As infecções do trato urinário (ITUs) causam mais de 8.1 milhões de visitas a profissionais da saúde a cada ano. Aproximadamente 12% a 14% dos homens terão pelo menos uma ITU durante a vida.[1]Infectious Diseases Society of America. Complicated urinary tract infections (cUTI): clinical guidelines for treatment and management. 2025 [internet publication].
https://www.idsociety.org/practice-guideline/complicated-urinary-tract-infections
[9]American Urological Association. Urinary tract infections in adults. Nov 2022 [internet publication].
https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults
Em 2002, estimou-se que as ITUs eram o tipo mais comum de infecção associada aos serviços de saúde nos EUA, respondendo por mais de 30% de todas as infecções relatadas por prontos-socorros em um hospital de atendimento de emergência.[10]Klevens RM, Edwards JR, Richards CL Jr, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep. 2007 Mar-Apr;122(2):160-6.
https://journals.sagepub.com/doi/10.1177/003335490712200205
http://www.ncbi.nlm.nih.gov/pubmed/17357358?tool=bestpractice.com
Praticamente todas as ITUs associadas aos serviços de saúde são causadas pela instrumentação do trato urinário.[11]Centers for Disease Control and Prevention. Infection control: v background: guideline for prevention of catheter-associated urinary tract infections (2009). Apr 2024 [internet publication].
https://www.cdc.gov/infection-control/hcp/cauti/background.html#:~:text=Urinary%20tract%20infections%20are%20the,reported%20by%20acute%20care%20hospitals.&text=Virtually%20all%20healthcare%2Dassociated%20UTIs,instrumentation%20of%20the%20urinary%20tract
O envelhecimento contribui para a ocorrência de ITU em homens, com estudos mostrando que a incidência de ITU clinicamente diagnosticada em homens por 100 pessoas-ano aumentou de 2.81 em pessoas de 65 a 74 anos para até 10.54 em pessoas com mais de 85 anos.[12]Ahmed H, Farewell D, Jones HM, et al. Incidence and antibiotic prescribing for clinically diagnosed urinary tract infection in older adults in UK primary care, 2004-2014. PLoS One. 2018 Jan 5;13(1):e0190521.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190521
http://www.ncbi.nlm.nih.gov/pubmed/29304056?tool=bestpractice.com
[13]Rodriguez-Mañas L. Urinary tract infections in the elderly: a review of disease characteristics and current treatment options. Drugs Context. 2020 Jul 8:9:2020-4-13.
https://www.drugsincontext.com/urinary-tract-infections-in-the-elderly:-a-review-of-disease-characteristics-and-current-treatment-options
http://www.ncbi.nlm.nih.gov/pubmed/32699546?tool=bestpractice.com
[14]Schaeffer AJ, Nicolle LE. Clinical practice. Urinary tract infections in older men. N Engl J Med. 2016 Feb 11;374(6):562-71. As ITUs raramente se desenvolvem em homens com menos de 50 anos.[1]Infectious Diseases Society of America. Complicated urinary tract infections (cUTI): clinical guidelines for treatment and management. 2025 [internet publication].
https://www.idsociety.org/practice-guideline/complicated-urinary-tract-infections
[15]Griebling TL. Urologic diseases in america project: trends in resource use for urinary tract infections in men. J Urol. 2005 Apr;173(4):1288-94.
https://www.doi.org/10.1097/01.ju.0000155595.98120.8e
http://www.ncbi.nlm.nih.gov/pubmed/15758784?tool=bestpractice.com
A incidência de ITU em homens é mais alta entre os residentes de unidades de cuidados de longa permanência.[1]Infectious Diseases Society of America. Complicated urinary tract infections (cUTI): clinical guidelines for treatment and management. 2025 [internet publication].
https://www.idsociety.org/practice-guideline/complicated-urinary-tract-infections
[14]Schaeffer AJ, Nicolle LE. Clinical practice. Urinary tract infections in older men. N Engl J Med. 2016 Feb 11;374(6):562-71.[15]Griebling TL. Urologic diseases in america project: trends in resource use for urinary tract infections in men. J Urol. 2005 Apr;173(4):1288-94.
https://www.doi.org/10.1097/01.ju.0000155595.98120.8e
http://www.ncbi.nlm.nih.gov/pubmed/15758784?tool=bestpractice.com
A razão da ocorrência de ITU entre mulheres e homens institucionalizados é quase igual (2 a 3:1), diferente da razão entre mulheres e homens mais jovens (25:1).[16]Shortliffe LM, McCue JD. Urinary tract infection at the age extremes: pediatrics and geriatrics. Am J Med. 2002 Jul 8;113(suppl 1A):55S-66S.
http://www.ncbi.nlm.nih.gov/pubmed/12113872?tool=bestpractice.com
Além disso, até 40% dos homens institucionalizados têm bacteriúria assintomática.[6]Nicolle LE, Gupta K, Bradley SF, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis. 2019 May 2;68(10):e83-110.
https://academic.oup.com/cid/article/68/10/e83/5407612
http://www.ncbi.nlm.nih.gov/pubmed/30895288?tool=bestpractice.com
[15]Griebling TL. Urologic diseases in america project: trends in resource use for urinary tract infections in men. J Urol. 2005 Apr;173(4):1288-94.
https://www.doi.org/10.1097/01.ju.0000155595.98120.8e
http://www.ncbi.nlm.nih.gov/pubmed/15758784?tool=bestpractice.com
[16]Shortliffe LM, McCue JD. Urinary tract infection at the age extremes: pediatrics and geriatrics. Am J Med. 2002 Jul 8;113(suppl 1A):55S-66S.
http://www.ncbi.nlm.nih.gov/pubmed/12113872?tool=bestpractice.com
Outros fatores de risco correlacionados ao aumento da incidência de ITU em homens incluem história de penetração anal, que está associada ao aumento de infecções tanto em homens quanto em mulheres.[17]Coull N, Mastoroudes H, Popert R, et al. Redefining urological history taking - anal intercourse as the cause of unexplained symptoms in heterosexuals. Ann R Coll Surg Engl. 2008 Jul;90(5):403-5.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645743
http://www.ncbi.nlm.nih.gov/pubmed/18634737?tool=bestpractice.com
Em um estudo, a ITU foi mais comum entre homens que fazem sexo com homens, em comparação com homens que fazem sexo exclusivamente com mulheres.[18]Barnes RC, Roddy RF, Daifuku R, et al. Urinary-tract infection in sexually active homosexual men. Lancet. 1986 Jan 25;1(8474):171-3.
http://www.ncbi.nlm.nih.gov/pubmed/2868203?tool=bestpractice.com
A penetração vaginal também pode resultar em ITU se a vagina for colonizada por organismos patogênicos.[19]Stamm WE, Hooton TM. Management of urinary tract infections in adults. N Engl J Med. 1993 Oct 28;329(18):1328-34.
http://www.ncbi.nlm.nih.gov/pubmed/8413414?tool=bestpractice.com