Can an enlarged prostate cause a UTI?

Yes. An enlarged prostate (benign prostatic hyperplasia or BPH) can increase the risk of a urinary tract infection (UTI) because it can obstruct urine flow and prevent the bladder from emptying completely. Residual urine can provide an environment where bacteria may grow, increasing the likelihood of infection and recurrence.

How does an enlarged prostate cause a UTI?

The prostate surrounds part of the urethra. As the prostate enlarges, it can narrow the passage through which urine leaves the bladder.

This may result in:

• Weak or slow urine flow
• Difficulty starting urination
• Straining to urinate
• Feeling that the bladder has not emptied completely
• Increased urinary frequency
• Urinary retention

When urine remains in the bladder after urination, bacteria may have more opportunity to multiply, increasing the risk of UTI.

Can BPH cause recurrent UTIs?

Yes. Repeated UTIs in a man with an enlarged prostate can be a sign that incomplete bladder emptying or urinary obstruction needs to be evaluated.

Simply treating each infection may not prevent recurrence if the underlying obstruction remains.

The EAU guidelines recommend assessing and managing urinary obstruction and other underlying urological abnormalities when treating systemic UTIs.

What symptoms may suggest both BPH and UTI?

A man with BPH and a UTI may experience a combination of prostate-related and infection-related symptoms, such as:

• Weak urine stream
• Difficulty starting urination
• Frequent urination
• Urinary urgency
• Burning while urinating
• Lower abdominal discomfort
• Feeling of incomplete bladder emptying
• Blood in the urine
• Fever or chills in a more significant infection

Does every man with BPH develop a UTI?

No. An enlarged prostate does not automatically cause a UTI.

Many men with BPH never develop urinary infections. The risk becomes more relevant when prostate enlargement causes significant obstruction, urinary retention, or incomplete bladder emptying.

What tests may be needed?

Depending on the symptoms, a urologist may evaluate:

• Urine examination
• Urine culture
• Urine flow rate
• Post-void residual urine
• Prostate size and condition
• Ultrasound of the urinary tract
• Other tests when stones, obstruction or another abnormality is suspected

If UTIs repeatedly occur, identifying the underlying cause can be as important as treating the infection itself.

Can treating BPH reduce UTI risk?

If prostate obstruction is contributing to incomplete bladder emptying or recurrent infections, treating the underlying obstruction may help reduce the risk of further urinary complications.

The appropriate BPH treatment depends on prostate size, symptoms, degree of obstruction, residual urine and the patient's overall condition.

SCI International Hospital

At SCI International Hospital, Dr. Gautam Banga evaluates men who have UTIs along with symptoms of an enlarged prostate to determine whether poor bladder emptying or urinary obstruction is contributing to the infection.

Depending on the patient's condition, evaluation may include urine testing, urine culture, urinary flow assessment, post-void residual measurement and imaging. If significant prostate obstruction is identified, appropriate medical or surgical treatment for BPH may be considered to address the underlying cause.