All you need to know about UTIs in men

A urinary tract infection (UTI) is a bacterial infection in the urinary system. Most UTIs affect the bladder and the urethra, which is the tube that drains urine from the bladder to outside the body. However, it can affect any part of the urinary system, including the kidneys and ureters.

Although a UTI is one of the most common infections in women, it is rare in men. UTIs are estimated to affect around 3 percent of men worldwide each year. This means that most men will have never had a UTI, especially if they are young.

When a UTI develops in men, it is usually considered complicated and more likely to spread to the kidneys and upper urinary tract. Some cases may even require surgery. We learn more about this condition, including its symptoms and treatment options, in this article.

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Men with UTIs may have no signs or symptoms of the infection. However, when symptoms do occur, they can include:

• pain during urination
• frequent urge to urinate
• inability to start urinating
• a slow urine stream or urine leakage
• a sudden need to urinate
• the release of only small amounts of urine at a time
• blood in urine
• pain in the central lower part of the abdomen
• cloudy urine with a strong odor

Men with complicated UTIs can also experience one or more of the following symptoms:

• fever
• chills
• nausea
• vomiting
• back pain

These symptoms are signs that the disease has spread to the kidneys or the upper urinary tract. An infection that has spread here is a more serious problem that requires prompt treatment.

UTIs are caused by bacteria. Older men have a higher risk of having a UTI, especially if they are after the age of 50. Most cases in older men are caused by the bacterium known as Escherichia coli, which is naturally present in the body.

Cases similar to UTIs in younger men are typically caused by sexually transmitted infections (STIs).

A UTI develops when the bacterium gets into the urinary tract through the urethra and starts multiplying.

As men have longer urethras than women, they are less prone to UTIs because bacteria need to travel a longer distance to reach the bladder.

UTIs are four times more common in women than in men.

A person’s risk of developing a UTI increases if they have:

• diabetes
• kidney stones
• an enlarged prostate
• an abnormal narrowing of the urethra
• an inability to voluntarily control urination
• an inability to empty the bladder completely
• not drunk enough liquids
• not been circumcised
• a past diagnosis of a UTI
• urinary tract abnormalities that prevent urine from leaving the body normally or cause urine to back up in the urethra
• had anal intercourse, which can expose the urethra to bacteria
• a health condition or taking medication that suppresses the immune system
• had a procedure involving instrumentation on the urinary tract

Examples of these procedures include the insertion of a tube to drain the bladder, or a small camera, known as a cystoscopy, to examine the bladder and urethra.

Can men get UTIs from women?

Men can get UTIs from women during sex, by getting the bacteria from a woman with the infection. However, this is unlikely.

Typically, the infection arises from bacteria that are already present in the man’s body.

A doctor can diagnose a UTI by carrying out a physical examination, taking a medical history, and through laboratory tests.

Physical examination

The doctor may perform a physical examination that includes:

• checking the vital signs
• checking the abdomen, bladder area, sides, and back for pain or swelling
• examining the genitals

Medical history

The doctor may ask if the person has had other UTIs in the past, or a family history of UTIs.

They may also question the person about their symptoms.

Laboratory tests

Laboratory tests are required to diagnose the infection as the symptoms of a UTI can be common to other diseases.

A urine sample is usually needed to look for the presence of pus and the bacteria causing the infection.

Men may be asked to give a urine sample. A man will need to start the urine stream to clean the urethra, and then collect a midstream sample in a cup. As bacteria multiply quickly at room temperature, this urine sample is either sent to the laboratory immediately or kept refrigerated until later.

The doctor may also ask for a urine test strip, also known as a urine dipstick test. This is a quick test in which a plastic or paper ribbon is dipped into the urine sample and then removed. If the person has a UTI, the ribbon will turn a particular color.

To obtain the best results for this test, the doctor will probably request that a person does it first thing in the morning.

Other medical exams

For people with a history of kidney stones, diabetes, polycystic kidneys, or tuberculosis, the doctor may also require imaging exams.

UTIs in men are usually complicated and require treatment.

The goal of treatment is to prevent the infection from spreading to the kidneys or the upper urinary tract.

The type of treatment used depends on the cause of the infection. Treatment plans usually include antibiotic medications to kill the bacteria and drugs to reduce the person’s symptoms, including those of pain and burning while urinating.

The duration of treatment can vary between 3 days and 6 weeks, depending on complicating factors, though a minimum of 7 days is usually warranted.

Prescription medications

Medication prescribed by a doctor may include:

• antibiotics, such as nitrofurantoin (Macrobid), fluoroquinolones, trimethoprim-sulfamethoxazole (Bactrim), fosfomycin, or aminoglycosides
• medications to reduce the fever
• medications to reduce or eliminate pain, including urinary analgesics such as phenazopyridine

Those with more complicated infections may require surgery. This can involve either draining areas of the urinary tract that are causing the infection, or removing inflamed areas of tissue.

In addition to treatment from doctors, the following home remedies may help with treating an infection:

• Drinking plenty of liquids, especially water. This is important to stimulate urination and flush the bacteria from the body.
• Drinking cranberry juice. Although it is not scientifically proven that cranberry juice is effective against UTIs, it contains substances that make it difficult for bacteria to stay in the urinary tract, helping to flush it out. Cranberry juice is available for purchase online.

Men can take a series of actions to reduce the risk of getting a UTI, such as:

• emptying the bladder often
• drinking plenty of liquids, especially water
• carefully cleaning the area under the foreskin after showering if not circumcised
• carefully cleaning the genitals before and after sex, to remove bacteria
• cleaning from front to back when toileting
• wearing condoms during sex. Condoms are available for purchase online.
• urinating after sex, to remove any bacteria that might have been passed during intercourse

UTIs are rare in adult men. This is mainly due to the longer length of the male urethra, and because the antibacterial properties of prostatic fluid prevent bacteria from growing. The incidence of the infection increases with age.

The clinical symptoms of UTIs in men are similar to women and include painful, urgent, and frequent urination.

UTIs in men are usually complicated and warrant at least 7 days of antibiotic treatment to prevent complications.