Prostatitis Symptoms: What You Should Know

Prostatitis is the most common urinary tract problem in men under the age of 50—and approximately 25 percent of men experience one form of prostatitis in their lifetime.

Illustration of prostate

Acute prostatitis is caused by bacterial infection and can lead to fever, chills, and painful urination or ejaculation.

Prostatitis refers to one of a number of conditions in which the prostate becomes inflamed. Men of any age can be affected by prostatitis symptoms, but it is more common in men who are 50 or younger.

The National Institute of Health (NIH) has divided prostatitis into four categories: acute bacterial prostatitis (category I), chronic bacterial prostatitis (category II), chronic prostatitis/chronic pelvic pain syndrome (category III), and asymptomatic inflammatory prostatitis (category IV).

All forms of prostatitis are non-cancerous conditions. Some studies have suggested a possible link between prostatitis and prostate cancer but others studies have shown no association between the two conditions. Research investigating whether or not there may be a relationship is ongoing.

Men with asymptomatic inflammatory prostatitis (category IV), as the name implies, do not experience any symptoms. Men suffering from one of the other three categories often experience one or more of the following prostatitis symptoms:

  • Urinary Frequency: Men with prostatitis often experience the need to urinate often.
  • Urinary Urgency: Prostatitis can cause the sensation of an urgent, immediate need to urinate.
  • Urinary Retention: Symptoms related to the obstruction of urine flow caused by the inflamed prostate often occur with prostatitis. These can include difficulty initiating urination, a weakened urine stream, and the inability to completely empty your bladder.
  • Painful Urination/Painful Ejaculation: Prostatitis can cause pain both during urination and ejaculation.
  • Lower Abdominal Pain/Perineal Pain: Prostatitis can cause pain in the lower abdomen, groin, and/or the perineum, the area between the scrotum and rectum.

Men with acute bacterial prostatitis will additionally often experience systemic symptoms such as fever and chills and will notice that their symptoms begin suddenly and intensely. Men with chronic bacterial prostatitis may have low-grade fevers but their symptoms often are much milder than those experienced with acute bacterial prostatitis. Men with chronic prostatitis/chronic pelvic pain syndrome may have symptoms that range in severity and wax and wane unpredictably.

Acute Bacterial Prostatitis (ABP)

Acute bacterial prostatitis is the least common form of prostatitis, accounting for less than 5 percent of prostatitis cases. It occurs when bacteria infect the prostate gland causing the sudden onset of painful inflammation. It is most often caused by the bacteria Escherichia coli (E.coli), a common cause of urinary tract infections, but it can be caused by many other bacteria including sexually transmitted organisms such as Chlamydia trachomatis and Neisseria gonorrhea.

Chronic Bacterial Prostatitis (CBP)

Chronic bacterial prostatitis is caused by the same organisms that can cause acute bacterial prostatitis and many of the symptoms are the same, although the symptoms are generally milder in CBP and last longer.

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)

CPPS is the most common form of prostatitis, accounting for 90-95 percent of all prostatitis cases. Some estimates suggest that 10 to 15 percent of U.S. men suffer from chronic pelvic pain syndrome. CPPS can be a frustrating condition for both patients and physicians because the cause is often unknown and treatment options are limited. It is thought that CPPS might possibly be due to an undetectable bacterial infection, an immune response to a past infection, or pelvic nerve impairment.

Asymptomatic Inflammatory Prostatitis

This is the rarest form of prostatitis and is usually an incidental discovery found when a doctor is testing for another urinary tract or reproductive disorder such as infertility. The only finding in asymptomatic inflammatory prostatitis is the presence of white blood cells in the urine or semen after prostatic massage. All other laboratory and physical exam tests are normal and the patient is always asymptomatic. No treatment is required and there are no known complications.

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UHN Staff

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