II. Epidemiology
- Significant underlying disorder in 50% of men with UTI
III. Causes
- Upper urinary tract causes
- Hydronephrosis
- Nephrolithiasis (in Kidney or ureter)
- Common cause in younger men
- Scarred or atrophic Kidney
- Pelvic Kidney
- Ureter dilation
- Lower urinary tract causes
- Outflow obstruction with residual urine
- Most common cause in men over age 50 years
- Diverticulum
- Bladder stone
- Outflow obstruction with residual urine
IV. Differential Diagnosis
- See Dysuria in Men
V. Management
VI. Diagnostic Approach to UTI source
- Initial Studies to consider
- Abdominal Ultrasound
- Abdominal XRay
- Urine flow rate
- Further evaluation based on initial studies
- No abnormalities
- No further imaging needed
- Upper tract abnormality
- Obtain Intravenous pyelogram
- Lower tract abnormality
- Cystoscopy
- Urodynamics
- Transrectal Ultrasound
- No abnormalities
- Modifications to algorithm
- Consider IVP or Spiral CT in younger patients
