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التهاب المسالك البولية لدى الرجال

Most urine infections in men are caused by germs (bacteria) which come from your own bowel. They cause no harm in your bowel but can cause infection if they get into other parts of your body. Some bacteria lie around your back passage (anus) after you pass a stool (faeces).

These bacteria sometimes travel to the tube which passes urine from your bladder (the urethra) to the outside. Some bacteria thrive in urine and multiply quickly to cause infection.

A urine infection is often called a urinary tract infection (UTI) by doctors. When the infection is just in the bladder and urethra, this is called a lower UTI, or cystitis. If it travels up to affect one or both kidneys as well then it is called an upper UTI or pyelonephritis. This can be more serious than lower UTIs, as the kidneys can become damaged by the infection.

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Male genitals side view and urinary tract cross-section diagram

Male genitals and urinary tract

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How common are urine infections in men?

UTIs are rare in men aged under 50. They become more common in older men. Urine infection is much more common in women.

In some cases an underlying problem can increase the risk of developing a UTI in men. These include the following:

In other cases the UTI occurs for no apparent reason.

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Symptoms of a UTI in men will depend on where the infection occurs.

Infection in the bladder (cystitis) symptoms:

Infection in the kidneys symptoms:

  • Pain in a loin (the side of the lower back over the kidney).

  • ارتفاع في درجة الحرارة (حمى).

  • Feeling or being sick (vomiting).

  • Feeling generally unwell.

In some elderly men, the only symptoms may be a recent onset of confusion or just feeling generally unwell or unsteady, even without any actual urinary symptoms.

ت اختبار البول can confirm the diagnosis and identify the germ (bacterium) causing the infection. Further tests are not usually necessary if otherwise well with a one-off infection. However, a doctor may advise tests of the kidney, prostate gland or bladder if an underlying problem is suspected.

An underlying problem is more likely if the infection does not clear with an antibiotic medicine, or if there are:

  • Symptoms that suggest a kidney is infected (not just the bladder).

  • Recurring urine infections, for example, two in a six-month period.

  • Problems with the kidney in the past, such as حصى الكلى or a damaged kidney.

  • Symptoms that suggest an obstruction to the flow of urine.

  • Blood-stained urine which persists after treatment with antibiotics.

UTI tests may include:

تابع القراءة أدناه

  • A short course of مضادات حيوية will usually clear the infection quickly. This is usually for seven days in men. Medical advice should be sought if the symptoms are not gone, or nearly gone, after the course of antibiotics is completed, or if the symptoms are getting worse whilst on the treatment.

  • الباراسيتامول will usually ease any pain, discomfort, or high temperature (fever).

  • Have plenty to drink to help prevent a lack of fluid in the body (الجفاف).

The following can help prevent urine infections in men:

  • Drinking enough fluids to avoid dehydration.

  • Emptying the bladder when needed and not "holding on".

  • Passing urine soon after sexual intercourse.

  • Sometimes preventive antibiotics are recommended to prevent recurrent UTIs. These are usually given daily at a low dose for several months. The antibiotics are often rotated to prevent antibiotic resistance from occurring. The antibiotics used include: nitrofurantoin, trimethoprim, cefalexin and amoxicillin.

The vast majority of men improve within a few days of starting treatment. If symptoms do not improve despite taking an antibiotic medicine, then an alternative antibiotic might be needed. This is because some germs (bacteria) are resistant to some types of antibiotics. This can be identified from tests done on the urine sample.

Occasionally the infection may spread and cause you more significant symptoms. Infection in the bladder (cystitis) may spread to the kidney (pyelonephritis).

Infection may also spread to involve the prostate gland, causing infection of the prostate gland (prostatitis).

Recurring urine infection in men

Recurrent urine infections are defined as two or more infections in six months or three or more infections in a year. It is unusual for men to have recurring urine infections.

Men with recurring infections may be referred to a urology specialist for further tests to try and establish why they are occurring.

Blood tests to assess the kidney and prostate gland, and ultrasound scans to look at the kidneys, bladder and prostate gland, will often be organised before seeing the urology specialists.

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احتباس البول

الكلى والمسالك البولية

احتباس البول

Urinary retention means that you are having problems emptying the bladder completely. It may occur suddenly (acute urinary retention) or it may develop over a longer period of time (chronic urinary retention). Acute urinary retention is a medical emergency. Urinary retention is more common in men than in women. It becomes more common as you become older. In men aged in their 70s, urinary retention occurs in about 1 in every 100 men. For men in their 80s, urinary retention occurs in about 3 in every 100 men. You may need tests to help find the cause of your urinary retention. The treatment and outcome for both acute and chronic urinary retention will depend on the underlying cause. You should see a doctor immediately if you are unable to pass any urine when your bladder feels full and painful.

بقلم الدكتورة روزالين أدلمان، MRCGP

أعراض الجهاز البولي السفلي لدى الرجال

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أعراض الجهاز البولي السفلي لدى الرجال

Lower urinary tract symptoms (LUTS) are a very common problem, especially in men over the age of 65 years. They can be caused by various conditions. These symptoms may include slowing of the urine stream and needing to get up to pass urine at night. There are different causes of LUTS and the treatment will depend on the cause. Some men choose not to have treatment if their symptoms are not too bothersome and the cause is not serious.

بقلم الدكتورة فيليبا فينسنت، MRCGP

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