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sasquapossum · 3 years

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Surviving a Urinary Tract Infection as a Male

Yeah, I know, this subject is going to be either irrelevant or uncomfortable for a lot of people. I also think it's important to get information out there, because there seems to be too little of it. Doctors, manufacturers, and retailers all seem to think UTIs are purely a female problem, even though that has very obviously never been the case. It's an interesting flip on the usual situation where health-care things are too narrowly focused on cis men, with everyone else left out in the cold. I like to think that my own experience has given me an opportunity to reflect on that and maybe gain some empathy, though it's not for me to determine whether I'm successful in that. Anyway, that's enough intro.

Diagnosis

Disclaimer: none of this is medical advice, which I'm not even qualified to give, and should not be construed as such. I'm just trying to share information from a personal layperson's perspective. Caveat emptor.

First, how do you even know you have a UTI? As with so many things medical, pain is going to be your most obvious clue. Does urination hurt? That's not normal. If you think it's normal, you might have some more serious chronic problem and should see an actual doctor. If it's something you're not used to but it's happening now, a UTI is the most likely explanation. Unusual color or odor are also tip-offs, especially if things are cloudy. What, you don't pay attention to these things? Well, start doing so, especially if you're over 40. These observations will tell you a lot about your day-to-day health, not just about UTIs. Producing smaller amounts more frequently, compared to whatever's normal for you, is also a hint. Maybe it's just the result of consuming diuretics like caffeine or alcohol, but if those are things you do they should already be incorporated into your baseline. I'm talking about *unusual* urinary behavior.

As it turns out, I'm more susceptible to UTIs than most cis men. My first encounter happened nearly 25 years ago. I've had a couple more since then, plus some raised eyebrows when doctors looked at whatever they look at to gauge kidney/urinary health. Some investigations ensued, but nobody ever really found anything. I have a couple of theories of my own, but even I have limits on what I'm going to talk about in public. Suffice it to say that I've been around this block a few times, most recently starting a couple of weeks ago. At least this time it didn't start with *blood* in my urine, which only happened that first time. That one will really freak you out. Again, if you see that, go see a doctor ASAP because there's a significant chance that it's something even more serious. And when I say ASAP I mean urgent or emergency care, not just an appointment a week out.

OTC Treatments

I don't happen to have a primary care doctor right now. Yeah, I know. Be that as it may, when I started experiencing symptoms my first impulse was to do the things I could do myself, regardless of whether I also got to a point where I needed/wanted real medical attention. There are quite a few over-the-counter products that are available for this.

The most common treatment is based on the idea of acidifying urine, creating an environment less hospitable to the good old e.coli that is practically always the culprit. Cranberries are the source of choice here, either as plain old juice or as extracts in pill form.

Vitamin C (a.k.a. ascorbic acid) is sometimes recommended for the same reason, but if you're not used to it then large doses of vitamin C can also cause some pretty nasty digestive effects. You have been warned; try at your own risk.

Some cranberry-based pills also contain d-mannose, which is a simple sugar. The idea is the same, to make the bladder a more hostile environment for e.coli.

Another common ingredient is probiotics, supposedly to displace e.coli. I was even able to find some scientific studies supporting this theory for a couple of ingredients - l.rhamnosus and l.reuteri. Unfortunately, even though I love this idea in the abstract, the actual organisms present in most probiotics - even probiotics sold for this speific purpose - are likely to be absolutely useless.

The last treatment-oriented option is methenamine, which is one of the few oral antibiotics (for any condition) that you can buy over the counter. The reason it's an exception is that it's highly specific; AIUI it combines with acidic urine - see above - to produce the actual antibiotic agent which I believe is formaldehyde or some relative. This drug will do absolutely nothing for any other kind of infection, and won't even work for this unless your urine is pretty highly acidic (very high correlation here). The chemistry is kind of cool, actually.

Speaking of interesting chemistry, that brings us to phenazopyridine. This stuff is a pain reducer, not a treatment, and it's funky. For one thing, it will turn urine a very bright yellow or orange, sometimes even bordering on red. I think it's really pretty, but the color has a downside that it could obscure blood in the urine. Also, the packages don't mention this, but it seems to make the urine significantly more viscous. Among other things, this means you have to work a bit harder to fully empty your bladder, unless you like making double trips as the first still leaves you uncomfortable. Practice, practice, practice. Also, I should mention that phenazopyridine has been known to cause neoplasms (benign tumors) in lab animals. Benign is benign, but it's probably still a good reason not to use it long term. Save it for those extra-unpleasant nights, or other times when you really can't afford to be going every 15-20 minutes.

Lastly, there are products that are supposed to help with long-term bladder function. Most of these seem to be based on the same set of pumpkin and/or soybean extracts. I don't know if they work - too soon to tell - but something to consider if you're like me and find yourself in this situation repeatedly.

Miscellaneous Info

This is where we get to the "UTI as a female thing" part. You might go into a drug store and try to find some of these products in logical places. Maybe near "digestive health" since those systems are near each other (and related)? Nope. Maybe in that aisle full of Depends and other old-person products that we all avoid? Nope again. Nine times out of ten, it'll be in the "feminine products" aisle, between pads/tampons and fungicidal creams. I personally have absolutely no problem browsing there, but I guess some other guys find it awkward. If you still don't find it, ask for "azo" products, since that seems to be the big brand. The name's almost certainly from azopyridine but they have multiple products covering most of the other categories as well.

Now, let's talk about leakage. You'll have some. Good fun. If you prefer to go commando ... well, stop. Especially if you're using the orange stuff, because it stains. (BTW it's kind of a dumb idea in general, for reasons ranging from hygiene to sensitivity.) To contain leakage, one option is to buy or borrow some "feminine" pads. Since I have both a wife and a daughter, I had multiple models to choose from. As it turns out, though, a folded-up paper towel works pretty well too. I'm told that this is not a great approach for those with female parts, but it seems like folded-down male parts and briefs keep things pressed in place pretty well. Don't try this with boxers. In fact, for the duration here boxers are kind of as useless as going commando.

You'll want to cut down on both caffeine and alcohol, because they're both diuretics and that's the last thing you want right now. Alcohol also doesn't interact so well with most of the medications you'll be using.

Lastly, you'll want to avoid sex. For one thing, it's likely to be pretty uncomfortable both in the moment and over time. More even than you'd think. For another thing, all these pipes are connected so it's another way for infection to spread or persist. And if those two reasons weren't enough, it's also adding complexity at a time when you might be trying to zero in on what works or doesn't for your own personal physiology. Yes, this includes solo sex, because all of these reasons still apply in that case.

Personal Experience

We're all different. You will probably have a different experience than I did. Nonetheless, I'm including this as one data point that you might consider when you're thinking about which options to try or skip.

Once I realized I was in UTI-land again, my first approach was cranberry juice and vitamin C. This might have worked somewhat, but it also meant being in the bathroom for one reason or another every half hour at most day and night. Unpleasant. So I hit the drug store to pick up some cranberry extract plus d-mannose, and also some azo for the discomfort/frequency. I couldn't find any pills containing probiotics with any science behind them, so I ordered some of those online and switched to those when they arrived.

This seemed to help, so after a couple of days (as long as you're supposed to keep taking azo anyway) I tapered off to see if I was done. Unfortunately nope. These things are all very highly personal and variable, as I said, but for me this approach didn't seem to be working. Time to switch gears. Back to the drug store, to replenish on azo and also get some methenamine this time. I tend toward the acidic side naturally, but I also tried to keep an eye on my diet to keep things that way so the methenamine could work.

Fortunately, third time seemed to be a charm. I was still going more often than usual, with some discomfort, but I chalked that up to the treatments themselves being a bit irritating plus some residual inflammation. The actual infection seemed to have abated, and in particular I hadn't seen any cloudiness for a couple of days, so I tapered off again. This time it seems to have held. The old pipes are still kind of beat up, so I figure it'll be another week before I'm fully back to normal, but it's normal enough that it's no longer interfering with my life. I can drive places further than half an hour away, and back, with confidence. I might even be able to consider flying, not that I have any plans to, but that would have been beyond tolerance before.

Summary

The key is to try something that's generally known to work. Pay attention to whether it's actually working for you. Consider that the treatments themselves are irritating, as you do your evaluation. Don't keep taking anything, especially azo, too long. If what you're trying isn't working, try something else. Avoid caffeine, alcohol, and sex. Expect about two weeks from onset through treatment and full recovery. If your trajectory seems to be taking longer than that, stop reading crap on the internet and get some real medical help.

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