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Andy Wong

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Understanding Urinary Tract Infections in Men

A surprising number of people assume that only women can get urinary tract infections. While the chance of women getting a UTI is high—about 1 in 2 women will get a urinary tract infection at some point in their lives, men can still contract urinary tract infections. Urinary tract infections lead to an estimated 8.3 million doctor visits each year. About 20 percent of those cases are from men.

Urinary tract infections are rare in men younger than 50 years old, but the chance of contracting a UTI goes up as men get older. Let’s take a closer look at urinary tract infections in men, what causes them, symptoms, and how you can treat and prevent them.

What is a Urinary Tract Infection?

A urinary tract infection describes any bacterial infection in the tract that makes up your urinary system. This system comprises:

  • The kidneys: These two organs sit on each side of your body, generally around the waist. They filter out excess water and waste from your blood to create urine.
  • The ureters: These two thin tubes run between the kidney and bladder, transporting urine to the bladder.
  • The bladder: This organ stores urine until it reaches a certain level, at which point you feel the need to pee. The body voluntarily contracts the muscles that line the bladder to urinate.
  • The urethra: This thin tube connects the bladder to the outside of the body. When you pee, a muscle called the urinary sphincter relaxes as your bladder contracts to remove urine from your body.

Although it does contain waste, salt, and other fluids, urine is normally a sterile substance that does not contain any fungi, viruses, or bacteria.

What Causes a UTI?

A urinary tract infection is the result of bacteria attaching to the opening of the urethra and reproducing, thus entering your urinary system and traveling to the bladder.

Bladder and urethral infections are generally the most common types of UTIs. Urethral infections are known as urethritis, while bladder infections are called cystitis. Infections are most often caused by the bacteria E. coli, which you most probably know for causing food poisoning and other intestinal issues when ingested.

Normally, E. coli are found in the intestines and around the anuses of humans and animals. While harmless in their normal state, E. coli can cause infections when they enters the urinary tract, often via microscopic fecal matter.

Generally, the farther up the urinary system the infection is, the more severe the UTI. When a urinary tract infection spreads to the kidneys it is known as a kidney infection, or pyelonephritis.

Why Do Women Get UTIs More Often Than Men?

The main reason that urinary tract infections are more common in women is their anatomy. A woman’s urethra is much shorter than a man’s, making it much easier for E. coli and other bacteria to reach the bladder in women. In other words, bacteria don’t have to travel as far to reach in the bladder in women.

Furthermore, a woman’s urethra is much closer to the anus. This makes it much easier for bacteria to travel from the anus to the urethra from something like toilet splash back or wiping improperly.

Causes of UTI in Men

E. coli accounts for about 90 percent of all urinary tract infections, but men can also get UTIs from other bacteria, like chlamydia and mycoplasma. These bacteria are sexually transmitted, requiring treatment for both partners involved. These infections are limited to the urethra and reproductive system.

Urinary systems are designed to keep infections at bay. The bladder and ureters prevent urine from backing up, while the simple act of urinating is supposed to flush bacteria out of your system. In men particularly, prostate glands are supposed to secrete fluids that slow down bacterial growth.

For these reasons, urinary tract infections often point to more serious causes. Benign prostate hyperplasia can obstruct the bladder, making it difficult to completely empty the bladder. Prostatitis—an inflammation of the prostate—or other enlarging of the prostate can lead to similar issues with bladder emptying, increasing the risk of infection. An enlarged prostate is more common in older men. Kidney stones can also block the urinary tract.

People with suppressed immune systems are also more susceptible to bacterial infections. This can include disorders like diabetes and HIV/AIDS as well as certain immunosuppressant medications, like chemotherapy for cancer.

Men who have not been circumcised may also be at greater risk of urinary tract infections as bacteria has a greater chance of building up. As E. coli is most commonly found in and around the anus, men who take part in unprotected anal sex are also more likely to develop urinary tract infections.

Catheters are often used in patients who are unconscious, ill, or otherwise unable to void. As clean and sterile as catheters are, extended use can cause incomplete urination, leading to irritation and a possible infection.

Symptoms of UTI in Men

The severity of the symptoms usually depends on how far the infection has reached. General symptoms you can expect of a lower urinary tract infection include:

  • Burning or pain during urination (a condition known as dysuria)
  • The sensation of needing to urinate constantly and urgently
  • Peeing a very small amount, despite the urgency and frequency
  • Urine that appears cloudy, red, pink, or a dark cola color
  • Urine that smells bad
  • Pain in the lower abdomen
  • Pain or pressure in the pelvis
  • A mild fever, usually less than 101 degrees Fahrenheit
  • General feeling unwell or ill

When the infection spreads to the upper urinary tract, you may experience some of the above symptoms combined with:

  • A fever higher than 101 degrees Fahrenheit
  • Nausea
  • Vomiting
  • Chills and shaking
  • Pain in the back and flanks, around waist level

Older men may also experience:

  • Hypothermia
  • Jaundice
  • A poor appetite or poor feeding

Remember that everyone is different. While some people exhibit these symptoms, others may experience symptoms more similar to a sexually transmitted disease. Other men may not experience any symptoms at all.

Understanding Frequent or Recurrent Infections in Men

Getting just one urinary tract infection as a man is rare, but getting more than one could actually point to other underlying issues. A recurring infection is often caused by a separate type or strain of bacteria. In other words, even if both infections are caused by E. coli, the second is likely a mutation or separate form of E. coli.

A study from the National Institute of Health found that bacteria has the ability to attach to the cells lining the urinary tract, a contributing factor to recurrent urinary tract infections.

In women, recurrent UTIs are often a result of changing bacteria within the urinary tract. In men, frequent urinary tract infections are caused by obstructions, like kidney stones or an enlarged prostate, and procedures that require the use of a catheter.

Treatments for Urinary Tract Infections in Men

The main mode of treatment for male UTIs is antibiotics, usually delivered over the course of one week or more. Your doctor may also prescribe medication that numbs your bladder and urethra to relieve painful, burning urination. The most common medications prescribed for urinary tract infections in men include:

  • Ampicillin
  • Nitrofurantoin
  • Trimethoprim
  • Sulfamethoxazole
  • Amoxicillin

In recent years, doctors have also begun to prescribe a class of drugs called quinolones. These drugs include:

  • Ciproflaxin
  • Norfloxacin
  • Ofloxacin
  • Trovafloxin

Urinary tract infections should get cured within a couple days of the treatment, assuming the infection is not caused by an obstruction or a separate disorder. Always make sure you take the full course of the prescribed medication to ensure elimination of remaining bacteria. The full course often lasts for over a week.

Doctors will prescribe longer term treatment for patients who show signs of prostate or kidney infections and patients with diabetes or structural abnormalities. Doctors also recommend longer treatments for men who have urinary tract infections as a result of mycoplasma or chlamydia. These are often treated with doxycycline, tetracycline, or a mix of trimethoprim and sulfamethoxazole.

If the infection is severe enough to have spread to the kidney, you may be hospitalized so doctors can administer antibiotics intravenously. Kidney infections can take several weeks of antibiotic treatment for full recovery. You’ll generally have to stay hospitalized until you can take fluids and medications on your own.

Treating an infection that has been caused by systemic disorder or obstruction usually requires taking care of the underlying issue, which could mean undergoing a surgical procedure. Without taking care of the underlying issue, you risk suffering kidney damage, which can lead to a whole host of other problems.

Home Remedies for Urinary Tract Infections in Men

While antibiotics do most of the heavy lifting during the treatment phase, you can take several steps to maintain your comfort and ensure that all the bacteria are eliminated from your body. Some beneficial steps to take include:

  • Drink more water. This dilutes your urine and encourages the flushing out of bacteria from your urinary tract.
  • Avoid alcohol, coffee, citrus juice, sugary sodas, and spicy foods. All of these may irritate your bladder and contribute to your frequent, urgent urinating.
  • Use a heating pad or hot water bottle. Using a warm heating pad on your abdomen can help with the pain and discomfort.
  • Quit smoking. Smoking is one of the main contributors to bladder cancer.
  • Drink cranberry juice. Some studies suggest that cranberry juice can help with UTIs by preventing bacteria from sticking to the walls of your urinary tract. Other studies are inconclusive or suggest otherwise, but if you think drinking cranberry juice is helping you, then by all means drink it. Just watch your calorie intake, and avoid drinking cranberry juice if you’re taking any blood-thinning medication, like aspirin or warfarin.

Preventing Male Urinary Tract Infections

As rare as urinary tract infections are in men, make sure you take the right steps to ensure you never have to worry about one:

  • Pee when you need to. Don’t hold your pee, and always try to empty your bladder fully.
  • Wear cotton underwear and loose fitting clothing. Tight pants and non-cotton underwear tend to trap moisture, making for a great environment where bacteria can grow.
  • Wash your genital area after sex.
  • If you’re uncircumcised, wash your foreskin regularly.
  • Urinate soon after sex to flush out any bacteria that may have entered your urethra.
  • Practice safe sex in general.
  • Take showers instead of baths.

Most importantly, make sure you go to your doctor regularly, especially if you suspect something is wrong. Urinary tract infections may point to more serious underlying issues. The best thing you can do is act early. Remember to get tested for sexually transmitted diseases if you are sexually active. And if kidney stones become a common issue, consult your doctor for help with changes in your lifestyle or diet.

If you experience any symptoms of UTI or STD, call or book online with PlushCare to set up a phone appointment with a top U.S. doctor today, and/or order a STD test now.

Read more of our UTI series:

UTI Signs, Symptoms, and Remedies

What to do if you have a Urinary Tract Infection

Can you have sex with a UTI?


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