Prostatitis (Prostate Inflammation): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate prostatitis (inflammation of the prostate):

  • Pain or discomfort with punctum maximum in the perineal area.
    • Radiation in the direction of the testicles or penis
    • Occasionally also pain continuation in the area of the urinary bladder, rectum and back
  • Pain during urination (alguria) (40%).
  • Pain associated with ejaculation (ejaculatory pain; 45%).
  • Micturition difficulties (bladder emptying disorders; 50-60%).
  • Impairment of sexual function (40-70%).

A component of the prostatitis syndrome, in addition to acute bacterial prostatitis, is chronic prostatitis (CP) or chronic pelvic pain syndrome (“CPPS”) (see classification below).

Acute bacterial prostatitis (ABP) [10% of all prostatitis cases].

  • Acute-onset, severe symptoms such as:
    • Dysuria – painful urination with difficulty urinating.
    • Pollakisuria – urge to urinate frequently without increased urination Urge symptomatology.
    • Urge symptomatology (symptomatology associated with a strong urge to urinate, frequent urination).
    • Strangury – unsuppressible urge to urinate with pain, which leads only to emptying a few droplets of urine.
  • Fever [note: exclude sepsis/blood poisoning].
  • Chills
  • Severe feeling of illness
  • Tense and extremely painful prostate
  • Ischuria (urinary retention) (10% of patients).
  • Pain during defecation (bowel evacuation) and/or ejaculation.

Chronic bacterial prostatitis (CBP)

There is often freedom from symptoms between episodes of chronic bacterial prostatitis. Palpation (palpation) findings of the prostate are unremarkable. Infection of the bladder may occur (recurrent urinary tract infections are typical), which may be responsible for some of the symptoms such as:

  • Bladder emptying disorders
  • Pollakisuria – urge to urinate frequently without increased urination
  • Dysuria – painful emptying of the bladder.
  • Pain during defecation (bowel emptying)
  • Sexual dysfunction
    • Libido disorders
    • Erectile dysfunction (ED)
  • Abnormal sensations in the genital and anorectal area.
  • Pain in the perineal area, possibly radiating to the testicles and inguinal region

Chronic pelvic pain syndrome ( CPPS)

  • Chronic pain or discomfort in the pelvic region for at least 3 months during the previous 6 months.
  • Frequent concomitant symptoms such as micturition difficulties (bladder voiding dysfunction), sexual dysfunction, and psychosocial impairment.