Prostatitis is a condition that involves inflammation of the prostate gland. The prostate is a small gland located below the bladder in men that produces fluid that nourishes and protects sperm. There are four main signs and symptoms that can indicate prostatitis: pain or discomfort in the genital or pelvic area, difficulty urinating, fever, and chills. Recognizing these key symptoms can help get a proper diagnosis and treatment plan.
What is Prostatitis?
Prostatitis refers to inflammation of the prostate gland. The prostate is a walnut-sized gland located below the bladder in men that produces fluid that nourishes and protects sperm. This important gland can become inflamed, swollen, and irritated, leading to a range of urinary and genital symptoms. There are four types of prostatitis:
- Acute bacterial prostatitis – Caused by a bacterial infection and comes on suddenly. It is the least common type but considered the easiest to diagnose and treat.
- Chronic bacterial prostatitis – Also caused by bacteria but develops more gradually and can come and go. It is harder to treat because bacteria can be difficult to eradicate.
- Chronic prostatitis/chronic pelvic pain syndrome – Not caused by bacteria but still involves inflammation and pain that can go on for at least three months. The exact cause is unknown.
- Asymptomatic inflammatory prostatitis – Does not cause any symptoms but is detected when testing for other conditions.
While the causes vary, the signs and symptoms tend to be similar across the types of prostatitis. Being able to recognize these symptoms is key to getting an accurate diagnosis and appropriate treatment.
Symptom #1: Pain or Discomfort in the Genital or Pelvic Area
One of the hallmark signs of prostatitis is pain or discomfort in the genital and pelvic region. This can include:
- Pain in the area between the genitals and rectum (perineum)
- Pain or burning during urination
- Pain during or after ejaculation
- Pain or discomfort of the testicles or scrotum
- Low back pain
- Abdominal pain
- Rectal pain
The pain may be mild and come and go, or it can be severe. It may be felt in different areas depending on the type and cause of prostatitis. This pelvic pain and discomfort is often the symptom that drives men with prostatitis to seek medical attention.
Why Pain Occurs
The pain and discomfort associated with prostatitis has several possible causes:
- The inflamed prostate gland can put pressure on surrounding tissues like the bladder, urethra, and rectum, causing pain.
- Spasms of the pelvic floor muscles can occur as the body tries to deal with inflammation.
- Nerve irritation or damage related to inflammation may make the pelvic area more sensitive.
- Voiding urine or ejaculating semen over an inflamed prostate can cause painful irritation.
Determining the location and characteristics of the pain and discomfort can help identify the type of prostatitis and appropriate treatments.
Symptom #2: Difficulty Urinating
Since the prostate gland surrounds a portion of the urethra, inflammation and swelling of this gland commonly leads to urinary symptoms. Difficulty urinating is a key sign of prostatitis. This can involve:
- Pain or burning during urination
- Urgent need to urinate
- Frequent urination, especially at night
- Difficulty starting or stopping urine stream
- Dribbling of urine
- Weak urine stream
- Inability to empty the bladder fully
These urinary difficulties are often early signs of prostatitis, since the inflammation impacts the urethra as it passes through the prostate gland. Determining the specific urinary symptoms can help identify causes and ensure proper treatment.
Why Urinary Problems Occur
Urinary symptoms occur with prostatitis for several reasons:
- Swelling puts pressure on the urethra, narrowing the passageway.
- Smooth muscle spasms may impact the urinary sphincter.
- Nerve irritation can make urination difficult and painful.
- Bacteria may directly infect the urethra.
- Scar tissue from chronic inflammation may block urine flow.
Relieving urinary difficulties is a major goal when treating prostatitis. Keeping track of specific urinary symptoms helps determine how well treatment is working.
Symptom #3: Fever and Chills
A fever with chills or body aches can signal an infection as the cause of prostatitis. A fever generally means:
- Temperature higher than 100.4°F (38°C)
- Feeling hot to the touch
- Chills and body aches
While chronic prostatitis is not associated with fever, having a fever with acute prostatitis is common. This is due to the bacterial infection triggering an inflammatory immune response. Body aches and chills may accompany the elevated temperature.
Why Fever Occurs
Fever and chills with prostatitis occur for the following reasons:
- Bacterial infection triggers the release of inflammation-causing cytokines.
- The hypothalamus raises body temperature to help fight infection.
- Infection and inflammation prompt an aggressive immune response.
- Tissue damage and irritation associated with inflammation lead to fever.
A fever requires prompt medical treatment not only for comfort but also to control infection. Bringing down a fever is a key part of treating acute bacterial prostatitis.
Symptom #4: Erectile Dysfunction
Some men with prostatitis also experience erectile dysfunction. This involves:
- Difficulty getting an erection
- Trouble maintaining an erection
- Reduced sexual desire
- Pain with ejaculation or reduced ejaculate
All types of prostatitis can impact sexual function, though this is more common with chronic prostatitis. Even after inflammation resolves, scarring may impair erectile abilities.
Why Erectile Dysfunction Occurs
Prostatitis can contribute to erectile dysfunction for these reasons:
- Nerve damage from inflammation disrupts signals for erections.
- Scar tissue compresses small blood vessels needed for erections.
- Pain and psychological distress affect libido.
- Altered prostate secretions change the composition of semen.
Seeking treatment for erectile difficulties is important, as sexual dysfunction further reduces quality of life for men with prostatitis.
Other Possible Symptoms
In addition to these four hallmark symptoms, other issues may arise with prostatitis:
- Blood in urine or semen
- Groin lymph node swelling
- Rectal pressure or fullness
- Constipation or pain with bowel movements
- Depression or anxiety
These non-specific symptoms demonstrate how inflammation of the nearby prostate gland can impact multiple body systems. Report any unusual symptoms to your doctor when diagnosing the cause.
If you suspect you have prostatitis based on these signs and symptoms, see your doctor for an accurate diagnosis. This will involve:
- Medical history – Description of symptoms and health background.
- Physical exam – Assess fever, abdominal, and genital pain.
- Urinalysis – Check for signs of infection.
- Urine culture – Identify bacteria causing infection.
- Prostate fluid culture – Test secretions for bacteria.
- Blood tests – Check for elevated white blood cells as sign of infection.
Additional tests like imaging or a cystoscopy may be needed in some cases. Diagnosing the specific type of prostatitis ensures appropriate antibiotic treatment for bacterial prostatitis or other approaches for inflammatory types.
Treatment will depend on the diagnosed cause but may involve:
- Antibiotics – Oral or intravenous medications to fight bacterial infection.
- Alpha blockers – Help relax muscle tension in the prostate and bladder.
- Anti-inflammatories – Reduce swelling and pain.
- 5-alpha reductase inhibitors – Slow prostate growth.
- Lifestyle changes – More fluids, bowel regulation, pelvic floor physical therapy.
- Surgery – Rarely needed for prostate drainage or removal.
Acute bacterial prostatitis requires aggressive antibiotic treatment, while chronic prostatitis may rely more on medications to manage pain and inflammation alongside lifestyle adjustments.
While some causes of prostatitis cannot be prevented, these strategies may reduce your risk:
- Practice safe sex and urinate after intercourse.
- Improve bowel regularity to avoid constipation and straining.
- Limit decongestants, antihistamines, and spicy foods that may irritate the prostate.
- Reduce stress levels and sedentary behavior.
- Stay hydrated to keep urine diluted.
- Take prostate-supporting nutrients like zinc, quercetin, and fish oil.
Seeing your doctor regularly and managing other prostate conditions like benign prostatic hyperplasia may also lower chances of developing prostatitis.
When to See a Doctor
Contact your doctor promptly if you notice any of the four key symptoms of prostatitis:
- Pelvic pain or genital discomfort
- Changes in urinary patterns or difficulty urinating
- Fever and chills
- Erectile dysfunction
You should also seek medical care for symptoms that persist after finishing antibiotic treatment for a prior bout of prostatitis. Catching prostatitis early and getting proper treatment can help resolve symptoms and prevent complications.
Prostatitis is a common condition marked by inflammation of the prostate gland that can significantly impact urinary function, sexual health, and overall well-being. The four hallmark signs of prostatitis include pelvic pain, urinary problems, fever, and erectile dysfunction. While causes vary, antibiotics, anti-inflammatories, muscle relaxants, and lifestyle changes make up the common treatment approaches. Seeking prompt medical care when these symptoms arise can help diagnose the specific type of prostatitis and initiate appropriate treatment to resolve discomfort and prevent permanent prostate or urinary tract damage. Being aware of the four signs and symptoms is key to getting proper treatment for prostatitis.