Objective: There have been few studies on urinary tract infections (UTIs) in adult males. This study aimed to look at the clinical features of males presenting with urinary tract infections in a predominantly gay general practice population.
Method: A retrospective audit and analysis was carried out of all male patients presenting with symptoms suggestive of a UTI and in whom a pathogen was cultured from urine. The subjects were drawn from two urban general practices in Melbourne. Subjects with known pre-existing urinary tract abnormalities, or in whom recent urinary tract instrumentation had been performed, were excluded, as were subjects in whom Neisseria gonorrhoeae was cultured from urine.
Results: Thirty-three subjects were identified, with a total of 47 presentations. Six subjects were excluded on the basis of pre-existing known factors which would predispose to UTIs, leaving 27 subjects, with 37 episodes of UTI. The mean age was 43 (range = 28-62) and 25 of the 27 identified as gay. Nine out of the 27 (33%) were HIV positive with a mean CD4 of 574/mm3 (range = 41-1812). The main presenting symptoms were dysuria/burning on micturition, urinary frequency, fever/sweats and haematuria. Urethral discharge occurred in two episodes. Multiple symptoms on presentation were common. The main organism cultured was E. coli. Fourteen subjects underwent further radiological investigation and two abnormalities were detected.
Conclusion: Uncomplicated UTIs are uncommon in males presenting to general practice. The symptoms are similar to those in females with UTIs, though fever may be more common. Treatment with oral antibiotics in a primary care setting is generally curative. Further investigation of males with UTIs may be appropriate, but more studies are needed as to the cost-benefit of this.