Men can and do get urinary tract infections, though they’re far less common than in women. The male anatomy provides several natural defenses: a longer urethra creates more distance for bacteria to travel before reaching the bladder, and secretions from the prostate gland actively kill bacteria. But when those defenses are compromised, whether by age, sexual activity, or an underlying health condition, bacteria can gain a foothold and cause infection.
Why Male UTIs Are Uncommon Before 50
In men between the ages of roughly 3 months and 50 years, UTIs are rare enough that a diagnosis often prompts doctors to investigate whether something structurally unusual is going on. The urethra in men runs the full length of the penis, giving bacteria a much longer path to the bladder compared to the short female urethra. On top of that, prostatic fluid has natural antibacterial properties that help neutralize pathogens before they can colonize.
After 50, those odds shift. The prostate gland tends to enlarge with age, a condition called benign prostatic hyperplasia, or BPH. The prostate sits just below the bladder, and the urethra passes through its center. As the gland grows, it progressively squeezes the urethra and restricts urine flow. This leads to incomplete bladder emptying, and that leftover urine becomes a breeding ground for bacteria. This mechanism of urinary stasis is the single biggest reason UTIs become more common in older men.
Sexual Activity and UTI Risk
Sex is a well-known UTI trigger for women, but it can cause infections in men too. The insertive partner during anal intercourse faces a higher risk because the bacteria found in the rectum, particularly E. coli, can enter the urethral opening during penetration. Wearing a condom during anal sex significantly reduces this risk by creating a barrier between rectal bacteria and the urethra.
Urinating after sexual activity also helps flush out any bacteria that may have entered the urethra before they have a chance to travel upward toward the bladder.
Diabetes and Weakened Defenses
Men with diabetes face a meaningfully higher risk of UTIs, and researchers at the Karolinska Institutet have identified a specific reason why. High glucose concentrations in urine reduce levels of an antimicrobial peptide called psoriasin, which normally strengthens the protective barrier of bladder cells and helps fight off bacteria. People with diabetes have lower levels of this natural defense, making it easier for bacteria to establish an infection. The effect comes from elevated blood sugar itself, not from insulin levels.
This means that good blood sugar management isn’t just about preventing the well-known complications of diabetes. It also plays a role in keeping the urinary tract’s built-in immune defenses functional.
Other Risk Factors
Beyond prostate enlargement, diabetes, and sexual behavior, several other situations can set the stage for a male UTI:
- Catheter use. Any tube placed in the urethra provides a direct path for bacteria into the bladder. Hospital-acquired UTIs from catheters are common in both sexes.
- Kidney stones. Stones can obstruct urine flow much like an enlarged prostate does, creating stagnant urine where bacteria thrive.
- Structural abnormalities. Narrowing of the urethra from scarring, congenital differences, or previous procedures can trap urine and increase infection risk.
- Weakened immune system. Conditions or medications that suppress immune function make it harder for the body to fight off bacteria that enter the urinary tract.
What a Male UTI Feels Like
The symptoms are similar to what women experience: a burning sensation during urination, a frequent or urgent need to go, and urine that looks cloudy or smells unusual. Some men also notice lower abdominal or pelvic discomfort. Blood in the urine can occur and tends to prompt faster medical evaluation.
Because male UTIs are less common and more likely to involve a complicating factor, doctors take them seriously. If you have persistent blood in your urine, symptoms that don’t improve with initial treatment, or signs of an upper tract infection like fever, flank pain, or chills, imaging with ultrasound or CT is typically recommended to check for kidney stones, structural issues, or other underlying causes.
How Treatment Differs for Men
Women with straightforward bladder infections often receive a short antibiotic course of just three days. Male UTIs are treated differently because they’re classified as complicated infections. Updated guidelines from the Infectious Diseases Society of America recommend 5 to 7 days of treatment, depending on the antibiotic used. If the infection is suspected to involve the prostate, which sits directly adjacent to the bladder and urethra, treatment may extend to 10 to 14 days to ensure bacteria are fully cleared from prostatic tissue.
This longer treatment window exists because the prostate can harbor bacteria that are harder to reach with antibiotics. Cutting treatment short increases the chance of recurrence or progression to a more serious infection.
When UTIs Spread Beyond the Bladder
One reason male UTIs warrant closer attention is the risk of complications that don’t occur in women. Bacteria from a urinary tract infection can spread to the prostate, causing acute bacterial prostatitis, which brings fever, severe pelvic pain, and difficulty urinating. The infection can also reach the epididymis, the coiled tube behind each testicle where sperm matures.
Epididymitis typically comes on gradually and may include a swollen or warm scrotum, one-sided testicular pain, painful urination, penile discharge, and sometimes blood in the semen. Prostate enlargement itself increases the risk of both bladder infections and epididymitis, creating a chain where one condition feeds into another. These complications are treatable, but they require prompt antibiotic therapy and sometimes a longer recovery period.
Reducing Your Risk
Prevention for men centers on a few practical habits. Staying well hydrated helps flush bacteria from the urinary tract before they can multiply. Urinating after sex clears out any bacteria introduced during activity. Using condoms during anal intercourse provides a direct barrier against the most common UTI-causing bacteria. Taking showers instead of baths reduces prolonged exposure of the urethral opening to bacteria in standing water.
For men with BPH, managing prostate symptoms effectively is one of the most impactful things you can do. The better the bladder empties, the less opportunity bacteria have to grow. If you’re noticing a weakening urine stream, frequent nighttime urination, or a sense that your bladder isn’t fully emptying, addressing those symptoms with your doctor also helps reduce UTI risk downstream.