UTIs in men: symptoms, causes and treatment
Quick answer
Urinary tract infections (UTIs) are less common in men than women, but they do happen, and are usually assessed by a GP rather than self-treated. Typical symptoms include pain when urinating, needing to go more often, and cloudy or strong-smelling urine. Treatment is usually a course of antibiotics, prescribed after a urine test.
Can men get UTIs?
Yes. Urinary tract infections (UTIs) are far more common in women, largely because the female urethra is shorter, giving bacteria a shorter distance to travel to reach the bladder. The male urethra is longer, which offers more natural protection, and this is one reason UTIs are less frequently diagnosed in men.
That protection isn't absolute, though, and men do get UTIs, particularly as they get older. From around midlife onwards, the prostate gland can gradually enlarge, and if this makes it harder to empty the bladder fully, urine left behind gives bacteria more opportunity to multiply. Because a UTI is relatively unusual in a man, especially one under 50, it's worth taking any symptoms seriously and getting them checked rather than assuming it will settle by itself.
Common symptoms of a UTI in men
The symptoms of a lower urinary tract infection (affecting the bladder and urethra) are broadly similar in men and women. They can include:
- pain, stinging or a burning sensation when urinating
- needing to urinate more often than usual
- a sudden or urgent need to go, sometimes with little warning
- needing to get up during the night to urinate
- cloudy, dark, blood-stained or strong-smelling urine
- a dull ache or discomfort in the lower tummy or lower back
- feeling generally unwell, tired or off-colour
Symptoms can develop quickly, sometimes over a day or so. If you notice a combination of these, it's a reasonable prompt to arrange a GP appointment rather than wait to see if they pass.
Older men can sometimes present a little differently, with confusion, a loss of appetite or general unsteadiness standing in for the more typical urinary symptoms, which is one reason a UTI is always worth considering and checking for in an older man who suddenly seems unwell or more muddled than usual.
What causes UTIs in men
Most UTIs happen when bacteria, often a strain called E. coli that lives naturally in the bowel, get into the urethra and travel up into the bladder. A number of things can make this more likely in men:
- an enlarged prostate (benign prostatic hyperplasia), which can make it harder to empty the bladder fully
- a urinary catheter, which gives bacteria a more direct route into the bladder
- kidney stones or other narrowing of the urinary tract, including from previous surgery
- diabetes, where higher blood sugar can make infections more likely and slower to clear
- not drinking enough fluids through the day
- unprotected anal sex, which can introduce bacteria into the urethra
Sometimes no clear cause is found, particularly in a man with a single, one-off infection.
When to see a GP, and red flags for urgent care
Because a UTI is relatively unusual in men, the sensible approach is to see a GP for any suspected infection rather than treat it yourself. A GP can confirm what's causing your symptoms and rule out other conditions that can look similar, such as prostatitis or a sexually transmitted infection.
- Pain or burning when urinating
- Going more often, or more urgently, than usual
- Cloudy or strong-smelling urine
- Mild discomfort in the lower tummy
- Fever, shivering or chills
- Pain in your back or side (loin pain)
- Nausea or vomiting
- Confusion or sudden drowsiness, especially in older men
- Blood in the urine
- Symptoms not improving after a few days of antibiotics
Back or side pain with fever can be a sign the infection has spread to the kidneys, which needs prompt treatment, so don't wait on these symptoms; call 111 or seek same-day care.
How a UTI in men is diagnosed
Your GP will usually ask about your symptoms and how long you've had them, and may examine your lower tummy. In most cases, they'll ask for a urine sample (a midstream urine or MSU sample) to check for infection and identify which bacteria are involved, so the most effective antibiotic can be chosen. This sample is sent to a lab, and results confirming the specific bacteria usually take a couple of days, though treatment is often started before those results are back if your symptoms and a quick in-clinic dipstick test point clearly to a UTI.
Because UTIs are less common in men, particularly infections that keep coming back, your GP may also want to check your prostate, arrange blood tests, or refer you for further investigation, such as an ultrasound scan, to look for an underlying cause like an enlarged prostate or a narrowing in the urinary tract.
Treatment options
A UTI in men is usually treated with a course of antibiotics, prescribed once a urine sample has been taken. Depending on what's suitable for you, this might be Trimethoprim 200mg for Men or Nitrofurantoin 100mg MR Capsules for Men, typically taken for around seven days, a longer course than is usually given to women, reflecting the extra caution taken given how much less common UTIs are in men.
Symptoms usually start to ease within three to five days of starting antibiotics. It's important to finish the full course even once you feel better, as stopping early can allow the infection to return or make it harder to treat. Drinking plenty of fluids and taking a standard painkiller such as paracetamol can help with discomfort while the antibiotics take effect. If symptoms haven't improved after a few days, or they come back, contact your GP again rather than waiting it out.
Reducing your risk of a UTI
There's no way to guarantee you'll never get a UTI, but a few habits can lower the risk:
- drink enough fluids through the day so your urine stays pale
- avoid holding in urine for long periods; go when you need to
- urinate after sex
- keep the genital area clean, washing ahead of sex and again afterwards
- manage conditions like diabetes well, as this is linked to a higher UTI risk
- treat constipation, which can put extra pressure on the bladder
- use protection during anal sex to reduce the risk of bacteria being introduced into the urethra
If you notice urinary symptoms alongside a weak stream or a feeling of incomplete emptying, mention this to your GP too, as it may point to an enlarged prostate that's worth managing in its own right.
What if UTIs keep coming back?
A single UTI in a man is usually straightforward to treat, but two or more infections within six months, or several within a year, counts as a recurrent UTI and is worth investigating further rather than simply treating each one as it comes.
Your GP may refer you to a urologist to look for an underlying cause, such as a kidney stone, a narrowing in the urinary tract, or a bladder that isn't emptying fully because of prostate enlargement. Investigations can include an ultrasound scan of the kidneys and bladder, or a cystoscopy, where a thin camera is used to look inside the bladder and urethra. In some cases, once other causes have been ruled out, a specialist may consider a lower-dose antibiotic taken over a longer period to reduce how often infections happen, though this is decided on an individual basis and isn't usually the first step. Keeping a simple note of when infections happen, and anything that seemed to trigger them, can be useful information to bring to these appointments.
Frequently asked questions
Are UTIs in men serious?
Most UTIs in men are straightforward to treat once diagnosed, but because they're less common than in women, doctors take them seriously and will usually want to check the underlying cause rather than assume it's a simple infection. Left untreated, an infection can occasionally spread to the kidneys or prostate, so it's worth being seen promptly.
Can a UTI in men go away on its own?
It isn't advisable to wait and see. Because UTIs are unusual in men, seeing a GP for a urine test and antibiotics is the recommended route, rather than trying to treat it yourself or hoping it clears up unaided.
What's the difference between a UTI and prostatitis?
Both can cause similar urinary symptoms, but prostatitis specifically involves inflammation or infection of the prostate gland and can also cause pain in the perineum, lower back or during ejaculation. A GP can examine you and arrange tests to tell the two apart, as treatment can differ.
How long does a UTI take to clear up in men?
With the right antibiotic, symptoms usually start to ease within three to five days, though a full course, often around seven days, should be completed even if you feel better sooner. If things haven't improved after this, contact your GP again.
Can UTIs in men be linked to an enlarged prostate?
Yes. An enlarged prostate can make it harder to fully empty the bladder, and urine left behind gives bacteria more chance to multiply. If UTIs keep recurring, your GP may want to check for this and other underlying causes.