Common Male Infections

About Male STIs

There are numerous microorganisms that cause infection of the male genitourinary tract, and male reproductive infections contribute to infertility. Common male infections include urethritis, epididymitis, orchitis, and prostatitis. Men have two testicles, one on each side of the scrotum, and each testis produces hormones and sperm. Sperm is stored in the epididymitis, a convoluted glandular tube located at the top and side of each testicle. The sperm matures in the epididymitis before it goes to the spermatic ducts. The urethra is the structure that runs from the bladder to the end of the penis, and it transfers sperm and urine from the body. The prostate is a gland that consists of glandular and fibromuscular tissue. It is located beneath the bladder, right in front of the rectum. The prostate secretes fluid that contributes to around 30 percent of semen. Any infection that damages the reproductive structures or causes blockage can result in infertility.

Urethritis

Urethritis is inflammation and infection of the urethra. The urethra is the small tube that connects to the bladder and travels down the penile shaft to the end of the penis. Both semen and urine pass through this structure. Urethritis is caused by microorganisms that cause infections. Men between the ages of 20 and 35 years are at the greatest risk for developing urethritis.

Incidence, Prevalence, and Causes

The majority of cases of infectious urethritis are caused by gonorrhea and chlamydia. Also, the herpes virus is known to cause this condition. Chemical irritants can contribute to the problem, such as colognes, soaps, lotions, and spermicides. Additionally, medical procedures, rough clothing, and vigorous sexual activity can cause irritation to the urethra. Urethritis occurs in four million American men each year, with gononcoccal urethritis affecting around 700,000 males.

Signs and Symptoms

The classic symptoms of urethritis are burning and pain with urination. A man may also feel an increased urge to urinate, have itching and swelling of the penis, and experience tenderness at the end of the penis. Severe cases of urethritis cause blood in the urine or semen. To diagnose this condition, the doctor will take a urine culture and analysis, a penile discharge culture, and do some basic blood tests.

Treatment

Infections that cause urethritis are treated with antibiotics. For severe pain and inflammation, NSAIDs and analgesics are used. If a sexually transmitted infection is present, all sexual partners will also need to be treated.

Epididymitis

The epididymis is a coiled tube that lies at the back of the testicle. This structure stores and carries sperm. When it is infected or inflamed, the condition is called epididymitis. Most men who develop this condition are between the ages of 20 and 35 years. Epididymitis is a common infection of the urethral structures. When a man has an infection of the bladder, prostate, or urethra, it can spread to the vas deferens, lymphatic system, vascular system, and the epididymitis gland.

Incidence, Prevalence, and Causes

Epididymitis is frequently the result of urinary catheterization or transurethral surgery. Also, sexually transmitted pathogens can lead to this infection, such as chlamydia, gonorrhea, and ureaplasma organisms. Risk factors for epididymitis include high-risk sexual behaviors, a personal history of a sexually transmitted infection, past prostate or urinary tract infections, an uncircumcised penis, medical procedures, and prostate enlargement. Health experts estimate that 1 in 1,000 men develop epididymitis each year, accounting for approximately 600,000 medical visits in the U.S. alone. Chronic epididymitis accounts for as many as 80 percent of patients who have scrotal pain.

Signs and Symptoms

The signs and symptoms of epididymitis include swelling and pain of the testicle. This is most always unilateral (on one side). Also, the man may experience inguinal node enlargement, painful urination, fever, and penile discharge. To diagnose this condition, the doctor will take a culture of the penile discharge, do a urine culture and analysis, and obtain a white blood cell count.

Treatment

The standard treatments for epididymitis are antibiotics, pain medications, rest, and a scrotal support device. If a sexually transmitted infection is the cause, this will need to be treated and all sexual partners must undergo treatment.

Orchitis

Orchitis is a rare testicular condition that is often caused by viral organisms. Mumps orchitis is not as common now as it was in the early to mid-1990s due to immunizations.

Incidence, Prevalence, and Causes

Orchitis is caused by either viral or bacterial microorganisms, such as chlamydia, gonorrhea, and E. Coli. In the U.S., around 20 percent of prepubertal patients with mumps develop orchitis, with four out of five cases occurring in males younger than age 10 years. With bacterial orchitis, sexually active males and men older than 50 years with BPH are more affected.

Signs and Symptoms

The signs and symptoms of orchitis include fever, reddened scrotal skin, scrotal pain, swelling, and nausea/vomiting. To diagnose this condition, the doctor will order a urine culture and analysis, a testicular ultrasound, and a white blood cell count.

Treatment

The main treatment for orchitis is antibiotics. Analgesics are used to relieve pain and discomfort, and NSAIDS often help to decrease swelling. The main goal of therapy is to prevent infertility, abscess development, testicular atrophy, and impotence.

Prostatitis

Prostatitis is inflammation and/or infection of the prostate gland. There are several categories of prostatitis, including acute bacterial prostatitis, chronic bacterial prostatitis, chronic pelvic syndrome, and asymptomatic inflammatory prostatitis.

Incidence, Prevalence, and Causes

Acute prostatitis is caused by a bacterial pathogen or a gastrointestinal microorganism. Risk factors for prostatitis include unprotected anal intercourse, recent urinary catheterization or cystoscopy, epididymitis, and urethral stricture. With the chronic pelvic syndrome, the cause is unknown. Additionally, the prevalence of prostatitis varies, with a rate of around six percent in the U.S. and Canada.

Signs and Symptoms

Most men with prostatitis have painful urination, urinary urgency and frequency, urinary retention, fever, and fatigue. The doctor diagnoses this condition by a digital rectal examination, a urine test, and some blood tests.

Treatment

Many cases of acute prostatitis require intravenous antibiotics followed by four weeks of oral medication. Common antibiotics used include the fluroquinolones, such as Cipro and Floxin. For chronic prostatitis, alpha-adrenergic blockers are used to reduce the stricture and enhance urine flow.

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