The essentials

A urinary tract infection (UTI) in men is less common than in women, but about 1 man in 7 has one in his lifetime, mostly after 50. Burning, urgency and frequent urination are the usual signs; fever or chills suggest the prostate or kidneys are involved. A urine culture is the key test, and treatment usually lasts longer than for women.

What is a UTI in men, at a glance?

  • What it is: bacteria growing in the bladder (cystitis), the prostate (acute bacterial prostatitis) or the kidneys (pyelonephritis). Our general guide to urinary tract infections covers both sexes; this page covers what is different in men.
  • How common: UTIs are uncommon in men before age 50, yet the lifetime risk is about 14%, against 53% in women[1].
  • Usual germ: Escherichia coli, but other bacteria cause up to half of male infections[4].
  • Key tests: urinalysis, urine culture with susceptibility testing, and sometimes blood tests, a prostate exam or imaging[3][10].

What are the symptoms of a UTI in men?

The bladder symptoms are the same as in women[4][3]:

  • Pain or burning when you urinate.
  • A frequent, urgent need to go, often passing only a little urine.
  • Pressure or cramping low in the belly or back.
  • Cloudy urine, or pink or red urine (blood in the urine).

Signs that the infection has spread further[3]:

  • Prostate: fever, chills or aches[13]. A fever with a UTI in a man very often means the prostate is involved, even when it is not tender[8]. See our page on prostatitis.
  • Kidneys: fever above 101°F (38.3°C), shaking chills, pain in the side, back or groin, nausea or vomiting[3].
  • Older men: confusion or a sudden change in behavior may be the only sign[3].

Is it a UTI or an STI?

Burning when urinating is not always a bladder infection. In sexually active men, it can come from urethritis, an inflammation of the tube that carries urine, often caused by chlamydia or gonorrhea[11]. Clues are a discharge from the penis and itching inside the urethra[11]. The test is different too: a nucleic acid test (NAAT) on a first-void urine sample, the first part of the stream[11], while a UTI is checked on a midstream sample. Both can be done on the same visit; our guide to STI testing explains the results.

When should a man see a doctor for UTI symptoms?

When to see a doctor

  • Emergency: call 911 or go to the emergency room if you cannot pass urine at all, have a high fever with shaking chills, severe pain in the back or side, vomiting that stops you keeping fluids down, or new confusion[3][13]. These can be signs of a kidney infection or sepsis.
  • Within 24 to 48 hours for burning, urgency or frequent urination, even without fever, so a urine sample can be taken before any antibiotic[3][13]. Also if you have a discharge from the penis.
  • At your next appointment if symptoms come back after treatment, if you have had more than one UTI, or if you have trouble emptying your bladder[3][4].

What causes a UTI in men?

A man's longer urethra is a natural barrier, so most men with a UTI have something that lets bacteria stay in the urinary tract[4]. From most to least frequent:

  • Common An enlarged prostate (BPH) that blocks the flow and leaves urine in the bladder[3][4].
  • Common A urinary catheter or a recent procedure on the bladder or prostate[4].
  • Possible Diabetes, older age, or a bladder that does not empty fully[3].
  • Possible Kidney stones[3].
  • Rare A narrowed urethra (stricture) or another blockage[3].

How is a UTI in men diagnosed? Reading the urine tests

The doctor asks about your symptoms and may examine your belly and, often, your prostate through a gloved finger in the rectum, to look for a tender or swollen gland[10]. The urine sample is a clean-catch midstream sample, taken before antibiotics[3].

A fictitious report for a 64-year-old man with burning and urgency:

Fictitious example of a urinalysis and urine culture report (United States format)
TestResultReference rangeFlag
Nitrite (dipstick)PositiveNegativeA
Leukocyte esterase (dipstick)2+NegativeA
WBC, urine (microscopy)25-50 /HPF0-5 /HPFH
Urine culture>100,000 CFU/mL Escherichia coliNo significant growthA
  1. Nitrite positive: in men with symptoms, a positive nitrite was right 96% of the time when checked against the culture[6]. A negative nitrite does not rule infection out. See nitrite in urine.
  2. Leukocyte esterase 2+ and white cells: signs of inflammation (pyuria). In men, adding the leukocyte esterase test did not improve accuracy over nitrite alone[6].
  3. Culture: names the germ and counts colony-forming units (CFU). In men, as few as 1,000 CFU/mL of one main germ in a midstream sample already points to a real infection[5], a lower cut-off than the 100,000 often quoted.
  4. Not shown: the susceptibility list (S, I, R) that tells which antibiotics work; it guides the final choice of treatment[1]. Read our guide to urine culture results.

A urinalysis, a culture and sometimes blood tests, each with its own flags and units? BloodSense explains every line of your full report in plain words, so you know what to ask at your next visit.

Explain my urine test results

With fever or feeling very unwell, blood tests are added: a complete blood count, sometimes a blood culture[3], and often CRP and creatinine to check inflammation and kidney function. An ultrasound or CT scan looks for a blockage or a stone when the infection is severe, does not improve or keeps coming back[3][10].

Does a UTI raise PSA?

Often, yes. In 70 men with a feverish UTI, PSA was high in 83% (median 14 ng/mL), although only 6 had a tender prostate[8]. PSA can stay raised for up to 6 months, and the ratio between the PSA forms can look like the pattern seen in cancer[9].

In practice, a PSA drawn during or just after a UTI is hard to read. Doctors usually wait several weeks after treatment and repeat it before deciding on further tests. Our page on reading PSA results explains the other causes of a high value.

Is a UTI in men always "complicated"?

For years, every UTI in a man was labeled complicated. Newer guidelines changed that. In 2025, the Infectious Diseases Society of America (IDSA) based its classification on symptoms, especially fever and signs that the infection has spread beyond the bladder[1]. The 2026 European urology guideline no longer counts male sex as a risk factor on its own and drops the words "complicated" and "uncomplicated"[10]. What matters is whether you have fever, how unwell you feel, and whether something blocks the urine.

How is a UTI in men treated, and for how long?

Treatment is an antibiotic chosen by your doctor, ideally matched to the culture result[1]. No doses are given here. What differs from women is the length:

  • Bladder infection without fever: men usually take antibiotics for 7 to 14 days, against 1 to 5 days for women[3]. In a trial of 272 men without fever (median age 69), 7 days worked as well as 14: symptoms cleared in 93.1% versus 90.2%[7].
  • Infection with fever: IDSA suggests about 7 days for most people who improve on an effective drug, but 10 to 14 days may help men with fever when the prostate is thought to be infected[2]. European guidance also prefers 14 days over 7 for men with a feverish UTI[10].
  • Repeated infections from the prostate may need much longer courses, decided by a specialist[4].

Finish the course as prescribed and drink enough fluids[3]. Call back if you are not better after 2 to 3 days of treatment[13].

What follow-up is needed after a UTI in men?

  • Feeling well after treatment: no repeat urine test is needed. Bacteria found in the urine of an older man without symptoms are usually left untreated[12].
  • Symptoms come back: a new culture before any new antibiotic[3].
  • Repeated or feverish infections: a urology check to look for a cause, such as a large prostate, a stone or a bladder that does not empty[4][10]. Our page on the prostate exam describes what it involves.
  • PSA: recheck only after the infection has settled, usually weeks later[9].

Can men prevent UTIs?

  • Treat what blocks the flow: discuss a weak stream or lower urinary tract symptoms with your doctor, since an enlarged prostate is the main risk[4].
  • If you use a catheter, ask your care team how to lower the infection risk: catheters are one of the main causes in men[4].
  • Do not take leftover antibiotics: a culture first gives the right drug[1].

Questions to ask your doctor

  1. Was a urine culture sent before I started the antibiotic, and when will I get the result?
  2. Could my prostate be involved, and does that change how long I take treatment?
  3. Should I also be tested for chlamydia or gonorrhea?
  4. Do I need an ultrasound or a urology visit after this infection?
  5. When is it sensible to recheck my PSA?

Frequently asked questions

My urine shows bacteria but I have no symptoms. Do I need antibiotics?

Usually not. Bacteria in the urine without symptoms are common in older men and generally are not treated; treating them adds side effects and resistance without benefit. The main exception is before certain urology procedures[12].

Why did my doctor examine my prostate for a urine infection?

A rectal exam can show a tender, swollen prostate, which suggests acute prostatitis and a longer treatment[10]. It takes a few seconds; a normal exam does not rule out prostate involvement[8].

I am a young man with a first UTI. Is something wrong?

UTIs are uncommon in men under 50[1], so your doctor will check for an STI and for a cause. Further tests such as imaging are mainly needed if the infection was feverish or comes back[4].

How often does a UTI come back in men?

In the trial comparing 7 and 14 days, symptoms returned within 4 weeks in about 1 man in 10 in both groups[7]. A return calls for a new culture rather than the same antibiotic again[3].

  1. Infectious Diseases Society of America. 2025 Clinical Practice Guideline on Management and Treatment of Complicated Urinary Tract Infections. idsociety.org (accessed November 14, 2026)
  2. Trautner BW, Cortés-Penfield NW, Gupta K, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA): 2025 guidelines on management and treatment of complicated urinary tract infections: duration of antibiotics for complicated UTI. Clin Infect Dis. 2026;82(Suppl 3):i79-i88. doi:10.1093/cid/ciaf462 (accessed November 14, 2026)
  3. MedlinePlus Medical Encyclopedia. Urinary tract infection - adults. Reviewed July 22, 2026. US National Library of Medicine. medlineplus.gov (accessed November 14, 2026)
  4. Lipsky BA. Urinary tract infections in men: epidemiology, pathophysiology, diagnosis, and treatment. Ann Intern Med. 1989;110(2):138-150. doi:10.7326/0003-4819-110-2-138 (accessed November 14, 2026)
  5. Lipsky BA, Ireton RC, Fihn SD, Hackett R, Berger RE. Diagnosis of bacteriuria in men: specimen collection and culture interpretation. J Infect Dis. 1987;155(5):847-854. doi:10.1093/infdis/155.5.847 (accessed November 14, 2026)
  6. Koeijers JJ, Kessels AGH, Nys S, et al. Evaluation of the nitrite and leukocyte esterase activity tests for the diagnosis of acute symptomatic urinary tract infection in men. Clin Infect Dis. 2007;45(7):894-896. doi:10.1086/521254 (accessed November 14, 2026)
  7. Drekonja DM, Trautner B, Amundson C, Kuskowski M, Johnson JR. Effect of 7 vs 14 days of antibiotic therapy on resolution of symptoms among afebrile men with urinary tract infection: a randomized clinical trial. JAMA. 2021;326(4):324-331. doi:10.1001/jama.2021.9899 (accessed November 14, 2026)
  8. Ulleryd P, Zackrisson B, Aus G, Bergdahl S, Hugosson J, Sandberg T. Prostatic involvement in men with febrile urinary tract infection as measured by serum prostate-specific antigen and transrectal ultrasonography. BJU Int. 1999;84(4):470-474. doi:10.1046/j.1464-410x.1999.00164.x (accessed November 14, 2026)
  9. Zackrisson B, Ulleryd P, Aus G, Lilja H, Sandberg T, Hugosson J. Evolution of serum prostate-specific antigen (complexed, total and unbound forms) and their ratios during 1 year of follow-up of men with febrile urinary tract infection. Urology. 2003;62(2):278-281. doi:10.1016/s0090-4295(03)00372-8 (accessed November 14, 2026)
  10. European Association of Urology. EAU Guidelines on Urological Infections, 2026 edition. uroweb.org (accessed November 14, 2026)
  11. Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021: urethritis and cervicitis. cdc.gov (accessed November 14, 2026)
  12. Nicolle LE, Gupta K, Bradley SF, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;68(10):e83-e110. doi:10.1093/cid/ciy1121 (accessed November 14, 2026)
  13. Santé.fr (French Ministry of Health). Infection urinaire chez l'homme. Published May 19, 2026. sante.fr (accessed November 14, 2026)

This page is general information. It does not replace the advice of a doctor, who interprets your results with your symptoms, your examination and your medical history.