BPH and UTIs in Men

4 min read

sitting on a park bench

When we talk about UTIs, they usually revolve around women’s health because they are much more common in women than men. However, it’s still possible to get a UTI if you’re a man. Men are just as affected by urinary tract infections, especially in relation to an enlarged prostate, or BPH (benign prostatic hyperplasia). As men age, it’s natural for the prostate to become bigger, but at some point it can lead to a condition called BPH. By age 60, 50% of men show some signs of BPH. By age 85, 90% of men will show signs for BPH. This common condition can lead to UTIs in older men, which is why we’re informing you on the causes, symptoms, and treatment options. 

What is the function of the prostate?

The prostate is a gland surrounding the neck of the bladder in males. It is responsible for releasing prostatic fluid that helps make up semen. A normal prostate is the size of a walnut, however, it can increase in size due to BPH, inflammation of the prostate (prostatitis), or bacterial infection & inflammation (bacterial prostatitis)

What is the difference between BPH, prostatitis and bacterial prostatitis

  • Benign prostate hyperplasia (BPH) is a noncancerous condition, it poses no life-threatening risks and won’t spread to other parts of the body. Although the amount of cells in the prostate increases, they are normal cells. 
  • Prostatitis means inflammation of the prostate tissue. Causes of the inflammation can be from infection or other health problems. Bacterial prostatitis occurs when there is a bacterial infection in the prostate. 
  • BPH can be treated but not cured, but prostatitis is curable. The large majority of men with prostatitis have an infection of the prostate gland, while those with BPH do not have an infection (BPH can cause urinary tract infections, but more on that later).

How do I know if I have BPH (enlarged prostate)?

The main BPH symptoms are: 

  • You find it difficult to start urination 
  • Interruptions in urine flow, or weak force of stream 
  • Dribbling after urination 
  • Feeling like you need to urinate even though your bladder is not full. 
  • Waking up repeatedly to urinate
  • Unable to empty the bladder completely

How are UTIs and enlarged prostates related?

One symptom of BPH is the inability to empty the bladder completely. That’s because an enlarged prostate constricts the urethra— making it difficult for urine to pass from the bladder through the urethra. 

 Side view of prostate and bladder: 

Courtesy of https://www.nhs.uk/conditions/prostate-enlargement/


  • When the urethra is constricted, urine (the blue arrow above) cannot escape and it remains in the bladder. 
  • With incomplete emptying, urine pools, and bacteria can grow in the urine
  • This can lead to UTIs in men with BPH 

Urinary tract infections in men with BPH can lead to further complications. Below we’ll discuss why this happens. 

Recurrent UTIs and bacterial prostatitis in men with BPH: 

Once you get a UTI, you are more likely to get another. The bacteria in your bladder from UTIs form biofilm, a mucus-like shield bacteria use to attach to your bladder walls and protect themselves from your immune responses and antibiotics. They remain in your bladder untouched and cause recurrent UTIs. 

Biofilm from UTIs leads to higher levels of antibiotic resistance, making it difficult to eliminate bacteria. This bacteria can travel to the prostate gland via the ejaculatory ducts and cause bacterial prostatitis. In order to prevent bacterial prostatitis and UTIs in men with BPH, the role of biofilm needs to be considered. 

In 2014, researchers from the Barcelona Centre for International Health Research examined the role of bacterial biofilms in recurrent UTIs and acute prostatitis. They state that bacterial prostatitis is a common infection in men and presents itself as a UTI with a fever. 

  • They found that “acute bacterial prostatitis is most commonly caused by an ascendant UTI, with E. coli [6],Proteus mirabilis, Pseudomonas aeruginosa, Klebsiella, Enterococcus spp., and Serratia spp.” as the pathogenic bacteria most frequently involved.
  • Biofilm formation "may even result in the increased ability of bacterial strains causing acute prostatitis to persist in the prostatic secretory system and lead to recurrent UTIs characteristic of chronic bacterial prostatitis [62].” This means biofilm enables the spread of bacterial infection to the prostate. 
  • The study states that acute prostatitis cultures were still positive 3 months after the end of a 6-week therapeutic regimen in one-third of men. “Biofilm formation may be the reason why bacterial prostatitis is so difficult to eradicate using conventional treatments.”

Treatment and solutions for biofilm-related infections requires further study, due to the high levels of antibiotic resistance demonstrated by biofilm structures.

UTI and catheters in men 

Besides biofilm, inserting a catheter is another source of incoming bacteria. Men with BPH may need to use catheters to fully clear their bladder, which dramatically increases UTI risk as this can introduce bacteria to the bladder. 70-80% of UTIs acquired in health facilities are due to indwelling urethral catheters. That’s because germs such as E.coli are introduced to the urethra when the catheter is inserted or while it remains in the bladder. Bacteria can travel up the catheter and adhere to the urethra or bladder walls and multiply. 

Click here for further steps on preventing UTIs from catheters in men

Antibiotic resistance, catheters, and biofilm make UTIs from an enlarged prostate seem like a never-ending uphill battle. In addition to following the steps necessary for preventing UTIs in men, you might need additional help to break the UTI cycle. 

BPH is a natural and common part of the aging process, but that doesn’t mean you have to endure painful urinary tract infections as a result. Our daily UTI-prevention capsule Control, breaks up biofilm and fights bacteria already living in the urinary tract from past UTIs. The ingredients in our drink mix Target adhere to bacteria and increases urinary flow, so you can flush out potential UTI-causing pathogens. 

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