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Male UTI

 

  • For a one off uti in otherwise healthy male  above the  age  of 40  do flow rates/residuals via ospic to look for evidence of bph or stricture and assess bladder emptying.

 

  • Do an uss to look for stones, anatomical abnormalities, and screen for tumour (see advice re stones).

 

  • Flexi cystoscopy referral is appropriate if persistent dip haematuria after treatment or risks for tcc such as smoking/industrial exposure, mention of  this  on referral  would be  helpful . Cystoscopy  not  the  standard in all cases.

 

  • Ask about uti risk factors such as poor fluid intake, anal sex, previous instrumentation/catheter that might suggest urethral stricture etc.

 

  • Alpha blocker +/- 5 alpha reductase inhibitor if large prostate - see luts guidlines.. if flows/uss normal and one off would not go further unless recurrent problem. then refer refer for further specialist assessment/investigation.

 

  • Younger (<40) more likely to be stones/anatomy and think about std, older more likely to be bph.