Urinary tract infections are often thought of as a “women’s health issue,” but roughly 12% of men will experience at least one UTI during their lifetime — and when it happens, the symptoms of a UTI in men can be more complicated than in women. According to the American Urological Association, UTIs in men are less common before age 50 but become increasingly prevalent with age, often linked to prostate enlargement, catheter use, or urinary retention. Because UTIs in men are considered “complicated” by default in medical guidelines, understanding the symptoms and getting prompt treatment is essential. For a broader overview of urinary and other health conditions, visit our medical conditions guide.
What Causes UTIs in Men?
A urinary tract infection occurs when bacteria — most commonly Escherichia coli (E. coli) — enter the urinary tract and multiply. In women, the short urethra provides easy access for bacteria. Men benefit from a longer urethra, which naturally reduces infection risk, but several factors can overcome this anatomical advantage.
Benign prostatic hyperplasia (BPH) — an enlarged prostate — is the most common predisposing factor in men over 50. The enlarged gland compresses the urethra, preventing complete bladder emptying. Residual urine becomes a breeding ground for bacteria. Other risk factors include urinary catheterization, kidney stones, diabetes, immunosuppression, and being uncircumcised. The NIDDK notes that any condition impairing normal urine flow increases UTI risk in men.
Common Symptoms to Watch For
The classic symptoms of a UTI in men overlap significantly with those in women, but men may also experience symptoms related to prostate involvement. A burning sensation during urination (dysuria) is the most widely recognized sign. Frequent urination — needing to go often but passing only small amounts — and urgency (a sudden, strong need to urinate that’s hard to delay) are hallmarks of a lower urinary tract infection.
Cloudy, dark, or foul-smelling urine is another common indicator. Some men notice blood in the urine (hematuria), which can range from a faint pink tinge to visible red. Pelvic pain or discomfort in the lower abdomen, particularly around the bladder area, is typical. For a comparison of UTI symptoms across both sexes, see our comprehensive guide to symptoms of a UTI.
Symptoms That May Indicate Prostate Involvement
When a UTI spreads to or involves the prostate gland — a condition called bacterial prostatitis — symptoms become more severe and distinctive. Pain in the perineum (the area between the scrotum and rectum), lower back pain, and pain during or after ejaculation are characteristic of prostatitis.
Difficulty starting urination, a weak or interrupted stream, and a sensation of incomplete bladder emptying suggest prostatic obstruction. Acute bacterial prostatitis can cause high fever, chills, nausea, and severe malaise — it’s a condition that requires urgent antibiotic treatment. The Mayo Clinic considers acute bacterial prostatitis a urologic emergency that can lead to sepsis if untreated.
Upper UTI Symptoms: When Infection Reaches the Kidneys
A lower UTI that ascends to the kidneys becomes pyelonephritis — a more serious infection requiring aggressive treatment. Symptoms of a kidney infection include high fever (often above 101 degrees F), chills and rigors, flank pain (one-sided pain in the upper back below the ribs), nausea, and vomiting.
Kidney infections can develop rapidly. According to the CDC, pyelonephritis leads to approximately 250,000 office visits and 200,000 hospitalizations per year in the United States. In men, pyelonephritis often indicates an underlying structural abnormality or obstruction that needs investigation.
How UTIs in Men Are Diagnosed
Diagnosis begins with a urinalysis and urine culture. The urinalysis checks for white blood cells, red blood cells, and nitrites — indicators of infection. A urine culture identifies the specific bacteria causing the infection and determines which antibiotics will be effective. Because UTIs in men are classified as complicated, a urine culture is considered standard practice rather than optional.
Your doctor may perform additional workup, including a digital rectal exam to assess the prostate, blood tests if systemic infection is suspected, and imaging studies (ultrasound or CT scan) to rule out kidney stones, abscesses, or structural abnormalities. According to the AUA, men with their first UTI or recurrent UTIs typically warrant urologic evaluation to identify predisposing factors.
Treatment for Male UTIs
Antibiotics are the primary treatment. Unlike the 3-day courses commonly prescribed for uncomplicated UTIs in women, men usually require 7 to 14 days of antibiotics due to the higher likelihood of deep tissue involvement (prostate, kidneys). Commonly prescribed antibiotics include trimethoprim-sulfamethoxazole, fluoroquinolones (ciprofloxacin, levofloxacin), and nitrofurantoin for lower UTIs.
Acute bacterial prostatitis may require 4 to 6 weeks of antibiotics because the prostate gland has limited blood flow and antibiotics penetrate it slowly. Severe infections with high fever or signs of sepsis may require IV antibiotics in a hospital setting. If you’re exploring virtual care options for UTI treatment, our guide to getting an online UTI prescription explains what telehealth providers can and can’t do for this condition.
Supportive measures include drinking plenty of fluids to help flush bacteria, over-the-counter phenazopyridine (Azo) for urinary pain relief (it turns urine orange — that’s normal), and NSAIDs for discomfort. Addressing underlying causes — managing BPH, removing kidney stones, or adjusting catheter care — is critical for preventing recurrence.
Frequently Asked Questions
Are UTIs in men sexually transmitted?
Standard UTIs are not sexually transmitted infections (STIs), though sexual activity can introduce bacteria into the urinary tract. However, some UTI symptoms in men overlap with STIs like chlamydia and gonorrhea — particularly urethral discharge and burning urination. Your doctor may test for both to ensure accurate diagnosis.
Can cranberry juice treat a UTI in men?
There is limited evidence that cranberry products may help prevent UTIs in some populations, but they are not effective as treatment for an active infection. The Cochrane Library concluded that cranberry products provide a modest reduction in UTI recurrence, but antibiotics remain the only proven treatment for established infections.
Why are UTIs in men considered “complicated”?
Medical guidelines classify UTIs in men as complicated because the male urinary tract’s anatomy makes infection less likely without a contributing factor — prostatic obstruction, structural abnormality, catheter, or immune compromise. This classification means longer antibiotic courses and more thorough diagnostic workup are standard.
Should I be worried about recurring UTIs?
Recurrent UTIs in men (two or more within six months or three within a year) warrant urologic evaluation. They may indicate an enlarged prostate, urethral stricture, kidney stones, or other structural issues. A post-void residual measurement and imaging studies can help identify the underlying cause.
When to See a Doctor
Any man experiencing UTI symptoms should see a healthcare provider rather than attempting self-treatment. This is especially important if symptoms include fever, back or flank pain, blood in the urine, or difficulty urinating. Because male UTIs often involve the prostate or upper urinary tract, early professional evaluation prevents complications.
When to seek emergency care: Call 911 or go to the nearest emergency room if you develop high fever with shaking chills, severe back or abdominal pain, inability to urinate despite a full bladder, confusion or altered mental status, or signs of sepsis (rapid heart rate, low blood pressure, extreme fatigue). Urosepsis — a bloodstream infection originating from the urinary tract — is a life-threatening emergency.
What to Do Next
If you recognize the symptoms of a UTI in men described here — burning urination, urgency, frequency, cloudy urine, or pelvic discomfort — don’t wait to see if it resolves on its own. Male UTIs require antibiotics, and the sooner you start treatment, the lower your risk of the infection spreading to the prostate or kidneys. Make an appointment with your primary care provider or urologist, provide a urine sample, and discuss whether further evaluation of your urinary tract is warranted. Prompt action turns what could become a serious complication into a quickly resolved inconvenience.