Men can develop a Urinary Tract Infection (UTI) without any involvement of sexual activity. While UTIs are statistically more common in women, the male urinary tract is susceptible to infection, typically from bacteria that enter the urethra. The common misconception that these infections are exclusively linked to sexual contact overlooks the distinct anatomical and health factors that put men at risk. A UTI is defined as an inflammatory response in the urinary tract lining caused by pathogenic microorganisms.
Understanding Non-Sexual Risk Factors
In men, UTIs are often considered “complicated” because they frequently point to an underlying issue that compromises the normal flushing mechanism of the urinary system. The most common non-sexual cause, particularly for men over 50, is Benign Prostatic Hyperplasia (BPH), or enlargement of the prostate gland. As the prostate enlarges, it presses against the urethra, obstructing the flow of urine and preventing the bladder from emptying completely.
This incomplete bladder emptying, known as urinary retention, leaves residual urine where bacteria can multiply undisturbed. The presence of this warm, nutrient-rich environment for bacteria, most commonly Escherichia coli (E. coli), significantly increases the likelihood of infection. The obstruction itself, caused by conditions like BPH, urethral strictures, or bladder stones, is a primary mechanism for non-sexually acquired UTIs in men.
Another significant risk factor is the use of urinary instrumentation, such as a catheter, a tube inserted into the bladder to drain urine. Catheter-associated UTIs (CAUTIs) are a frequent type of hospital-acquired infection, as the device provides a direct route for bacteria to enter the bladder. The risk of developing bacteriuria—bacteria in the urine—increases the longer a catheter remains in place.
Certain chronic health conditions also weaken the body’s defenses, making UTIs more likely. Diabetes mellitus, for instance, can compromise the immune system and lead to higher glucose levels in the urine, offering a food source for bacteria. Any condition that suppresses the immune system increases vulnerability to infection.
Identifying Common UTI Symptoms in Men
Recognizing the signs of a UTI is important for seeking timely treatment and preventing the infection from spreading to the kidneys. The most frequent sensation reported is dysuria, which is a painful or burning feeling during urination. This discomfort is often accompanied by increased urinary frequency and urgency, the strong need to urinate more often than usual, often passing only small amounts.
Changes in the urine itself can also signal an infection. The urine may appear cloudy, dark, or have an unusually strong odor due to the presence of bacteria and white blood cells. Hematuria, or the presence of blood, may be visible, causing the urine to look pink, red, or cola-colored.
Pain location can help distinguish the severity and location of the infection. Lower tract infections, involving the bladder or urethra, typically cause discomfort in the lower abdomen or pelvic area. If the infection has progressed to the upper urinary tract, such as the kidneys, symptoms can include fever, shaking chills, nausea, and pain in the lower back.
The symptoms of a male UTI can frequently overlap with those of prostatitis, an inflammation of the prostate gland. Prostatitis can cause pain in the perineum, the area between the scrotum and anus, as well as difficulty or pain during ejaculation. Because of this anatomical connection, a UTI in a man often involves the prostate, requiring a more specialized and longer course of treatment.
Diagnosis and Treatment Options
A healthcare provider typically begins the diagnosis with a urine analysis (urinalysis) to check for signs of infection, such as the presence of white blood cells, red blood cells, or nitrites. A clean-catch midstream urine sample is collected to minimize contamination from external bacteria. If the urinalysis suggests an infection, a urine culture is performed to specifically identify the type of bacteria causing the infection.
The culture results determine which antibiotics will be most effective against the specific microorganism, a process known as sensitivity testing. Treatment for a male UTI involves a course of antibiotics, which must be completed entirely to ensure the infection is fully eradicated and to minimize the risk of antibiotic resistance. Symptomatic relief, such as pain medication, may also be prescribed to lessen the burning sensation during urination.
Because male UTIs are commonly linked to underlying structural or functional issues, imaging tests may be necessary, especially for recurrent infections or if an upper tract infection is suspected. Imaging, such as an ultrasound or CT scan, helps the provider visualize the urinary tract to identify obstructions like kidney stones or the enlargement of the prostate (BPH). Addressing the root cause, such as managing BPH or removing a stone, is a necessary step to prevent the infection from returning.