Almost everything written about urinary infections assumes the reader is a woman. For men the rules change — starting with the fact that UTIs in men are never treated as a simple, straightforward infection.
This article covers why UTIs in men are less common but more significant, why the standard women’s pathway doesn’t apply, the symptoms and red flags worth knowing, and what actually happens next if you’re a man with these symptoms.
In this article
- Why UTIs are less common in men
- Anatomy, and why that protects against infection
- Why that makes a male UTI more significant
- Why male UTIs are classed as complicated
- What that means for treatment length
- The symptoms of UTIs in men to recognise
- Burning, frequency and urgency
- Symptoms that point higher up the tract
- The prostate question
- Prostatitis and how it differs
- Why an enlarged prostate raises the risk
- Incomplete emptying as an underlying cause
- Catheters, diabetes and other risk factors
- Why the NHS Pharmacy First UTI route doesn’t apply to men
- Where men should go instead
- Why a urine sample usually matters
- Why the treatment course is usually longer
- Red flags — fever, back or flank pain, rigors, confusion
- Sepsis signs and when to call 999
- Blood in the urine and why it always needs review
- Recurrent infection and what gets investigated
- What can reduce the risk
- What to do next
Why UTIs are less common in men
Urinary tract infections are considerably less common in men than in women, and that difference comes down to anatomy rather than anything about general health or hygiene. Even so, UTIs in men are taken seriously precisely because they are uncommon.
Anatomy, and why that protects against infection
A man’s urethra is longer than a woman’s and sits further from the bacteria naturally present around the back passage, which makes it harder for bacteria to travel up into the bladder in the first place. This anatomical distance is the main reason male UTIs are relatively rare, and it’s a key part of why UTIs in men are relatively uncommon in the first place.
Why that makes a male UTI more significant
Precisely because the natural protection is stronger, a UTI that does develop in a man is taken more seriously — it’s less likely to be an isolated, unlucky infection and more likely to mean something is helping bacteria get past that protection. It’s part of why UTIs in men are treated as more significant than a typical bladder infection in a woman.
Why male UTIs are classed as complicated
Clinically, every UTI in a man is classed as “complicated” — not because it’s automatically severe, but because male anatomy means an underlying cause always needs to be considered, rather than assumed to be a one-off. This is a formal classification that shapes the entire approach to treatment, and it’s central to how UTIs in men are managed from the outset.
What that means for treatment length
Because male UTIs are classed as complicated, the antibiotic course used is longer than the short course typically given for a straightforward infection in a woman — often around double the length. Your GP or prescriber will confirm exactly what’s appropriate. Longer courses are simply part of how UTIs in men are usually treated.
The symptoms of UTIs in men to recognise
The core symptoms of a UTI in men overlap with those in women: pain or burning when urinating, needing to go more often than usual, and a sense of urgency that doesn’t match how much is actually passed.
Burning, frequency and urgency
Burning or stinging while urinating, going more frequently including overnight, and a persistent urge to go even straight after urinating are the symptoms most people recognise first, and the ones worth mentioning clearly when you’re assessed. These are among the most recognisable early symptoms of UTIs in men.
Symptoms that point higher up the tract
Pain in the back or side, a fever, chills or generally feeling unwell alongside urinary symptoms can mean the infection has spread up towards the kidneys, which is more serious than a bladder-level infection and needs prompt attention. Such symptoms are a reason UTIs in men are never left unassessed.
The prostate question
In men, urinary symptoms don’t always mean the bladder is the problem — the prostate sits right next to the urinary tract and can cause a very similar pattern of symptoms. This overlap is one of the complicating factors specific to UTIs in men.
Prostatitis and how it differs
Prostatitis — inflammation or infection of the prostate — can cause pelvic pain and discomfort on top of the usual urinary symptoms, and it’s assessed and treated differently from a straightforward bladder infection. Distinguishing prostatitis from a bladder infection matters because UTIs in men are assessed with this overlap in mind.
Why an enlarged prostate raises the risk
An enlarged prostate is common as men get older and can press on the urethra, making it harder to fully empty the bladder. Urine left sitting in the bladder gives bacteria more opportunity to multiply, which raises the risk of infection. An enlarged prostate is one of the recognised risk factors behind UTIs in men.
Incomplete emptying as an underlying cause
Whatever the reason behind it — prostate-related or otherwise — not fully emptying the bladder is one of the most common underlying causes doctors look for once a man has had a confirmed UTI, because fixing that reduces the chance of it happening again. Incomplete emptying is one of the most common underlying causes doctors look for with UTIs in men.
Catheters, diabetes and other risk factors
A urinary catheter bypasses the body’s normal defences and is a well-recognised risk factor for infection. Diabetes, kidney stones and other structural issues in the urinary tract can also raise the risk, which is part of why a first male UTI is worth investigating rather than simply treating and moving on. These are recognised risk factors clinicians consider when assessing UTIs in men.
Why the NHS Pharmacy First UTI route doesn’t apply to men
The NHS Pharmacy First UTI service, which lets a pharmacist assess and treat a suspected infection without a GP appointment, is only available for women aged 16 to 64 with straightforward symptoms. Men with urinary symptoms are asked to see a GP instead, because of the higher chance of an underlying cause needing proper assessment. This is the clearest practical difference in how UTIs in men are handled compared with the women’s pathway.
Where men should go instead
A GP is the right first step for a man with UTI symptoms, and NHS 111 is there if you need same-day advice or the surgery is closed. This is also why NewGen’s online cystitis consultation, which is designed for straightforward infections in women, isn’t the right route for a new male UTI. A GP assessment is the appropriate starting point for UTIs in men.
Why a urine sample usually matters
A urine sample doesn’t just confirm there’s an infection — it identifies which bacteria are involved, which matters more in men because the higher likelihood of an underlying cause means getting the right treatment first time counts for more. Identifying the right bacteria first time matters more for UTIs in men given the higher chance of an underlying cause.
Why the treatment course is usually longer
Once confirmed, treatment for a male UTI usually runs longer than the short course used for a straightforward infection in a woman, reflecting the complicated classification rather than any single symptom being more severe. A longer course reflects how UTIs in men are classified rather than any single symptom being worse.
Red flags — fever, back or flank pain, rigors, confusion
A fever, pain in the back or side, uncontrollable shivering (rigors), or confusion alongside urinary symptoms are signs the infection may have reached the kidneys or spread further, and need urgent medical attention rather than a routine appointment. These red flags need urgent attention whenever they appear alongside UTIs in men.
Sepsis signs and when to call 999
Call 999 or go to A&E if you or someone else has urinary symptoms along with breathing very fast, confusion, slurred speech or not making sense, skin that looks blue, pale or blotchy, or a very high or very low temperature with shivering. These are sepsis red flags as set out by the NHS and the UK Sepsis Trust, and they always need emergency care, not an online consultation.
Blood in the urine and why it always needs review
Visible blood in the urine should always be checked by a GP, even if it seems to clear up once a suspected infection is treated. From age 45, NICE guidance means this routinely triggers an urgent specialist referral to rule out other causes, and younger men should still have it followed up rather than assumed to be “just the infection.” Any blood in the urine needs review regardless, and this is no different for UTIs in men.
Recurrent infection and what gets investigated
A UTI that comes back after treatment, or more than one episode in a relatively short space of time, is a reason for further investigation into what’s causing it — the prostate, incomplete emptying, or a structural issue — rather than simply repeating the same antibiotic course each time. Recurrent UTIs in men are always a reason for further investigation rather than repeat treatment alone.
What can reduce the risk
Staying well hydrated, not delaying urination when you need to go, and keeping any known condition like diabetes well managed can all help reduce risk. If a prostate or bladder-emptying issue has already been identified, addressing that with a GP is more effective than any of these on its own. These measures can help reduce the risk, though they don’t remove the need for proper assessment of UTIs in men.
What to do next
NewGen’s online cystitis service is built for straightforward urinary infections in women and doesn’t cover male UTI symptoms, so if you’re a man with these symptoms, a GP is the right first step, or NHS 111 if you need same-day advice. Knowing the right next step is the most useful thing to take away about UTIs in men. Our guide to what a pharmacist can and can’t treat and NHS services pages cover what NewGen’s Pharmacy First service does offer in person.
If your symptoms turn out to be related to a sexually transmitted infection rather than a straightforward UTI, our STI testing page is the place to start, and if a clinic has already assessed and recommended treatment for non-specific urethritis, you can start your consultation for that here. Our full treatments list and how it works page cover everything else NewGen can help with.
Frequently Asked Questions
Can men get cystitis?
Yes, though it’s much less common than in women, mainly because of anatomical differences.
Why is it treated differently?
Every UTI in a man is classed as complicated, because male anatomy means an underlying cause always needs to be considered rather than assumed to be a one-off.
Can I use the Pharmacy First UTI service?
No — NHS Pharmacy First for UTIs is only available to women aged 16 to 64. Men are asked to see a GP.
Do I need a urine test?
Usually yes. It confirms the infection and identifies which bacteria are involved, which matters more given the higher chance of an underlying cause in men.
Is it an STI?
Not usually, but some sexually transmitted infections can cause similar symptoms, which is one reason a proper assessment matters rather than assuming it’s a standard UTI.
Could it be my prostate?
Possibly — prostatitis and an enlarged prostate can both cause symptoms that feel very similar to a bladder infection.
How long is treatment?
Usually longer than the short course given for a straightforward infection in a woman, reflecting the complicated classification. Your GP or prescriber will confirm the exact length.
Is blood in urine an emergency?
Not always an emergency, but it should always be reviewed by a GP, even if it seems to settle once an infection is treated.
When should I call 999?
If urinary symptoms come with very fast breathing, confusion, mottled or very pale skin, extreme shivering, or passing little or no urine — these are sepsis red flags.
Why does it keep coming back?
Recurrent infection in men is a reason for further investigation into an underlying cause, such as the prostate or incomplete bladder emptying, rather than repeating the same treatment each time.
Can it affect fertility?
A single treated UTI is unlikely to affect fertility, but recurrent infections, particularly involving the prostate, can sometimes be relevant and are worth raising with a GP if it’s a repeated pattern.
Does drinking more water help?
Staying well hydrated is a sensible general measure, though it isn’t a substitute for investigating the cause if infections keep recurring.
Compliance note
This article is general health information about urinary tract infections in men, based on NICE and NHS guidance and on the services listed on the NewGen Pharmacy website at the time of writing. Service details, availability and eligibility may change. It is not a diagnosis and not a promise that any treatment will be supplied. NewGen’s online cystitis service is designed for straightforward infections in women; it does not treat male UTI symptoms, which need in-person GP assessment. NHS Pharmacy First for UTIs is available only to women aged 16 to 64.
Treatment depends on clinician assessment, patient suitability, and whether it is safe, lawful and clinically appropriate, and the final prescribing decision always rests with the clinician. Seek urgent medical attention for fever, back or flank pain, confusion, or any sepsis red flags, and always have visible blood in the urine reviewed by a GP. Suspected side effects from any medicine can be reported to the MHRA through the Yellow Card scheme.
Author & Content Writer: Dr. Naeem Aslam