From the Guidelines
Prostatitis symptoms include pain or discomfort in the pelvic area, painful urination, increased urinary frequency and urgency, difficulty starting urination, weak urine flow, and sometimes pain during ejaculation, with the severity varying widely between individuals depending on the type of prostatitis. According to the guidelines for the prevention, diagnosis, and management of urinary tract infections in pediatrics and adults: a wikiguidelines group consensus statement published in JAMA network open in 2024 1, the clinical presentation of acute bacterial prostatitis (ABP) often involves febrile UTI symptoms, while chronic bacterial prostatitis (CBP) involves more persistent symptoms or recurrent UTIs. Some key symptoms of prostatitis include:
- Pain or discomfort in the pelvic area
- Painful urination
- Increased urinary frequency and urgency
- Difficulty starting urination
- Weak urine flow
- Pain during ejaculation
- Flu-like symptoms such as fever, chills, and body aches in cases of acute bacterial prostatitis
- Persistent dull pain in the lower back, perineum, or genitals in cases of chronic prostatitis
- Urinary problems that come and go over months
- Blood in semen or urine
- Sexual dysfunction The diagnosis of ABP relies on clinical presentation and laboratory tests, while CBP diagnosis involves comparing bacteria levels in prostatic fluid and urinary cultures 1. It is essential to seek medical attention promptly if experiencing these symptoms, as bacterial forms require antibiotic treatment. Treatment options may include fluoroquinolones like ciprofloxacin or trimethoprim-sulfamethoxazole, and symptoms can be managed with pain medications, alpha-blockers, and warm sitz baths while treatment addresses the underlying cause.
From the Research
Prostatitis Symptoms
- Prostatitis is a common condition that can cause a range of symptoms, including pelvic pain, lower urinary tract symptoms, and systemic symptoms such as fever and chills 2, 3, 4.
- The symptoms of prostatitis can vary depending on the type of prostatitis, with acute bacterial prostatitis typically presenting with acute onset pelvic pain, lower urinary tract symptoms, and systemic symptoms 2, 3, 4.
- Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder characterized by pelvic pain and lower urinary tract symptoms, with a range of potential causes including bacterial infection, autoimmune processes, and altered neuroendocrine pathways 5, 4.
- The diagnosis of prostatitis is typically based on a combination of clinical assessment, laboratory tests, and imaging studies, with a digital rectal examination and midstream urine sample collection important components of the diagnostic workup 3, 4.
Types of Prostatitis
- Acute bacterial prostatitis is a common and clinically important genitourinary disorder, typically caused by an ascending infection or introduced during transrectal prostate biopsy 2, 3.
- Chronic bacterial prostatitis is a documented history of recurrent urinary tract infections, with duration of symptoms > 3 months defining chronicity 4.
- Chronic pelvic pain syndrome is a multifactorial condition characterized by pain, with potential causes including pelvic floor muscle abnormalities, altered neuroendocrine pathways, and bacterial infection 5, 4.
- Asymptomatic inflammatory prostatitis is a condition characterized by inflammation of the prostate gland without symptoms 4.
Treatment Options
- Treatment for prostatitis typically involves antibiotics, with oral or intravenous antibiotics effective for curing acute bacterial prostatitis 2, 3.
- For chronic prostatitis/chronic pelvic pain syndrome, a range of pharmacological interventions may be effective, including alpha blockers, 5-alpha reductase inhibitors, antibiotics, anti-inflammatories, and phytotherapy 5.
- Other treatment options for prostatitis include botulinum toxin A injection, allopurinol, and traditional Chinese medicine, although the evidence for these interventions is limited 5.