All About the Symptoms of Cystitis in Men

10 September, 2020
Cystitis in men involves changes in urination habits as well as pain. How can you identify it? What should you do in the case of symptoms? We'll tell you in this article!

Cystitis refers to an inflammation of the bladder. While it’s a fairly frequent disorder in women, men can also fall victim to this type of infection. How can you recognize cystitis in men?

The symptoms don’t differ very much between men and women. However, it’s important to be attentive to the infection’s evolution. In general, this infection affects men between the ages of 15 and 50. While it usually isn’t serious, it’s uncomfortable and, on occasion, can be a sign of other illnesses.

Below, we’ll tell you what you need to know about cystitis in men.

Urinary tract infections and cystitis in men

Urinary tract infections in men can affect both the lower urinary tract – especially the bladder – as well as the upper urinary tract and the kidneys. The term “cystitis” refers to a urinary tract infection that involves the bladder and the lower urinary tract.

In general, when we talk about simple acute cystitis, we’re referring to an infection that affects only the bladder, but not the rest of the urinary tract of the kidneys. This is an important distinction since it completely changes patient management and his prognosis.

The symptoms of cystitis in men

In men, cystitis is not as common as it is in women given that men have a longer urethra, anatomically speaking. This makes it harder for pathogens to reach the bladder. At the same time, according to a publication in the National Center for Biotechnology Information, it can also result from antibacterial defenses that come from the prostate liquid

In most cases, this infection doesn’t involve complications and the symptoms are similar to those the women experience. In general, the symptoms of cystitis in men include the following:

  • Dysuria: This refers to pain while urinating. Patients may perceive it as a burning or stinging sensation.
  • Frequency of urinationAn increase in the number of times a person urinates.
  • The urgency to void: In other words, a sudden need to urinate, or an inability to hold in urine.

Other less frequent symptoms include:

  • Suprapubic pain
  • Nocturia, which refers to urination that’s more frequent during the night than during the day
  • Difficulty emitting the urinary stream
  • Hematuria, (blood in the urine)
Urinary incontinence in men.
The symptoms of cystitis in men are similar to those of women. They can include a burning sensation when urinating, an urgente need to urinate, and frequent urination.

Possible complications

When men experience recurrent symptoms of cystitis, or the symptoms appear along with pelvic or perineal pain and fever, it’s best to consider the possibility of prostatitis. Therefore, doctors should evaluate referring patients to a specialist in urology.

At the same time, the presence of fever, chills, fatigue, and sensitivity in the flank or costovertebral angle is not compatible with simple acute cystitis in men. In the case of these clinical manifestations, patients may really be dealing with pyelonephritis.

The correct diagnosis of cystitis is essential when it comes to prescribing the right antimicrobial treatment and avoiding complications. A doctor will determine if symptoms are the result of cystitis or another pathology.

You may also want to read: Why Urinary Tract Infections Occur

Diagnostic exams

In order to diagnose cystitis in men, a doctor will begin with an exhaustive list of questions regarding symptoms. By doing so, he or she will determine if complementary studies are necessary, which may include the following:

  • Urine analysis: Doctors perform this either via a microscope or through the use of a reactive strip, in order to detect pyuria.
  • Urine culture: Doctors may order a urine culture using antibiotic susceptibility data. A Gram stain may be useful when it comes to choosing empiric antibiotic therapy while awaiting the results of the culture. Then, doctors will observe the presence of bacteriuria. As a general rule, in the case of a suspected case of cystitis in men, doctors will always conduct this test. They will never prescribe an antibiotic treatment without first collecting a sample for a urine culture.
  • Other studies: Doctors will perform a gentle digital rectal exam if they suspect acute prostatitis. A sensitive and edematous prostate will confirm this alternative diagnosis.

In men with cystitis, especially those with recurring urinary tract infections caused by the same bacterial strain, doctors will consider a diagnosis of chronic prostatitis.

A proctologist appointment.
In order to confirm a cystitis diagnosis and rule out other possible causes, a doctor will suggest complementary exams, such as a urine analysis.

Risk factors for more serious infections

Certain particular characteristics can increase a person’s chances of developing a more complicated acute UTI. Therefore, doctors must pay special attention when treating patients with the following characteristics

  • Urinary tract anomalies: Nefrolitiasis, stenosis, stents, or urinary derivations
  • Immunocompromised patients: Neutropenia or an advanced HIV infection
  • Poorly controlled diabetes mellitus

See also: Sexual Dysfunction in Diabetic People

What to do in the case of urinary symptoms

As we mentioned, the development of cystitis in men that are healthy, under the age of 50, and don’t suffer from another disorder is low. However, after the age of 50, the risk increases, given the prostatic hypertrophia that some tend to develop.

Given the presence of urinary type symptoms, individuals should see a doctor as soon as possible. This will prevent delays in diagnosis and allow doctors to implement the correct course of treatment. At the same time, doctors should control the evolution of the infection along with the results of the urine culture.

On certain occasions, doctors may need to evaluate the complete urinary tract as well as the prostate. In the case of the latter, the nephrologist or urologist will be responsible for the exam.

In conclusion, it’s worth mentioning the importance of having a healthy lifestyle and drinking plenty of water. These factors will help prevent this type of infection from recurring.

  • Zanella MC, Schoofs F, Huttner B, Huttner A. Infections urinaires basses non associées aux sondes urinaires chez l’homme. Urétrite, cystite et prostatite [Lower urinary tract infections in men. Urethritis, cystitis and prostatitis]. Rev Med Suisse. 2017;13(558):808‐814.
  • Hooton Thomas, Acute simple cystitis in men, retrieved on 10 June 2020, Evidence-based Clinical Decision Support- UpToDate. https://www.uptodate.com/contents/acute-simple-cystitis-in-men?search=cistitis%20men&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
  • Kasper y col., Principios de medicina interna de Harrison, edición número 19, Editorial McGrawHill.
  • Li R, Leslie SW. Cystitis. [Updated 2020 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482435/
  • Roberts, R. G., & Hartlaub, P. P. (1999, September 1). Evaluation of dysuria in men. American Family Physician.
  • Lee G, Romih R, Zupančič D. Cystitis: from urothelial cell biology to clinical applications. Biomed Res Int. 2014;2014:473536. doi:10.1155/2014/473536
  • Lipsky BA. Prostatitis and urinary tract infection in men: what’s new; what’s true?. Am J Med. 1999;106(3):327‐334. doi:10.1016/s0002-9343(99)00017-0
  • Price TK, Dune T, Hilt EE, et al. The Clinical Urine Culture: Enhanced Techniques Improve Detection of Clinically Relevant Microorganisms. J Clin Microbiol. 2016;54(5):1216‐1222. doi:10.1128/JCM.00044-16