Men get urinary tract infections when bacteria enter the urethra and travel up into the bladder, prostate, or kidneys. It’s far less common than in women, with only about 1 to 2.4 cases per 1,000 men under 55 each year, but the risk climbs significantly with age, reaching 7.7 per 1,000 in men 85 and older. When men do get UTIs, the underlying cause usually points to something specific worth investigating.
Why Men Get UTIs Less Often Than Women
The main reason is simple anatomy. The male urethra is significantly longer than the female urethra, which means bacteria have a much greater distance to travel before reaching the bladder. That extra length acts as a natural barrier against infection. The prostate gland also produces secretions with antibacterial properties that offer some additional protection.
This doesn’t make men immune, though. When something disrupts the normal flow of urine or introduces bacteria directly into the urinary tract, infections happen. And because UTIs in men are relatively uncommon, doctors typically treat them as “complicated” infections that warrant a closer look at the cause.
The Most Common Causes by Age
What triggers a UTI in a 25-year-old man is usually very different from what triggers one in a 70-year-old. In sexually active men under 50 with no structural abnormalities, the far more common explanation for burning and urinary discomfort is actually a sexually transmitted infection rather than a true UTI. Gonorrhea and chlamydia both cause urethritis, an inflammation of the urethra that mimics UTI symptoms closely. When younger men do develop a genuine UTI, it often signals an underlying anatomic abnormality worth investigating.
For men over 50, the picture shifts dramatically. An enlarged prostate becomes the dominant risk factor. The prostate sits directly beneath the bladder, and the urethra passes straight through it. As the prostate grows, it squeezes the urethra and makes it harder to fully empty the bladder. That leftover urine becomes a breeding ground for bacteria. This is the single most common pathway to UTIs in older men.
Men 70 and older face the highest risk, largely because of increasing difficulty emptying the bladder completely, weaker immune responses, and a greater likelihood of needing catheters or other medical devices.
Catheters and Medical Procedures
Urinary catheters are one of the most significant risk factors for UTIs in men of any age. About 75% of UTIs that develop in hospitals are associated with a catheter. The tube provides a direct route for bacteria to bypass the body’s natural defenses and enter the bladder. The longer a catheter stays in place, the higher the risk of infection.
Any procedure that involves instruments entering the urinary tract, including cystoscopy (a camera exam of the bladder) or prostate surgery, can also introduce bacteria. These procedure-related infections are well recognized, which is why doctors often prescribe preventive antibiotics before urological procedures in high-risk patients.
Sexual Activity and STI Overlap
Sexual contact can introduce bacteria into the urethra. Anal intercourse carries a particularly high risk because it exposes the urethra to intestinal bacteria. Having multiple sexual partners also raises the likelihood of infection.
One important distinction: if you have burning during urination and urethral discharge but your urine test doesn’t show bacteria, the cause is more likely a sexually transmitted infection than a UTI. In men aged 15 to 50, STI-related urethritis is far more common than a true bladder infection. A urethral swab, not just a urine test, is often needed to tell the two apart. Using condoms consistently helps prevent both sexually transmitted urethritis and bacteria-related UTIs.
Diabetes and Immune Function
Men with diabetes face a notably higher risk of UTIs. High blood sugar impairs the white blood cells responsible for fighting off bacterial invaders in the urinary tract. Elevated glucose in the urine also gives bacteria an easy food source, encouraging faster growth. The combination of weakened immune defense and a more hospitable environment for bacteria makes diabetic men especially vulnerable to recurrent infections.
Other conditions that suppress immune function, including HIV and long-term use of immunosuppressive medications, raise UTI risk through similar mechanisms.
Which Bacteria Are Responsible
E. coli, the same gut bacterium that causes most female UTIs, is responsible for about 25% of male UTIs. That’s a smaller share than in women, where E. coli accounts for the vast majority. In men, other intestinal bacteria play a larger role, including Proteus and Klebsiella species. When UTIs are associated with chronic prostate infections, however, E. coli dominates again, causing roughly 80% of those cases.
The greater bacterial diversity in male UTIs is one reason doctors almost always order a urine culture when a man presents with symptoms. Identifying the exact bacterium and testing which antibiotics it responds to helps ensure the right treatment, since not all of these organisms respond to the same drugs.
Symptoms to Recognize
Male UTI symptoms overlap with what women experience but can also involve the prostate. Common signs include a frequent, urgent need to urinate, burning or pain during urination, cloudy or strong-smelling urine, and pain in the lower abdomen or pelvic area. Blood in the urine is possible but not always present.
If the infection reaches the prostate, you may notice pain between the scrotum and rectum, painful ejaculation, or a feeling of heaviness in the pelvic floor. If it spreads to the kidneys, symptoms escalate to flank pain, fever, chills, nausea, and vomiting. Kidney infections require prompt treatment to prevent the bacteria from entering the bloodstream.
Why Male UTIs Need More Investigation
In women, an occasional UTI is common and often needs nothing more than a short course of antibiotics. In men, a UTI usually signals something else going on. Doctors will typically want a urine culture to confirm the diagnosis and identify the bacteria involved. Depending on your age and symptoms, they may also recommend imaging of the urinary tract or a prostate exam to look for an enlarged prostate, kidney stones, or structural abnormalities that could be trapping urine.
Chronic bacterial prostatitis is the most common cause of recurring UTIs in men. The prostate can harbor bacteria that are difficult to fully eliminate, leading to repeated infections even after antibiotic treatment. These cases often require longer courses of antibiotics and ongoing monitoring.
Reducing Your Risk
Staying well hydrated helps flush bacteria from the urinary tract before they can establish an infection. Urinating soon after sexual activity clears bacteria that may have entered the urethra. If you have an enlarged prostate and frequently feel like your bladder isn’t fully empty, addressing that underlying problem, whether through medication or a procedure, is the most effective way to prevent recurrent infections.
For men with diabetes, keeping blood sugar well controlled reduces both the immune impairment and the excess urinary glucose that fuel bacterial growth. And if you ever need a urinary catheter during a hospital stay, asking about the earliest possible removal date is one of the simplest ways to lower your infection risk.