UTIs in Men: Rare, but Often Overlooked
Last Thursday, James came into my office looking a little embarrassed.
“Doc, I feel silly being here,” he said. “My wife made me come. I’ve got burning when I pee and I’m going all the time—but UTIs are a women’s thing, right?”
They’re not. And that belief is exactly why many men delay getting care.
Here’s what surprises most people: urinary tract infections in men are uncommon enough that when they happen, we take them seriously. Women can develop UTIs from relatively minor triggers. Men usually can’t. So when a man develops one, it’s rarely random—and that’s why it matters.
After more than fifteen years treating urological conditions, I’ve learned this simple rule: a male UTI is a signal, not just an infection.
Why UTIs Are Different in Men
Enlarged prostate is by far the leading cause in men over 50. As the prostate grows, it can block urine flow, leaving urine behind in the bladder. That leftover urine becomes a perfect environment for bacteria.
One patient, Robert, had four UTIs in less than two years. Each time, he was given antibiotics and sent home. No one asked why they kept happening. Once we treated his prostate obstruction, the infections stopped.
Kidney stones are another frequent culprit. Even small stones can harbor bacteria, triggering repeated infections without obvious pain.
Diabetes increases infection risk by weakening immune response and feeding bacteria through elevated blood sugar.
Urethral strictures, often caused by old injuries or infections, can trap urine and bacteria.
Long-term catheters dramatically increase UTI risk and require careful management.
Symptoms Look Familiar—But Mean More
Men usually experience the same symptoms women do:
- Burning or pain during urination
- Frequent or urgent urination
- Cloudy or foul-smelling urine
- Lower abdominal or pelvic discomfort
- Sometimes fever or chills
The difference isn’t how it feels—it’s what it signals. In men, these symptoms almost always warrant deeper evaluation.
Why Ignoring Male UTIs Is Risky
Prostate infection (prostatitis) is a major concern. Bladder infections can spread to the prostate, leading to prolonged pain, urinary issues, and long treatment courses.
I’ve treated men who spent months on antibiotics because an initial UTI wasn’t properly evaluated. With earlier investigation, many of those cases could have been avoided.
Kidney involvement is another risk. When urine flow is impaired, infection can travel upward to the kidneys, sometimes requiring hospitalization.
In rare cases, a UTI can be the first sign of something more serious, including significant prostate disease or bladder tumors.
How I Evaluate UTIs in Men
When a man comes to me with UTI symptoms, I focus on understanding the full picture.
First, a detailed history—urinary stream, emptying, prior infections, medical conditions, recent procedures. Small details matter.
A urine culture is essential. We need to know exactly what bacteria we’re treating and which antibiotics will actually work.
A post-void residual test measures how much urine remains in the bladder after urinating. High residual volumes often point to obstruction.
If needed, imaging studies help identify stones or anatomical problems. For recurrent infections, cystoscopy allows direct visualization of the bladder and urethra.
Treatment Is More Than Antibiotics
Antibiotics are necessary—but they’re only step one.
Long-term success comes from fixing the underlying issue:
- Prostate enlargement may require medication or minimally invasive treatment
- Stones need to be removed
- Strictures may require dilation or repair
Hydration helps support recovery, and finishing the full antibiotic course is critical—even if symptoms improve early.
When to Seek Immediate Care
Some symptoms should never be ignored:
- High fever and chills
- Severe back or flank pain
- Nausea or vomiting
- Confusion
- Inability to urinate
These can signal kidney infection or bloodstream involvement and require urgent care.
Recurrent UTIs Are a Warning Sign
If a man has more than one UTI, something is being missed.
I once treated a 48-year-old man with diabetes who had six UTIs over three years. No one had checked his bladder emptying. He had developed nerve-related bladder dysfunction from diabetes. Once we addressed that, the infections nearly disappeared.
Prevention That Actually Helps
- Stay well hydrated
- Address urinary symptoms early
- Manage diabetes carefully
- Follow catheter care instructions closely if applicable
Good hygiene matters, but in men, flow and emptying matter far more.
Why Male UTIs Are Called “Complicated”
In medical terms, male UTIs are automatically considered “complicated”—not because they’re worse, but because they’re uncommon in healthy men. That classification simply means they deserve thorough evaluation.
This isn’t overkill. It’s prevention.
My Perspective After Years of Practice
I approach male UTIs with one principle: treat the infection, but always ask why it happened.
Men who do best are the ones who allow us to look deeper instead of just taking antibiotics and hoping it won’t happen again. Identifying the root cause prevents future infections—and bigger problems down the road.
Age Matters
- Under 35: UTIs are rare and usually linked to specific risk factors
- 35–50: Early prostate issues or metabolic conditions may be emerging
- 50+: Prostate enlargement is the most common cause
The Bottom Line
If you’re a man with UTI symptoms, don’t brush them off or assume antibiotics alone will fix everything. Male UTIs are uncommon—and that’s exactly why they deserve attention.
Your body gave you a natural defense against infection. When that defense fails, something usually helped it along. Finding that cause protects your health long-term.
There’s no reason to feel embarrassed about urinary symptoms. Getting evaluated early prevents complications and preserves quality of life.
