How to Diagnose and Treat Cystitis in Men

Recognizing Common Symptoms

Make note of needing to pee more often than usual. One of the most common symptoms of cystitis is urinary frequency, or feeling like you need to go all the time. You might also feel like your need is more urgent than usual, or you may even have trouble making it to the toilet in time. When you have cystitis or a bladder infection, you might feel an urgent need to go, then find that you have only a small amount of urine in your bladder. Or, you might go to the bathroom and then need to go again just a few minutes later. Most people don’t have to pee more than 7 times a day with a healthy bladder, and don’t have to get up more than once in the middle of the night to go. If you have to pee more frequently, you might have cystitis.

Watch for burning or pain when you pee. If you feel a stinging or burning sensation when you urinate, it’s possible that you have a bladder infection or inflammation. Look out for a burning or tingling feeling right after you finish peeing, too. Burning or stinging when you pee can also be a sign of other conditions, such as a sexually transmitted disease (STD), irritation from a personal care product (such as soap), kidney or bladder stones, or a problem with your urethra. Because it can have so many causes, you should always see your doctor if you have painful urination. They can help you determine what’s causing it and find an appropriate treatment.

Check for urine that’s cloudy, discolored, or bad-smelling. If you suspect you have cystitis, take a look at your pee. It may be cloudy, darker than usual, or even appear red, pink, or brown. It may also smell unusually strong or unpleasant. These can be signs of blood, pus, or other contaminants in your urine. Keep in mind that other things can also affect the smell or appearance of your urine. For example, eating asparagus can give your urine a strong odor, and certain medications can affect its color.

Look out for difficulty emptying your bladder. With cystitis, you might have a hard time starting to pee or emptying your bladder completely once you start. Pay attention to how difficult it is for you to get all the pee out of your bladder next time you go to the bathroom. This is more likely to happen if you have inflammation that affects your prostate as well as your bladder.

Pay attention to pain in your pelvis or lower abdomen. If you feel an ache or cramps in your lower belly or pelvis, this could be a sign of inflammation or an infection in your bladder. It might also feel like pressure or discomfort rather than pain. If you develop pain in your back or side, especially with a fever or nausea and vomiting, call your doctor immediately or go to the emergency room. This can be a symptom of a kidney infection.

Take your temperature to check for a fever. Cystitis is usually caused by an infection in your bladder, so it sometimes causes a low fever. If you have other symptoms of cystitis and are feeling generally fatigued or unwell, take your temperature to determine if you have a fever. For an adult, a fever is any temperature over 100.4 °F (38.0 °C). If your fever gets any higher than 102 °F (39 °C), call your doctor right away, since this might mean you have a more serious infection.

Getting a Medical Diagnosis

See your doctor if you have any unusual urinary symptoms. If you have cystitis symptoms, especially if they last a day or more or you notice blood in your urine, call your doctor for an appointment. You’ll probably need an antibiotic prescription if your symptoms are caused by a bladder infection, so it’s important to get a diagnosis and start treatment as soon as possible. An untreated bladder infection can sometimes become more serious or spread to your kidneys. Cystitis is less common in cis men or people who were assigned male at birth than it is in cis women or people who were assigned female at birth. If you’re otherwise healthy and have never had symptoms of cystitis before, it’s especially important to see a doctor right away.

Get emergency care if you have back pain, a high fever, or nausea and vomiting. Most bladder infections don’t cause severe symptoms, especially if you treat them promptly. However, sometimes the infection can spread into your kidneys or bloodstream, which is a medical emergency. Call emergency services or go to the emergency room if you develop symptoms such as: A fever higher than 102 °F (39 °C) Chills Pain in your back or side Nausea or vomiting Confusion

Talk to your doctor about your medical history. Tell your doctor about any symptoms you have, even if they don’t seem related to your possible cystitis. This will help them diagnose the underlying cause of your symptoms. They may ask you when the symptoms started, if you have any other health conditions, or if you’ve been diagnosed with cystitis before. Let your doctor know if you are currently taking any medications or supplements, since this can affect what kinds of treatments you can safely use. Your doctor may also ask questions about whether you are sexually active and what forms of protection you use. It can be awkward to talk about these things, but do your best to answer honestly. This will help your doctor determine what’s causing your symptoms and how to treat them. They will also probably do a physical exam to check your general health and look for any obvious problems (like visible irritation on your penis or lumps in your pelvic area).

Allow them to take a sample of your urine. If your doctor suspects a bladder or urinary tract infection, they will probably ask for a urine sample. They’ll send the sample to the lab to check for signs of an infection, such as blood, white blood cells, pus, or bacteria in your urine. They may also do a urine culture to determine which antibiotic will work best to treat your infection. To give a urine sample, you will probably need to do a clean catch: Clean the head of your penis with a cleansing wipe. If you’re uncircumcised, gently pull back your foreskin first. Let the first few drops of urine flow into the toilet, then stop the flow. Continue urinating into the collection cup, until it is half full. Release the rest of your urine into the toilet. Close the cap on the cup and leave it in a designated collection area.

Consent to further tests if your doctor recommends them. If the results of the urine test are unclear, or if your doctor suspects a more serious problem, they might recommend other testing procedures. Ask your doctor about the risks and benefits of these procedures. They may include: Cystoscopy. For this procedure, the doctor will insert a very thin tube with a camera attached into your bladder through your urethra. This will allow them to examine the inside of your bladder. While this sounds a bit scary, try not to worry. You’ll be numbed with a local anesthetic or sedated, so the procedure won’t hurt. Biopsy. This procedure involves taking a small sample of tissue from your bladder. Your doctor may do this during a cystoscopy to check for abnormal cells in your bladder. Imaging tests, like an X-ray or ultrasound. These tests will help your doctor spot any possible abnormalities in your bladder, such as a tumor or growth.

Managing Your Symptoms at Home

Put a heating pad against your lower belly to soothe pain. Heat can be very soothing when you have bladder pain. Lay a heating pad over your lower abdomen, or use a hot water bottle. To protect your skin from burns, always keep a layer of cloth between your skin and the heating pad or water bottle. Keep the heating pad or water bottle on for no more than 30 minutes at a time. After you take it off, give your skin a chance to cool off before putting the heat source back in place. Never lie down on top of an electric heating pad or go to sleep with it on your body, since this could put you at risk of burns.

Relieve discomfort with a 15 to 20-minute sitz bath. A sitz bath is another way to soothe your pelvic area with heat. Fill a tub with comfortably warm or hot water that’s at least hip deep. Sit down in the tub with your lower abdomen and pelvis submerged and stay there for 15-20 minutes. A warm bath can also help relax you and relieve stress, which may help your symptoms improve. Don’t add bubble bath or any other similar products to the water, since this could irritate your urinary tract and make your symptoms worse. Stick to plain water.

Take over-the-counter painkillers to minimize pain and inflammation. If you’re in a lot of pain or discomfort, take a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil) or naproxen (Aleve). These medications will reduce your pain and also help manage swelling and inflammation in your bladder. You can also take acetaminophen (Tylenol) to reduce your pain, but it won’t relieve inflammation. These medications can also help reduce a fever.

Drink water and clear fluids to stay hydrated. Drinking plenty of fluids can help flush bacteria out of your urinary tract and keep you hydrated while you’re sick. In addition to water, you can also drink other fluids, such as broth or mild fruit juices, to get the hydration you need. There’s some evidence that drinking cranberry juice can help prevent cystitis and bladder infections. However, it’s not clear how much it will help if you already have cystitis. Avoid drinking it if it seems to make your irritation worse.

Avoid spicy foods and other common bladder irritants. Spicy or acidic foods and drinks can irritate your bladder and urinary tract and make your symptoms worse. Until your infection clears up, stay away from things like: Coffee Alcohol Citrus juices Caffeinated soft drinks Tomato products Spicy foods

Limit sex until your infection clears up. If you’re sexually active, talk to your partner about taking a break until your symptoms are gone. Sexual activity can irritate your urethra and aggravate symptoms of a bladder infection. Although cystitis can be caused by bacteria (such as E. coli) getting into your urethra during sex, it isn’t considered a sexually transmitted disease. You don’t have to worry about passing it to your partner. Peeing immediately after having sex can reduce your chances of getting cystitis or a bladder infection.

Using Medical Treatments

Take antibiotics as prescribed by your doctor. The most common treatment for cystitis is a short course of antibiotics. Follow your doctor’s instructions for taking the antibiotics, and don’t stop taking them until you’ve finished the whole course. You should start to feel better within a few days. Even if your symptoms are gone, don’t stop taking your antibiotics unless your doctor tells you to. Stopping the medication too soon could cause the infection to come back and make it harder to get rid of. In some cases, cystitis may keep returning or become chronic. If this happens, your doctor might recommend different antibiotics or a more long-term course of treatment with low doses of antibiotics.

Ask your doctor about medications to relieve pain or relax your muscles. If you have severe pain or inflammation that doesn’t go away with a short course of antibiotics, your doctor may recommend additional medications to help manage your symptoms. Some of these medications can be especially helpful if you have interstitial cystitis, a type of chronic bladder inflammation. Ask your doctor about trying options such as: Tricyclic antidepressants, such as amitriptyline or imipramine, which can help relax the muscles in your bladder and reduce pain Antihistamines to reduce urinary urgency Pentosan polysulfate sodium (Elmiron), which can help heal the inner surface of your bladder and protect it from further irritation

Discuss trying bladder instillation to reduce severe inflammation. Bladder instillation is a process where medication is administered directly into your bladder through a thin tube via your urethra. Talk to your doctor about this option if you have chronic pain or inflammation that doesn’t respond to other treatments. During bladder instillation, your doctor will probably administer a medication called dimethyl sulfoxide, or DMSO, into your bladder. This medication relaxes your muscles, reduces pain and inflammation, and even helps break down scar tissue in your bladder. Sometimes DMSO is used in a bladder instillation “cocktail” alongside other medications, such as steroids or painkillers. Typically, your doctor will ask you to hold the instillation in your bladder for 15-20 minutes, then urinate to flush it out. You may need several of these treatments over the course of a few months to get the best results.

Try TENS or sacral nerve stimulation for overactive bladder muscles. If you suffer from chronic bladder pain, inflammation, or urinary urgency, ask your doctor about TENS (transcutaneous electrical nerve stimulation) or sacral nerve stimulation. These therapies work by sending electrical impulses to the nerves around your bladder. The electrical stimulation helps relieve pain and relax your bladder muscles. TENS involves using electrodes that are attached to the outside of your skin, while sacral nerve stimulation is a more invasive treatment in which wires are surgically implanted in your sacrum (the lowest part of your backbone). Before trying one of these therapies, talk to your doctor about your health history. You may not be a good candidate for TENS or sacral nerve stimulation if you have certain medical conditions, such as heart disease or a bleeding disorder.

Look into surgery if other treatments don’t work. In rare cases, surgery may be a last resort option for treating severe interstitial (chronic) cystitis. If you’ve tried all other options and still aren’t getting the relief you need, ask your doctor about surgical procedures. They may recommend a procedure such as: Fulguration, which involves burning away lesions inside the bladder that may be causing pain or irritation Resection, a surgery to cut away lesions or ulcers using small tools inserted through the urethra Bladder augmentation, a rare procedure that can reduce urinary frequency by enlarging your bladder