Urinary tract infections (UTIs) are often thought of as a woman’s health issue, but UTIs can affect men as well. It may be less common, but UTIs in men are usually more complex, and they often signal an underlying urological condition that requires attention.
I see many patients who come in with symptoms of UTIs, sometimes after repeated courses of antibiotics that have not fully solved the problem. Understanding the causes, symptoms, and treatment options is key to preventing recurrence and protecting long-term urinary and sexual health.
What Is a Urinary Tract Infection?
A urinary tract infection (UTI) happens when bacteria enter the urinary system and multiply. In men, UTIs most commonly involve the bladder (cystitis) or the urethra (urethritis), but infections can also spread to the prostate (prostatitis) or kidneys (pyelonephritis), making them potentially more serious.
Why do Urinary Tract Infections occur in men?
UTIs are less common in men because the longer urethra provides some natural protection. However, when they do occur, it is often due to an underlying factor. These can include:
- Prostate enlargement (BPH): An enlarged prostate can obscure urine flow, leading to incomplete emptying end bacterial growth.
- Kidney stones: Stones can block urine flow and act as a site for bacteria to thrive.
- Urethral strictures: Narrowing of the urethra can cause difficulty emptying the bladder.
- Catheter use: Prolonged catheterisation increases the risk of infection.
- Chronic conditions: Diabetes and other immune-weakening conditions may predispose men to UTIs.
Symptoms to look out for
The symptoms of a urinary tract infection in men can vary depending on which part of the urinary tract is involved. Common signs include:
- Burning or pain when passing urine
- Frequent urge to urinate, often with small amounts of urine
- Cloudy or foul-smelling urine
- Blood in the urine (haematuria)
- Pain or discomfort in the lower abdomen, back, or perineum
- Fever, chills, or feeling unwell (this may indicate that the infection has spread to the kidneys or prostate)
Diagnosis
Diagnosing a UTI involves a urine culture to detect bacteria and, in recurrent cases, imaging studies or further urological assessment to identify any underlying cause. As part of my practice, I often combine laboratory testing with a detailed discussion of symptoms, medical history, and any risk factors.
Treatment options
Treatment depends on the severity of infection and whether it is complicated by an underlying condition.
- Antibiotics: the first line of treatment. The choice of antibiotic depends on the type of bacteria and resistance patterns.
- Addressing the cause: If prostate enlargement, kidney stones or strictures are contributing to the UTIs, targeted treatment is needed to prevent recurrence.
- Supportive measures: Staying well-hydrated, avoiding fluids that irritate the bladder (such as caffeine or alcohol), and ensuring good bladder emptying.
In men with recurrent infections, I often perform further investigations such as a cystoscopy (a camera examination of the bladder) or an ultrasound to identify any hidden causes.
The link with prostate health
An often-overlooked aspect of UTIs in men is the prostate. Acute prostatitis, sometimes triggered by infection, can cause ongoing urinary symptoms, pelvic pain, and sexual dysfunction. Recognising when a urinary tract infection has become prostate-related is vital for effective management.
Prevention
While not all UTIs can be prevented, steps that may help reduce risk include:
- Ensuring good hydration
- Emptying the bladder fully when urinating
- Managing underlying conditions such as diabetes or prostate enlargement
- Seeking medical advice early if symptoms recur
The Takeaway
A urinary tract infection in a man is rarely “just a simple infection.” It often points to an underlying factor that requires professional evaluation. With the right diagnosis and management, infections can be treated effectively and recurrence prevented.
If you are experiencing symptoms of a UTI, or if you have had multiple infections, I encourage you to see a Urologist. Identifying the cause early can make all the difference in safeguarding your urinary and sexual health.
