Men get urinary tract infections when bacteria enter the urethra and travel up into the bladder or, less commonly, the kidneys. While UTIs are far more common in women, men are not immune. The male urethra is significantly longer than the female urethra, which means bacteria have a greater distance to travel before reaching the bladder. That anatomical advantage lowers the risk but doesn’t eliminate it, especially as men age or encounter specific medical situations that make infection more likely.
Why Men Are Less Prone but Not Protected
The primary reason UTIs are rarer in men comes down to plumbing. The longer urethra creates more distance between the outside world and the bladder, giving bacteria fewer opportunities to establish an infection. On top of that, the prostate gland produces fluid containing natural antibacterial substances, including zinc and infection-fighting antibodies. These two defenses together mean most younger men rarely deal with UTIs.
But those defenses have limits. When something disrupts the normal flow of urine, weakens the immune system, or introduces bacteria directly into the urinary tract, infection can take hold. The bacterium responsible is usually E. coli, which normally lives in the gastrointestinal tract and can migrate to the urethral opening.
The Most Common Causes in Men
An Enlarged Prostate
An enlarged prostate is one of the most frequent reasons older men develop UTIs. As the prostate grows, it can squeeze the urethra and partially block the flow of urine out of the bladder. This obstruction means the bladder may not empty completely each time you urinate, and urine that sits in the bladder becomes a breeding ground for bacteria. The stagnant urine also impairs the body’s natural “washout” mechanism, which normally flushes bacteria out before they can multiply. Some men with chronic prostate problems also have lower levels of the protective antibacterial substances in their prostatic fluid, further reducing their defense.
Catheter Use
Urinary catheters are a major infection risk. A catheter is a thin tube inserted through the urethra into the bladder to drain urine, typically used during hospital stays or for men who cannot urinate on their own. About 75% of UTIs that develop in hospitals are associated with catheter use, and the single most important risk factor is how long the catheter stays in place. The tube essentially creates a direct highway for bacteria to bypass the body’s natural barriers and reach the bladder. Between 15% and 25% of hospitalized patients have a urinary catheter at some point during their stay, making catheter-related infections one of the most common hospital-acquired infections overall.
Sexual Activity
Sexual intercourse can introduce bacteria into the urethra. Anal intercourse carries a higher risk because of the proximity to E. coli and other gut bacteria. Unprotected sex also increases the chance of picking up organisms like gonorrhea or chlamydia, which cause a related condition called urethritis (infection of the urethra itself rather than the bladder). While urethritis is technically different from a UTI, the symptoms overlap considerably, and untreated urethral infections can progress deeper into the urinary tract.
Other Medical Factors
Kidney stones or other structural abnormalities in the urinary tract can trap urine and create pockets where bacteria thrive. Diabetes weakens the immune system’s ability to fight off infections throughout the body, including in the urinary tract. Any condition or medication that suppresses immune function raises the risk. Men who have had recent urinary tract procedures, such as a cystoscopy, also face a temporarily elevated chance of infection because instruments passing through the urethra can carry bacteria with them.
What a Male UTI Feels Like
The symptoms are similar to what women experience, though men sometimes dismiss them or attribute them to prostate issues. Common signs include:
- Unusually frequent urination
- An intense, sudden urge to urinate
- Pain, discomfort, or burning during urination
- Waking up at night to urinate more than usual
- Pain or pressure in the lower abdomen, below the navel
- Cloudy or foul-smelling urine
If the infection moves beyond the bladder into the kidneys, symptoms escalate. Fever, chills, nausea, vomiting, and pain in the side or upper back all suggest an upper tract infection that needs prompt treatment. Prostatitis, an inflammation of the prostate that can accompany or mimic a UTI, may add deep pelvic pain or pain during ejaculation.
Because the symptoms of a bladder infection, prostatitis, and sexually transmitted urethritis can look almost identical, a urine test is essential to identify the actual cause. For men with recurrent infections, a doctor may also perform a rectal exam to assess the prostate’s size and shape, looking for enlargement or tenderness that could explain repeated episodes.
How Male UTIs Are Treated
Antibiotics are the standard treatment, but the course tends to be longer for men than for women. A straightforward bladder infection in a woman might be treated in three days, while men typically need at least seven days because the longer urethra and prostate involvement make it harder to fully clear the bacteria. If the infection has reached the kidneys or prostate, treatment can extend to three weeks or more.
Most men with an uncomplicated bladder infection will take oral antibiotics and feel noticeably better within a day or two. Finishing the full course matters, though. Stopping early because symptoms have improved can leave surviving bacteria in place, leading to a harder-to-treat recurrence. For severe infections involving fever, vomiting, or signs of the bacteria spreading into the bloodstream, hospital-based treatment with intravenous antibiotics may be necessary, typically for about seven days total.
Because UTIs in men are less common than in women, doctors often investigate further after a first infection. Imaging or other tests may be recommended to check for structural problems, kidney stones, or significant prostate enlargement that could be setting you up for repeated infections.
Reducing Your Risk
Stay well hydrated. Drinking enough fluids keeps urine flowing regularly, which helps flush bacteria out of the bladder before they can multiply. Urinating after sexual activity serves the same purpose, clearing any bacteria that may have been introduced during intercourse. Showers are preferable to baths, since sitting in bathwater can allow bacteria to reach the urethral opening more easily.
If you use a catheter, minimizing the duration is the single most effective way to prevent infection. For men with an enlarged prostate, treating the underlying obstruction (whether through medication or a procedure to improve urine flow) can significantly reduce recurrent UTIs by restoring the bladder’s ability to empty completely. Keeping blood sugar well controlled matters for men with diabetes, since elevated glucose impairs immune defenses throughout the urinary tract.