Men younger than 60 years of age are less likely to experience a urinary tract infection (UTI) than those who have passed that significant birthday.1 The increased incidence comes at considerable cost in the form of more hospitalizations, a greater risk of bacteremia, and UTI recurrence. A recent review in NEJM is an excellent source of “everything you ever wanted to know about urinary tract infections in elderly men.”1 It could help answer myriad questions you’re afraid to ask. I have posed 3 here to get you started.
Why are older men vulnerable to UTIs?
Older men have a number of risk factors that are absent when they are younger. Prostatic hyperplasia impairs normal voiding and may cause obstruction and turbulent urinary flow.1 The older demographic also is likely to have comorbid conditions—such as diabetes—that increase the risk of infections. Elderly men with functional disability, incontinence, immobility, and dementia have urine more frequently colonized by bacteria.1 Some studies have found that men are more likely than women to have urinary pathogens that are extended beta-lactamase producers.2 Bottom line, note the NEJM authors, is that the “majority of older men with urinary tract infection have underlying urologic abnormalities.”1