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White urine is a surprisingly common symptom in men. You would think the underlying problem might have something to do with ejaculation, especially since white urine is something that shows up around puberty in many men. Sometimes it is. When men, especially young men, for whatever reason, don't ejaculate, semen can escape the prostate and flow our with urine, making the urine white or cloudy.

When men ejaculate on a regular basis but still have white urine, there are usually other factors at work:

  • Sometimes the "white" in a man's urine is actually lymph fluid. Doctors are most familiar with a disease called filariasis as a cause of this symptom. The condition is caused by infection with a parasitic nematode that causes lymph glands to expand so that eventually they leak from the groin into the urethra. Before there is white urine, there has also been swelling or pain in the groin or testicles and maybe an odd skin reaction that just didn't make any kind of sense, something like seeing scraped skin but not remembering the scrape. Usually by the time there is leaking into the urinary tract the parasite is already dead, so the condition is not treated. The leakage of lymphatic fluid into the urine is called chyluria, which can also be caused by a lymphatic fistula, a "hole" in the lymph canal. It may be necessary to see a urologist for a referral to a surgeon for an operation to repair the fistula.
  • White urine can also be a symptom of a severe bladder infection. The whiteness of the urine is usually caused by the bacteria themselves, but it can also be caused by an accumulation of white blood cells sent by the immune system to fight the infection. In younger men, these infections are usually transmitted sexually. In men over about 50, bladder infections seem to happen for no apparent reason at all, that is, men who don't have sex can get them. It's possible that the tip of the penis comes in contact with feces in undergarments and the infection is transmitted that way. This condition can be treated, but it is necessary to send a urine sample to the lab to be cultured to identify the microorganism causing the infection to choose the right antibiotic to treat it. Often these kinds of infections can be treated with oral antibiotics, but it is possible to get a UTI that is so severe it has to be treated in the hospital or ER with an intravenous antibiotic.

White urine can have an awful smell. It can almost smell rotten. That's because it actually is. Fragments of the lining of the urinary canal plus dead white blood cells and bacteria can release a distinctive odor that can be something like a dead body (caused by the accumulation of an amino acid called cadaverine or another amino acid called, appropriately enough, putrescine) or seminal fluid and/or pears (caused by the accumulation of an amino acid called spermidine, which is found both in semen and in blossoms of pear and linden trees). These smelly chemicals only get smellier as they break down. The longer you go without urinating, the more odiferous your urine will be. Spermidine is actually toxic in large doses, although one would have to consume (and we won't even speculate how this might happen) about 50 grams of the substance for a lethal result.

White urine is also possible in men who eat too much meat. The phosphates in the meat are more than the body can handle, and are excreted in urine. There have even been cases in which men added milk to their urine to appear to have an overflow of semen, but to do so at the doctor's office will earn a referral to a psychiatrist.

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