Why is cystitis rare in men?
The structure of the male genitourinary system itself protects the bladder. The urethra, about 18–20 centimeters long, creates a serious barrier to ascending infection, the external opening is located far from the anus, and the secretion of the prostate gland contains substances that inhibit the growth of bacteria. Therefore, isolated cystitis in a healthy young man is very rare, and its occurrence almost always indicates an additional factor: impaired urine flow, chronic inflammation in the prostate, or a decrease in the defenses of diabetes.
- Long and curved urethra
- Distance of the external opening from sources of bacteria
- Antibacterial properties of prostate secretion
- Isolated cystitis in men is rare
- There is almost always a predisposing factor
Main reasons
Most often, the bladder becomes inflamed when it is not completely emptied, and urine remains in it, in which bacteria multiply. This happens with prostate adenoma in men over 50 years old, with narrowing of the urethra after injuries and infections, with bladder stones and neurogenic disorders. In young men, cystitis is often associated with chronic prostatitis and sexually transmitted infections. A separate group included patients with a catheter and after endoscopic interventions, as well as men with uncompensated diabetes mellitus.
- Prostate adenoma
- Chronic prostatitis
- Urethral stricture
- Bladder stones
- Sexually transmitted infections
- Diabetes mellitus and bladder catheterization
Symptoms
The clinical picture is similar to female cystitis: frequent urge, pain and burning during urination, especially at the end, pain and heaviness above the pubis, a feeling of incomplete emptying. The urine becomes cloudy, sometimes with an unpleasant odor, and there may be an admixture of blood. Men often experience signs of prostatitis: pain in the perineum, radiating to the rectum, discomfort during ejaculation. A rise in temperature and lower back pain means that the infection has spread to the kidneys, and this condition requires emergency care.
- Frequent and imperative urges
- Cutting and burning when urinating
- Pain above the pubis
- Cloudy urine, sometimes with blood
- Feeling of incomplete emptying of the bladder
- Pain in the perineum with concomitant prostatitis
Survey
Diagnosis is not limited to urine analysis. A general analysis confirms inflammation, culture determines the pathogen and its sensitivity to antibiotics. An ultrasound of the bladder with measurement of residual urine and assessment of the prostate shows whether there is an obstruction to the outflow. Uroflowmetry objectively measures flow velocity. In men over 50 years of age, PSA is assessed. In case of repeated episodes, blood in the urine and treatment failure, cystoscopy and computed tomography are prescribed to exclude stones, diverticula and bladder tumors.
- General urine analysis and bacterial culture
- Ultrasound of the bladder with residual urine
- Ultrasound and TRUS of the prostate
- Uroflowmetry
- PSA in men over 50 years of age
- Cystoscopy for relapses and blood in the urine
Treatment and prevention
The antibiotic is selected based on culture results, and the course is usually longer in men than in women because the prostate is often involved. Short one-day regimens used in women are not suitable here. At the same time, the cause is eliminated: adenoma, prostatitis are treated, stones are removed, and narrowing of the urethra is eliminated. It is recommended to drink enough fluids, resist the urge, and avoid hypothermia and constipation. Regular examination by a urologist after 50 years helps to detect an adenoma in time, and compensation for diabetes mellitus significantly reduces the frequency of infections.
- Antibiotic by culture, course longer than in women
- Eliminating the cause of obstructed urine flow
- Treatment of prostatitis and adenoma
- Sufficient drinking regime
- Glucose control in diabetes
- Annual examination by a urologist after 50 years
