Urinary tract infection in males

Scope

  • This guideline covers the assessment and management of adult male patients with suspected urinary tract infections.

Out of scope

  • Females
  • Children

Assessment

Signs and Symptoms

Risk factors include
  • Increasing age
  • Diabetes
  • Sexual intercourse
The common symptoms include
  • Dysuria
  • Frequency
  • New retention
Other possible symptoms include
  • Polyuria
  • Suprapubic tenderness
  • Haematuria
  • Urgency

Red Flags

Consider emergency admission

If evidence of:

  • Dehydration
  • Haemodynamic instability

Management

If UTI is a recurrence
If UTI is first presentation

Patient does not have CLEAR symptoms of UTI

Patient has CLEAR symptoms of UTI

  • No dipstick needed
  • Send MSU
  • Patient has MSU
    • Patient has no symptoms of Pyelonephritis
      • Treat for UTI
      • Joint formulary advice is based on local epidemiology, you must review previous culture results for resistance
      • Phone microbiology is unsure
      • Relieve symptoms with paracetamol or ibuprofen
    • Patient has prostatic symptoms or recurrence
      • Prostatic symptoms include;
        • Perineal pain
        • Retention
      • Consider treating for prostatitis
    • Patient has symptoms of Pyelonephritis
      • Suspect Pyelonephritis if;
        • Temperature greater than 39°C
        • Rigors
        • Nausea and Vomiting
        • Diarrhoea
        • Loin pain
      • No evidence of dehydration or haemodynamic instability
      • Evidence of dehydration or haemodynamic instability
        • Urine samples
        • Refer to secondary care
        • Consider emergency admission

Joint formulary – Chapter 5 – Infections

Joint formulary – Chapter 7 – urinary-tract disorders

Referral

Referral Criteria

Refer to secondary care/consider emergency admission

If evidence of:

  • Dehydration
  • Haemodynamic instability

Referral Instructions

Referral to Urology
  • Refer using e-Referral service selection
    • Specialty: Urology
    • Clinic Type: Not otherwise specified
    • Service: DRSS-Northern – Urology – New Devon CCG – 99p

Referral Forms

DRSS Referral Proforma

Supporting Information

Pathway Group

This pathway was signed off by the NEW Devon CCG Northern Locality Clinical Pathway Group.

Publication date: May 2017

 

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