Table of Contents
Urinary Incontinence
Both men and women can get infected with urinary tract infections (UTIs) although the risk factors may differ in both genders. In both men and women, however, UTIs occur following the colonization of different parts of the urinary system by microbes which gain entry through the urethra. Due to the anatomy of the women’s genitalia, they are at a higher risk of suffering from these infections when compared to the rate of infection among men (Cuzick et al., 2014). The women’s urethra is short and relatively close to the anus, a potential reservoir for such etiologic agents. With such short urethra, sexually transmitted diseases like herpes, trichomoniasis, chlamydia and gonorrhea may be among the etiologic agents of UTIs in women, making them be at a greater risk than men. Men become at high risks of developing UTIs when their prostates get extremely enlarged to prevent the bladder from fully emptying its contents during urination (Ehdaie et al., 2014).
Women also get pregnant, a condition that further exposes them to a higher risk of suffering from UTIs considering that their urinary system gets dilated by pregnancy and the growing size of the uterus may limit complete emptying of the bladder making it a reservoir for bacterial growth. Women also use certain forms of birth control like diaphragms which slow the rate of urination and allows time for bacterial growth along the urinary system (Flores-Mireles, Walker, Caparon, and Hultgren, 2015). The use of feminine products like tampons and sanitary napkins also encourages microbial growth along the urinary tract if not changed regularly. Post-menopausal women are at higher risks of developing UTIs considering the high potential for suffering from urinary incontinence. Other risk factors affecting both men and women are pre-exposure to diabetes, kidney stones, diarrhea, HIV and AIDS, constipation, old age, and being sexually active.
BPH: American Urology Association on Drawing PSA Levels
The AUA made recommendations on when it is necessary to draw PSA levels among male patients. For instance, it is not advisable to draw PSA levels for patients below 40 years of age due to the low prevalence levels associated with this age group (Cuzick et al., 2014). It is also not advisable for clinicians to recommend routine screening among male patients between 40 and 54 years unless individualized decisions based on family history are made by competent clinicians. When the patients are between 55 and 69 years, clinicians can order a PSA screening test to detect prostate cancer although such a decision should be based on weighing the options of the benefits of screening and treatment of prostate cancer (Flores-Mireles et al., 2015). Men at this age are most suitable for diagnosing prostate cancer and planning for early treatment. Furthermore, the AUA considered the importance of recommending PSA screening at intervals of two years to reduce the harm associated with routine screening. However, the AUA advised against screening men aged 70 years and above or men with less than 10 to 15 years to live considering the benefits and drawbacks associated with the screening outcomes (Ehdaie et al., 2014). Nonetheless, such men can be screened if they are in perfect health conditions upon their informed consent on the dangers associated with PSA screening and prostate cancer treatment.
Situation not to Treat UTI
Most UTIs are treatable with antibiotics, and a large number of patients who present with such symptoms are treated on an ambulatory basis as outpatients. The exceptions would be immunocompromised individuals or elderly patients with UTIs that manifest as a sepsis syndrome with circulatory insufficiency (Ehdaie et al., 2014). These conditions come with mental status changes and profound weakness that may prompt hospitalizations.
- Cuzick, J., Thorat, M. A., Andriole, G., Brawley, O. W., Brown, P. H., Culig, Z., … & Ilic, D. (2014). Prevention and early detection of prostate cancer. The Lancet Oncology, 15(11), e484-e492.
- Ehdaie, B., Vertosick, E., Spaliviero, M., Giallo-Uvino, A., Taur, Y., O’Sullivan, M., … & Touijer, K. (2014). The impact of repeat biopsies on infectious complications in men with prostate cancer on active surveillance. The Journal of Urology, 191(3), 660-664.
- Flores-Mireles, A. L., Walker, J. N., Caparon, M., & Hultgren, S. J. (2015). Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Reviews Microbiology, 13(5), 269.