UTIs in Men: What Are They?
Also known as: Urinary tract infection in men, Male UTI, Bladder infection in men
What is a urinary tract infection in men?
A urinary tract infection (UTI) in men happens when bacteria multiply in the urinary system. While less common than in women, it’s considered more complicated in men because of male anatomy and the possibility that the prostate or kidneys are involved. It can affect the bladder (cystitis), the urethra (urethritis), or spread up to the kidneys (pyelonephritis) or prostate (prostatitis).
Causes and risk factors
The main cause of UTIs in men is the bacterium Escherichia coli, naturally present in the digestive tract. Other bacteria such as Klebsiella, Proteus, or Enterococcus can also be involved. Several factors raise the risk: an enlarged prostate that blocks complete bladder emptying, a history of kidney stones, anatomical abnormalities, diabetes, a weakened immune system, having a urinary catheter, or unprotected sex.
Symptoms
The most common signs of a UTI in men include:
- Burning or pain when urinating
- Frequent, urgent need to urinate
- A feeling that the bladder isn’t fully empty
- Cloudy, foul-smelling, or blood-tinged urine
- Pain in the lower abdomen or perineum
If the infection spreads to the prostate or kidneys, more general symptoms can appear: high fever, chills, back pain, or significant body aches.
Diagnosis
The doctor first asks about symptoms and history. The key test is a urine dipstick test, followed by a urine culture, which identifies the bacteria involved and guides antibiotic choice. If a complication is suspected, a urinary tract ultrasound or blood work may be ordered to assess kidney or prostate involvement.
Available treatments
Treatment mainly relies on antibiotics, chosen based on the bacteria identified in the culture and its antibiotic sensitivity. Any UTI in a man is technically considered complicated, but many doctors treat a clear-cut bladder infection in an otherwise healthy man much like a simple UTI, with first-line options such as trimethoprim-sulfamethoxazole, fosfomycin, or nitrofurantoin. Fluoroquinolones are preferred when the kidneys or the prostate are involved, because they penetrate those tissues well, though resistance rates to them are high. Treatment usually lasts longer than in women, typically 7 to 14 days, and longer still for prostatitis: urologists usually prescribe at least 2 weeks of oral antibiotics for acute bacterial prostatitis, and some recommend 6 to 8 weeks. Men often need a longer course because bacteria can move into the prostate, where infection is harder to clear. Along with antibiotics, it’s recommended to:
- Drink plenty of water
- Rest if you have a fever
- Take pain relievers as needed
Prevention and practical tips
A few simple habits can reduce the risk of recurring UTIs. It’s recommended to stay well hydrated every day, urinate regularly without holding it too long, and always empty the bladder completely. Good personal hygiene also helps limit the risk. For men with an enlarged prostate, monitoring and treating that condition is essential to prevent urine retention. Finally, protected sex lowers the risk of certain sexually transmitted infections that can affect the urinary tract.
When should you see a doctor?
See a doctor promptly if you have burning during urination, abnormal urine, or pelvic pain. Urgent care is needed for a fever above 101°F (38.3°C), chills, intense back pain, or if symptoms persist or worsen despite treatment. These signs can point to a kidney or prostate complication.
Sources
- MedlinePlus: Urinary tract infection - adults, U.S. National Library of Medicine
- MedlinePlus: Cystitis - acute, U.S. National Library of Medicine, on E. coli as the usual cause and its intestinal origin, risk factors, and the 7-to-14-day course in men
- StatPearls: Uncomplicated Urinary Tract Infections (NIH National Library of Medicine Bookshelf), on the causative organisms and on fluoroquinolones being preferred for pyelonephritis and prostatitis
- StatPearls: Complicated Urinary Tract Infections (NIH National Library of Medicine Bookshelf), on UTI in men being complicated and on first-line antibiotic options
- MedlinePlus: Urinary Tract Infections, U.S. National Library of Medicine
- MedlinePlus: Urine culture, U.S. National Library of Medicine
- NIDDK: Bladder Infection (UTI) in Adults - Definition & Facts, National Institute of Diabetes and Digestive and Kidney Diseases
- NIDDK: Bladder Infection (UTI) in Adults - Treatment, National Institute of Diabetes and Digestive and Kidney Diseases, on antibiotic choice by bacteria, self-care (fluids, pain relievers), and men needing a longer course
- NIDDK: Bladder Infection (UTI) in Adults, National Institute of Diabetes and Digestive and Kidney Diseases, on prevention (drinking liquids, urinating regularly without holding, emptying the bladder fully)
- NIDDK: Prostatitis: Inflammation of the Prostate, National Institute of Diabetes and Digestive and Kidney Diseases