Urinary tract infections (UTIs) are typically associated with women, but men are not immune to this uncomfortable and sometimes serious condition. Although UTIs are less common in men, they can signal underlying health concerns that require attention. At 1Prostate Center, led by Dr. David Shusterman in Manhattan and Queens, patients often seek answers about symptoms, diagnosis, and treatment options related to male UTIs. Understanding what causes UTIs in men and how to recognize early signs is critical for prompt and effective care.

What Is a Urinary Tract Infection?

A urinary tract infection occurs when bacteria enter and multiply in any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra. In men, UTIs are more frequently found in the lower urinary tract, which includes the bladder and urethra. When left untreated, a UTI can progress to the kidneys, leading to more severe infections and possible complications.

UTIs in men can be classified as either uncomplicated or complicated. Most male UTIs fall under the complicated category, often due to structural or functional abnormalities, such as an enlarged prostate or urinary retention. These underlying conditions can make treatment more difficult and increase the likelihood of recurrence.

Common Causes of UTIs in Men

In men, UTIs are frequently caused by bacteria entering the urinary tract through the urethra, but the underlying reasons are often more complex than in women. One of the most common causes is urinary retention, where the bladder doesn’t completely empty during urination. This can create a breeding ground for bacteria.

Another contributing factor is benign prostatic hyperplasia (BPH), which leads to an enlarged prostate gland that compresses the urethra and obstructs urine flow. Additionally, kidney stones, urinary catheter use, or recent urologic procedures can increase the risk of infection. Men with diabetes or weakened immune systems are also more susceptible due to their bodies’ reduced ability to fight off infection.

Sexual activity can introduce bacteria into the urinary tract, especially when anal intercourse is involved without proper hygiene. Older men are particularly vulnerable due to age-related changes in the urinary and immune systems.

Recognizing the Symptoms of a UTI

While the symptoms of UTIs in men may resemble those in women, they can also manifest in ways that are specific to male anatomy. The most common symptom is a frequent urge to urinate, often accompanied by a burning sensation. Other typical signs include cloudy or strong-smelling urine, blood in the urine (hematuria), and discomfort in the lower abdomen or pelvic area.

Men may also experience:

• Pain or a burning sensation during urination
• A persistent feeling of bladder fullness even after urinating
• Difficulty starting or maintaining urine flow
• Fever and chills (especially if the infection has spread to the kidneys)
• Pain in the lower back or sides

In some cases, especially among older men, symptoms may be subtle or confused with other medical conditions. It’s important to seek medical attention if any of these symptoms appear, as early diagnosis and treatment are essential to preventing complications.

Diagnosing UTIs in Men

Diagnosing a urinary tract infection in men typically begins with a detailed medical history and a review of symptoms. A urine sample is usually required to identify the type of bacteria responsible and determine the appropriate antibiotic treatment. In some cases, a urine culture may be conducted to assess the infection’s resistance to certain antibiotics.

Additional diagnostic tools may be used depending on the suspected underlying cause. These can include a digital rectal exam to assess the prostate, blood tests to check for signs of infection, or imaging tests such as ultrasound or CT scans to identify structural issues like kidney stones or bladder abnormalities. In men with recurrent UTIs, a cystoscopy might be performed to visually inspect the inside of the bladder and urethra.

Because UTIs in men are often linked to other health conditions, comprehensive evaluation is critical to ensure that the root cause is addressed along with the infection itself.

Treatment and Management Options

Treatment for male UTIs typically involves a course of antibiotics tailored to the specific bacteria identified in the urine culture. Most uncomplicated infections respond well to oral antibiotics taken for 7–14 days. However, complicated cases, such as those involving the kidneys or prostate, may require longer treatment or intravenous antibiotics.

In addition to medication, patients are encouraged to stay well-hydrated to help flush bacteria from the urinary tract. Pain relief may be provided using over-the-counter medications such as acetaminophen or ibuprofen. It’s also essential for men to complete the full course of prescribed antibiotics even if symptoms resolve early, to avoid recurrence and antibiotic resistance.

For recurrent UTIs or cases linked to structural problems, addressing the underlying cause is crucial. This may include managing prostate enlargement, removing kidney stones, or adjusting catheter use. In some situations, minor surgical procedures may be necessary to restore normal urinary function.

Preventing Future Infections

Although not all UTIs are preventable, men can take steps to reduce their risk of infection. Proper hygiene, particularly after bowel movements or sexual activity, helps prevent the spread of bacteria. Staying well-hydrated and urinating regularly can also aid in flushing bacteria from the system before it takes hold.

Men with a history of urinary retention or BPH should monitor their symptoms and discuss long-term management options with a healthcare provider. Regular follow-ups and screenings can help detect and address abnormalities before they result in infection.

Preventive strategies also include avoiding unnecessary catheter use, managing chronic health conditions like diabetes, and practicing safe sex. In men who suffer from frequent UTIs, a urologist may suggest prophylactic antibiotics or lifestyle changes to reduce recurrence.

Understanding and managing UTIs in men requires a comprehensive approach that includes recognizing symptoms, addressing underlying causes, and implementing preventive strategies. Though less common than in women, UTIs in men can indicate more serious health concerns and should never be ignored. At 1Prostate Center in Manhattan and Queens, men are encouraged to stay proactive about their urinary health and consult with a healthcare provider when symptoms arise.

Resources
Miller, L. G., & Tang, A. W. (2018). Urinary Tract Infections in Men. Primary Care: Clinics in Office Practice.
Foxman, B. (2014). Urinary Tract Infection Syndromes: Occurrence, Recurrence, Bacteriology, Risk Factors, and Disease Burden. Infectious Disease Clinics of North America.
Nickel, J. C. (2003). Management of Urinary Tract Infections: Historical Perspective and Current Strategies. Journal of Urology.