, this takes longer and is not always necessary. In addition, a so-called urine culture can be created. This serves to characterize and quantitatively detect the pathogen that causes the urinary bladder infection. A bacterial count of 105 CFU (colony-forming units) per milliliter of urine is considered a significant bacterial excretion. Any necessary antibiotic therapy can then be adapted to the pathogen. 10 Home remedies for cystitis
What to do for cystitis?
It is important to distinguish between an actual bladder infection with symptoms and a bacterial excretion without pain or other symptoms, a so-called asymptomatic bacteriuria. Such bacterial excretion without corresponding symptoms should not be treated with antibiotics. In uncomplicated cystitis, antibiotic treatment may not be necessary. Sufficient drinking (at least three liters a day are recommended) may be sufficient to get rid of the inflammation. Since cystitis in men is by definition considered a complicated cystitis, antibiotic therapy by a physician is always necessary. If the cystitis was caused by anatomical changes in the urinary tract, the physician will initiate appropriate therapy in addition to treating the acute symptoms to correct the underlying causes.
Treating cystitis: Antibiotics and duration
The doctor decides which antibiotic is used to treat cystitis. Antibiotics from the group of third-generation cephalosporins, such as cefotaxime or ceftriaxone, are particularly suitable. Fluoroquinolones such as ciprofloxacin can also be used, although this group of agents should only be used secondarily due to their side effects. The advantage of these antibiotics is that they also help against possible prostate involvement. If prostate involvement could be excluded, the antibiotics pivmecillinam and nitrofurantoin can also be used. The duration of treatment differs depending on the severity of the infection. If it is a bladder infection without prostate involvement, the antiobiotic therapy lasts about three days. If prostate involvement is present or cannot be ruled out, the duration of therapy ranges from seven to 14 days.
What else helps with cystitis?
Various home remedies can be used especially for mild cystitis. For men, however, it is recommended to see a doctor in any case. In addition, it is useful to ensure adequate fluid intake (water and tea) and to take it easy on yourself physically. Homeopathy can also be used for supportive treatment. Some homeopathic remedies such as Apis, Nux vomica, Dulcamara and Cantharis are said to be effective for urinary tract infections. However, they cannot replace antibiotic therapy for severe cystitis.
Complications of urinary tract infection in men
In men, the prostate gland is located in close proximity to the urinary tract. It may be involved in inflammation of the urinary tract. In addition, inflammation can also spread to the epididymis and cause epididymitis (inflammation of the epididymis). The greatest danger is that the inflammation will continue to ascend to the kidneys. The consequence is pyelonephritis (inflammation of the renal pelvis). This is a serious disease that is usually accompanied by general symptoms such as fever and chills. In this case, rapid and targeted antibiotic therapy is necessary. In addition, cystitis can also cause life-threatening blood poisoning (urosepsis) in rare cases.To prevent such complications, men should always see a doctor if they have cystitis.
How can men prevent cystitis?
Specific measures to prevent bladder infections are not essential, as men are generally less affected by urinary tract infections. Good intimate hygiene and adequate fluid intake are recommended. In addition, the use of condoms can protect both parties from sexual transmission of numerous bacteria and STDs. In addition, after sexual intercourse, both sexes should visit the toilet to urinate. This protects the urinary tract from ascending infections and thus from the development of cystitis.
