Urinary Tract Infections (UTIs) in Men

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Men can get urinary tract infections (UTIs), but it is not as common as in females. The urinary tract includes the bladder, kidneys, ureters, and urethra.

Signs of a UTI in men include painful or burning urination, needing to urinate more frequently, fever, and fatigue. UTIs are diagnosed with a urinalysis (U/A) or urine culture and treated with antibiotics.

UTIs are less common in men because their urethra—the tube that carries urine out of the body—is longer than in females, making it harder for bacteria to get to the bladder. Prostate disease, sexually transmitted infections (STIs), and structural abnormalities increase a man's risk of UTIs.

This article discusses UTIs in men. It explains the common symptoms and causes of male urinary tract infections and how they are diagnosed and treated.

Symptoms of Urinary Tract Infection
Verywell / Gary Ferster

Symptoms of UTIs in Men

UTIs may cause a variety of symptoms in males. Sometimes, a UTI does not cause any symptoms in the early stages but becomes more noticeable as it worsens.

Symptoms of UTIs in males include the following:

  • Burning or pain when you urinate (dysuria)
  • Cloudy urine
  • Fever, tiredness, or shakiness
  • Frequent urge to urinate
  • Pain in your back or side below the ribs
  • Pressure in your lower abdomen
  • Reddish urine, which could indicate blood in the urine (hematuria)
  • Urine that smells bad

These symptoms can come and go for a while before worsening.

Complications

Without treatment, UTIs can cause major health problems. If you have a weak immune system, complications are more likely to occur.

Severe effects of a UTI that can develop in males include:

  • Pyelonephritis: An infection involving the kidneys
  • Sepsis: A dangerous, systemic, whole-body infection

Some males have recurrent UTIs. This is concerning and a sign that there is a major risk factor that needs to be treated.

Types of UTIs in Men

A UTI can affect any part of the urinary tract system. The male urinary tract includes the following organs:

  • Bladder, a reservoir that holds urine 
  • Kidneys, two bean-shaped organs that filter blood to remove waste and balance fluids
  • Ureter, tubes that connect the kidneys to the bladder
  • Urethra, the tube that carries urine from the bladder out of the body through the penis

Lower urinary tract infections are more common and include cystitis (bladder infection) and urethritis (infection of the urethra).

Upper urinary tract infections infections affect the ureters and kidneys. Pyelonephritis (kidney infection) is a serious infection that can cause permanent damage and lead to chronic kidney disease.

Causes and Risk Factors

UTIs can affect men of any age but are more common in older males. UTIs are usually caused by bacteria, but they can be viral as well.

Lower urinary tract infections are often caused by intestinal bacteria that spread from the skin, enter the urethra, and travel to the bladder. Bacterial STIs like gonorrhea or chlamydia can also lead to lower UTIs.

Upper urinary tract infections can occur when bacteria from a lower UTI migrate up the ureters to the kidneys or by bacteria in the bloodstream.

UTIs in men are 10 times more common among males who are uncircumcised. Other risk factors associated with male UTIs include:

Urethritis, inflammation of the urethra, is the most common type of UTI. In some cases, urethritis can happen for no known reason, a condition referred to as nonspecific urethritis (NSU).

Young males who develop UTIs may have a congenital malformation of part of the urinary system.

Males ages 20 to 35 are generally at low risk of developing UTIs unless it is caused by an STI. Having multiple sex partners and having sex without using a condom increases the risk of getting an STI.

Diagnosing UTIs in Men

If you have symptoms of a UTI, your healthcare provider will likely take a detailed medical history, perform a physical examination, and have you provide a urine sample. Other diagnostic tests may be needed as well.

Urine Test

A urine test may show an elevation of white blood cells, which is a sign of infection.

Sometimes the type of bacteria causing the infection can be identified in a urine culture. A urine culture uses a sample of urine in a lab to evaluate bacterial growth over the course of several days.

Red blood cells in the urine are a sign of a severe infection or more significant urinary tract disease, requiring follow-up with a urologist.

There are a few other medical problems that can cause some symptoms similar to those of a UTI. For example, diabetes can cause urinary frequency and urgency, and a urinalysis can differentiate between diabetes (which causes high levels of glucose in the urine) and a UTI.

Imaging Tests

You may also need to have imaging tests, such as a computed tomography (CT) scan or ultrasound of the pelvis.

These tests can detect problems such as growths, cancer, or malformations that may predispose you to a UTI.

Diagnostic Procedures

Depending on your condition, you may need certain diagnostic procedures that can give your healthcare provider more detailed information about your urinary tract anatomy.

These tests are invasive and can be uncomfortable. If there is a concern that you could experience pain, you might need to have an anesthetic during the procedure.

A digital rectal examination is a test in which your healthcare provider examines the size and shape of your prostate by placing a gloved finger in your rectum. This test, along with the results of imaging tests, can help identify prostate enlargement or serious problems, such as prostate cancer.

A cystoscopy is a test in which an instrument (can be flexible or rigid) with a camera is inserted into the urethra to observe the urethra and bladder from the inside. This test can detect anatomical defects such as strictures, and it may also help in diagnosing cancer.

Treating UTIs in Men

Usually, antibiotic medications are necessary for the treatment of a UTI. These are prescription medications that destroy bacteria.

For the treatment of uncomplicated UTIs, oral (by mouth) antibiotics are usually adequate. However, for major complications such as sepsis or pyelonephritis, intravenous (IV) antibiotics may be typically necessary.

Your healthcare provider may initially select an antibiotic that is usually effective for treating UTIs in males, such as:

  • Macrobid (nitrofurantoin)
  • Monurol (fosfomycin)
  • Bactrim
  • Trimethoprim-sulfamethoxazole
  • Cipro (ciprofloxacin)
  • Levaquin (levofloxacin)

Often, people feel better within a few days after starting an antibiotic for the treatment of a UTI. However, if you stop taking your antibiotics when you start feeling better rather than taking the full prescription, you are likely to have a partially treated infection, with a resurgence of symptoms a few days after you stop taking your antibiotics.

Try to stay hydrated when recovering from a UTI. Passing an adequate flow of urine helps flush out the infectious organism. Ideally, water is the best fluid for staying hydrated because sugary or caffeinated beverages can dehydrate you.

Is There an OTC UTI Treatment for Men?

UTIs in men usually require treatment with antibiotics to clear up. Over-the-counter pain relievers, like acetaminophen and ibuprofen, can help ease pain from a UTI. Additionally, drinking cranberry juice or taking cranberry supplements may help relieve UTI symptoms. However, these OTC remedies only treat the symptoms and will not treat the underlying infection.

Preventing UTIs in Men

Reducing your risk of UTIs may require treatment of major medical issues. For example, if you have prostate or bladder cancer, you may need surgery. If you have a congenital malformation, you may also benefit from a corrective procedure.

Keep in mind that recurrent UTIs can make it likely for you to develop further UTIs because they can lead to strictures and scarring in the urethra.

UTIs in males are not common, but any male can develop one. It is important that you seek medical attention if you develop symptoms of a UTI because these infections do not improve on their own.

Also, if you are prone to recurrent UTIs, it is vital that you discuss this with your healthcare provider so you can have treatment to reduce your risk.

Summary

Painful, burning, and frequent urination are common symptoms of a urinary tract infection in men. UTIs can also cause foul-smelling, cloudy, or reddish urine and pain in your back, side, or lower abdomen. If you have symptoms of a UTI, see your healthcare provider. 

UTIs can often be diagnosed using an in-office urine test to detect white blood cells. To determine the specific bacteria causing the infection, a urine culture can be sent to a lab for analysis. 

Antibiotics are prescribed to treat UTIs. Be sure to finish all of your medication and drink plenty of water. If symptoms do not resolve following treatment, you may need a different medication. Recurring UTIs in men may be caused by an underlying medical problem and additional tests may be needed. 

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Jerry Kennard
 Jerry Kennard, PhD, is a psychologist and associate fellow of the British Psychological Society.