By Gabrielle Gleeson-Solomon, CEO of Tota
Scientific Review by Dr Nick Parkinson, PhD
On male UTI's.
Men Get UTIs Too. Here's Why That Doesn't Get Talked About Enough.
Most of what's written about UTIs, including (until now) most of what we've written, is written for women. That's not an accident: women are around 30 times more likely than men to get a UTI and roughly half of women will have one at some point in their life, so it's understandable that testing and awareness has focused there first [1]. But it's left a gap. Men get UTIs too and when they do, it doesn't always get the same attention.
Why male UTIs get missed
Because a UTI is uncommon in men, it isn't always the first thing considered when symptoms appear and research suggests clinicians themselves report lower confidence diagnosing UTI in men than in women, which can affect how it's investigated and treated [2]. In older men in particular, symptoms can present less typically, which adds to the risk of it being missed or addressed later than it should be [2]. And because standard testing for men works the same way it does for women (checking a sample against a specific, known list of organisms) a 'normal' result reflects that list, not the full picture of what's present. If symptoms continue after a normal result, that's worth raising with your GP rather than assuming the story ends there.
Left unclear or unresolved, a urinary tract infection in men can, in some cases, also involve the prostate, which is one more reason recurring or ongoing symptoms are worth taking seriously rather than waiting out.
That limitation isn't unique to any one test or any one clinician. Standard urine testing, for men and women alike, is designed to be quick and to check for the organisms most commonly responsible for infection. A microbiome test reads more broadly, which is the distinction we go into in How Tota Compares.
The male urinary microbiome
For a long time, urine was assumed to be sterile unless there was an infection. Research over the past decade has changed that picture.
In 2014, research led by Professor Alan Wolfe at Loyola University Chicago helped demonstrate that bacteria can be found in the urinary tract even when there is no obvious infection. This contributed to a growing understanding of what we now call the urinary microbiome: the community of microorganisms that can live within the urinary tract.
The male urinary microbiome tends to be a relatively quiet neighbourhood. In people without urinary symptoms, there generally aren't large numbers of different organisms present in high quantities.
The female urinary microbiome can look somewhat different. Research suggests there can be considerable overlap between the bacteria found in the bladder and vagina, meaning the urinary microbiome may more closely reflect the vaginal microbiome and can be a busier microbial environment.
We're still learning what these microbial communities mean for health. Finding an organism doesn't automatically mean it is causing an infection or needs treating. But understanding that the male urinary tract isn't simply "sterile" has changed how researchers think about urinary health and is one reason newer DNA-based approaches can provide a different view from traditional culture alone.
What Tota does for men
Tota's testing is available for men as well as women. Using the same non-targeted DNA sequencing approach described elsewhere on our site, we look at what's actually present in a urine sample, across a broad range of bacteria and fungi, and explain it in plain English, the same way we do for every result we send out. You can read more about how the process works end to end, from sample to report, on About Our Tests.
For men, that means a look at your urinary microbiome specifically, the community of organisms naturally present in the urinary tract, rather than the combined vaginal and urinary picture we test for in women.
What it cant tell you
As with our testing for women, this isn't a diagnosis. It doesn't identify prostatitis or any other condition, and it doesn't replace a GP or urologist. What it can do is give you a broader, more complete picture of what's present in your urinary microbiome, to bring into a conversation with a healthcare professional, particularly if you have ongoing symptoms you'd like to explore further.
Is this for you?
You might consider this kind of testing if recurring urinary symptoms are part of your life, or if you'd simply rather understand what's going on in your body proactively rather than wait for something to get worse.
If this sounds familiar
If you've had recurring symptoms and repeated "normal" results, take a look at About Our Tests to see how Tota's urine testing works.
Sources
- Schaeffer AJ, Nicolle LE. Urinary tract infections in older men. N Engl J Med. 2016;374:562-571. Medscape: Urinary Tract Infection (UTI) in Males
- Lower clinician confidence is associated with longer intended treatment duration for outpatient men with urinary tract infections. PubMed Central (PMC)
- Medscape. Urinary Tract Infection (UTI) in Males: epidemiology, clinical presentation and diagnosis. Medscape/eMedicine
This article is for general information and does not replace medical advice. If you're experiencing new, severe, persistent or worsening symptoms, please speak to a GP or another qualified healthcare professional.
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