Everything you need to know about urinary tract infections (UTIs) in men

A UTI or urinary tract infection refers to an infection of any part of the urinary tract, which includes the bladder, kidneys, ureter (the tube through which urine passes from the kidneys to the bladder), urethra (the tube through which urine passes out of your body), and in men, the prostate. 

UTIs are more common in women as their urethra is shorter than the male urethra, which makes it easier for bacteria to enter the urinary tract. However, men are still at risk of UTIs, especially if they have an enlarged prostate, kidney stones or use a catheter (a thin plastic tube inserted into the bladder via the urethra).

UTI symptoms in men

Symptoms of UTIs in men are similar to those in women with the most common symptom being a burning or painful sensation when urinating. This can also be a symptom of a sexually transmitted infection (STI). 

However, an STI is more likely to also cause a discharge from your genitals, whereas a UTI will cause cloudy, bloody and/or foul-smelling urine and a frequent urge to urinate even when your bladder is empty. 

Other symptoms of a UTI include fever, fatigue and the sensation of pressure in your bladder or lower back. 

Causes of UTIs in men

UTIs in men and women are usually caused by bacteria entering the urinary tract via the urethra, invading or sticking to the lining of the bladder and then growing in number. The bacteria usually responsible for UTIs is E.coli, which is found in your gastrointestinal system and stools.

Any condition that obstructs your flow of urine increases the chances of bacteria growing and consequently, your risk of developing a UTI. This is why in men, an enlarged prostate increases the risk of UTIs. Kidney stones can also sometimes obstruct the flow of urine or become colonised with bacteria leading to UTIs.

Having a urinary catheter increases your risk too as you’re more likely to introduce bacteria into your urinary tract. 

Conditions or treatments that weaken your immune system, such as diabetes, immunosuppressant medication and chemotherapy, also increase your risk of UTIs as they make it harder for your body to fend off harmful bacteria. 

When to see a doctor

It is important to see your GP as soon as you notice symptoms of a UTI as there may be an underlying health problem, such as an enlarged prostate, that needs to be addressed.

Depending on your symptoms and medical history, your GP may refer you to a doctor who specialises in treating the urinary system (a urologist).

Treating UTIs

If you notice symptoms of a UTI, it is important to arrange to see your GP. They will test your urine to determine if you have an infection.

While you’re waiting for your appointment, there are steps you can take to treat your suspected UTI, namely staying well hydrated and urinating regularly. This will help flush out any bacteria.

You can also take cranberry supplements — while cranberry juice is not a proven treatment for UTIs, there is evidence to support the use of cranberry supplements. The sugar D-mannose, also available as an off-the-shelf supplement, can help treat UTIs too.

If your doctor diagnoses you with a UTI, they will usually prescribe a course of antibiotics to clear the infection. The specific antibiotic you’re prescribed will depend on the type of bacteria causing your UTI and any pre-existing medical conditions and drug allergies.

In most cases, antibiotics are prescribed for seven to 14 days. If the bacteria causing your UTI spreads to your prostate, you may develop acute bacterial prostatitis, which needs a longer course of antibiotic treatment, usually four weeks.

In either case, it is important to complete your course of antibiotics, even if your symptoms get better before the end of your treatment. This will ensure all of the bacteria are eliminated. If you don’t complete your course of antibiotics, your infection is more likely to recur and the bacteria may become resistant (unresponsive) to the antibiotics you’re taking.

Your doctor may also suggest taking an over-the-counter non-steroidal anti-inflammatory drug (NSAID), such as low-dose naproxen or ibuprofen, to reduce any inflammation and reduce your pain.

If you have recurrent UTIs, you may need further investigations and follow-up to ensure your infection clears, to monitor your symptoms and review the results of investigations into underlying causes.

How to prevent UTIs

You can reduce your risk of developing UTIs by staying well hydrated, wearing breathable, cotton underwear and practising good hygiene, especially before and after sex. This includes trying to urinate after sex to flush out any bacteria.

Avoid holding your urine for long periods of time as this causes your urine to stagnate, which increases the chances of bacterial growth. Also, avoid eating or drinking anything that will irritate your bladder, such as caffeinated drinks, alcohol and spicy food.