Men get urinary tract infections when bacteria enter the urethra and multiply in the urinary tract, but it happens far less often than in women. In men under 50, the rate is only about 5 to 8 cases per 10,000 each year. The male urethra is roughly 20 cm (7 to 8 inches) long, compared to just 3 to 4 cm in women, which means bacteria have a much longer path to travel before reaching the bladder. That built-in protection doesn’t make men immune, though. Several specific factors can overcome that barrier and lead to infection.
Why the Risk Rises With Age
The biggest driver of UTIs in men is age, and the reason comes down to the prostate. The prostate gland sits just below the bladder, and the urethra runs directly through it. As men get older, the prostate commonly enlarges, a condition called benign prostatic hyperplasia (BPH). When that happens, the growing gland squeezes the urethra and partially blocks urine flow.
The result is incomplete bladder emptying. Urine that stays in the bladder becomes a breeding ground for bacteria. This is called urinary stasis, and it’s the primary reason UTI rates climb significantly in men over 50 and especially after 65. If you’ve noticed that your stream is weaker than it used to be, that you need to urinate more often at night, or that your bladder never feels fully empty, those are signs of the same obstruction that raises UTI risk.
Sexual Activity and Foreskin
Sexual activity is one of the more common ways younger men develop UTIs. Anal intercourse, in particular, can introduce fecal bacteria (the same bacteria responsible for most UTIs) into the urethra. Being uncircumcised also increases risk, because bacteria can accumulate under the foreskin and migrate into the urinary opening. Using condoms and urinating after sex both help reduce the chance of bacteria gaining a foothold.
Catheters and Medical Procedures
Any device or procedure that enters the urinary tract creates a direct route for bacteria. Urinary catheters are the most common culprit. The longer a catheter stays in place, the higher the risk of infection. Men who’ve had recent urologic surgery, cystoscopy (where a small camera is inserted into the bladder), or any instrumentation of the urinary tract are also at elevated risk. Hospital-acquired UTIs from catheters tend to involve a wider range of bacteria than typical community infections, which can make them harder to treat.
Other Factors That Increase Risk
- Kidney stones or structural abnormalities. Anything that blocks or disrupts normal urine flow, like a stone lodged in the ureter, creates the same stasis problem as an enlarged prostate.
- Diabetes. High blood sugar impairs the immune system’s ability to fight infection and can change the composition of urine in ways that favor bacterial growth.
- Weakened immune system. Conditions or medications that suppress immune function make it easier for bacteria to establish an infection once they enter the urinary tract.
- Not drinking enough fluids. Regular urination physically flushes bacteria out of the urethra. Low fluid intake means less frequent urination and more time for bacteria to multiply.
What a Male UTI Feels Like
The classic symptoms overlap with what women experience: a burning sensation when you urinate, a frequent or urgent need to go, and urine that looks cloudy or has a strong odor. But male UTIs have a few distinctive features. You may feel pain or pressure in the area between the scrotum and rectum, in the groin, or in the lower back. Some men notice a weak or interrupted urine stream or feel like the bladder isn’t emptying all the way.
If the infection spreads to the prostate, symptoms escalate. Fever, chills, nausea, body aches, and severe pain in the lower abdomen or genital area can develop. Painful ejaculation is another sign that the prostate is involved. Blood in the urine, a complete inability to urinate, or high fever with urinary symptoms are signs that warrant immediate medical attention.
Why Male UTIs Are Treated Differently
Women with a straightforward bladder infection often take antibiotics for just 3 days. Male UTIs almost always require longer treatment. Current guidelines recommend 5 to 7 days as a minimum for complicated urinary infections. If the prostate is suspected to be involved, treatment typically extends to 10 to 14 days, because prostate tissue is harder for antibiotics to penetrate and infections there are more likely to come back if undertreated.
Because UTIs are uncommon in younger men, doctors often investigate further when one occurs. If you have persistent blood in your urine, symptoms that don’t respond to initial treatment, or signs of an upper tract infection (like flank pain and fever), imaging of the urinary tract is typically recommended to rule out structural problems like stones, blockages, or anatomical abnormalities that could be causing recurrent infections.
Reducing Your Risk
Staying well hydrated is the simplest preventive measure. Frequent urination keeps bacteria from settling in the bladder. If you have an enlarged prostate, managing that condition effectively also lowers UTI risk, since the goal is to improve bladder emptying. Practicing good hygiene, using condoms during anal sex, and urinating soon after sexual activity all reduce the chance of bacteria entering the urethra. Men with diabetes benefit from keeping blood sugar well controlled, which supports the immune system’s ability to fight off infections before they take hold.