All forms are more or less painful; there may be other symptoms and complications:
- Acute form: A strongly painful urge to urinate and difficult urination, pain in the perineal area and during defecation are typical. At the beginning, blood is often found in the urine. Those affected usually have a high fever with chills and feel really sick. As a complication, the infection can spread and there may be inflammation of the urinary bladder, epididymis, renal pelvis, abscesses and even life-threatening septic shock (colloquially blood poisoning).
- Chronic form: One speaks of a chronic prostatitis – regardless of whether germs are the trigger or not – if the complaints last longer than three months. Here, too, discomfort during urination and pulling, stabbing or even dull pain in the area of the urinary bladder, anus, perineum or pelvis occur, which can radiate into the back. However, the symptoms are usually less severe than in the acute clinical picture. Some patients also complain of erectile dysfunction and muscle or joint pain.
Prostatitis: How is the diagnosis made?
Often, the doctor will already make the tentative diagnosis based on the symptoms described. On palpation of the rectum, the prostate often feels enlarged and is very painful – especially in the acute infection.
The range of diagnostic possibilities includes urine examination (before and after a prostate massage), urethral smear, search for signs of inflammation and germs in the blood, ultrasound examination (e.g. also to exclude an abscess) and X-ray examination using contrast medium (urography). In chronic pelvic pain syndrome, functional measurements of the urinary bladder and its sphincters are also performed (urodynamics).
