A urinary tract infection (UTI) in men is a bacterial infection that develops in any part of the urinary system: the urethra, bladder, or kidneys. While UTIs are far more common in women, men do get them, particularly after age 50 when prostate changes begin interfering with normal urine flow. Unlike the straightforward bladder infections women often experience, UTIs in men are almost always classified as “complicated” infections because they typically involve an underlying factor like an enlarged prostate, a catheter, or an anatomical abnormality.
Why Men Get UTIs
Men have a longer urethra than women, which makes it harder for bacteria to reach the bladder. That built-in protection means that when a UTI does develop in a man, something is usually helping the bacteria along. The most common culprit after age 50 is benign prostatic hyperplasia (BPH), a condition where the prostate gland enlarges and partially blocks the flow of urine. When the bladder can’t empty completely, the leftover urine becomes a breeding ground for bacteria.
Urinary catheters are another major risk factor. About 75% of UTIs that develop in hospitals are associated with catheter use, and 15 to 25% of hospitalized patients have one in place at any given time. The longer a catheter stays in, the higher the risk. Other factors that raise the odds include urethral strictures (narrowing of the urethra), kidney stones, diabetes, and any procedure that involves instruments entering the urinary tract.
In younger men without these risk factors, UTIs are uncommon. When they do occur, they often prompt further investigation to rule out a structural or functional problem that allowed the infection to take hold in the first place.
Symptoms to Recognize
The symptoms of a male UTI overlap significantly with what women experience, but the location of the infection shapes what you’ll feel. A bladder infection (cystitis) typically causes a burning sensation when urinating, a persistent and urgent need to go, frequent trips to the bathroom that produce only small amounts of urine, pelvic pressure or discomfort in the lower belly, and sometimes blood in the urine that makes it look pink, red, or cola-colored.
If the infection is limited to the urethra, burning during urination and discharge are the primary signs. When a UTI spreads to the kidneys, the picture changes: you may develop fever, chills, nausea, vomiting, and pain in your back or side. A kidney infection is a more serious situation that needs prompt treatment.
UTIs vs. Prostatitis
Because the prostate sits right at the base of the bladder, bacterial infections in men can easily involve the gland itself. This condition, called bacterial prostatitis, shares many symptoms with a standard UTI but adds a few distinctive ones. Acute bacterial prostatitis comes on suddenly with high fever, chills, body aches, pain around the base of the penis or behind the scrotum, difficulty urinating or a weak stream, and sometimes nausea and vomiting. It feels more like a full-body illness than a simple bladder infection.
Chronic bacterial prostatitis is subtler. It tends to cause recurring urinary symptoms: urgency, painful urination, a weak stream, and a heavy feeling behind the scrotum. Pain during ejaculation is a particularly telling sign that the prostate is involved rather than just the bladder. Distinguishing between these conditions matters because prostatitis typically requires a longer course of treatment, often 10 to 14 days of antibiotics compared to 5 to 7 days for a straightforward complicated UTI.
How Male UTIs Are Diagnosed
Diagnosis starts with a urine sample. A urinalysis can quickly detect signs of infection like white blood cells and bacteria. If bacteria are present, a urine culture identifies the specific organism and which antibiotics will work against it. A bacterial count of 100,000 or more colony-forming units per milliliter in a single clean-catch sample is considered diagnostic in men.
Because male UTIs usually signal an underlying issue, your doctor may order additional tests. These can include blood work to check for signs the infection has spread, imaging of the urinary tract, or urodynamic testing to evaluate how well your bladder empties. If your prostate is suspected, a physical exam will check for swelling or tenderness. For recurrent infections, a cystoscopy (a thin camera threaded into the bladder) or ultrasound may be used to look for structural problems.
Treatment and What to Expect
Antibiotics are the standard treatment. For a complicated UTI that’s responding well to medication, current guidelines recommend 5 to 7 days of treatment, though the specific antibiotic depends on what the urine culture reveals. If acute bacterial prostatitis is suspected, the course extends to 10 to 14 days because the prostate tissue is harder for antibiotics to penetrate.
Most men start feeling better within a day or two of starting antibiotics, but finishing the full course is important to clear the infection completely. If a catheter is involved, removing or replacing it is a key part of treatment. When an enlarged prostate is contributing to incomplete bladder emptying, managing the prostate issue becomes part of the long-term strategy to prevent future infections.
What Happens If a UTI Goes Untreated
An untreated bladder infection can climb from the lower urinary tract into the kidneys, causing pyelonephritis. From there, bacteria can enter the bloodstream and trigger urosepsis, a life-threatening condition where the body’s response to infection begins damaging its own organs. Urosepsis can lead to organ failure, septic shock, and death. It’s a medical emergency that requires immediate hospital care.
The progression from a simple bladder infection to something dangerous isn’t inevitable, but men are at higher risk for complications precisely because their UTIs tend to involve complicating factors. An enlarged prostate that traps urine, for example, creates conditions where bacteria can multiply rapidly and spread upward toward the kidneys. Pressure from a chronically full bladder can also damage the kidneys directly over time, independent of infection.
Reducing Your Risk
Staying well hydrated helps flush bacteria from the urinary tract before they can establish an infection. If you have BPH, working with your doctor to manage it reduces the amount of residual urine sitting in your bladder. For men who require catheterization, using the catheter for the shortest time possible is the single most effective way to prevent catheter-associated infections. Intermittent catheterization, where the catheter is briefly inserted and then removed, carries less risk than an indwelling catheter that stays in place continuously.
Men who experience even one UTI should take it seriously as a signal worth investigating, since the infection itself is often the visible symptom of a less obvious underlying problem.