Acute prostatitis often begins with chills and fever, lower abdominal discomfort, perineal pain (pain in the area between the genitals and the anus), and burning with urination. Symptoms of more advanced prostatitis include a diminished urine stream and difficulty urinating.

Prostatitis may occur in conjunction with epididymitis or orchitis, especially if caused by an STD, in which case symptoms of the accompanying condition may also be present.

Symptoms of acute prostatitis include the following:

• Fever
• Chills
• Low back pain
• Abdominal pain (above the pubic bone)
• Perineal pain (pelvic floor)
• Pain and burning with urination (dysuria)
• Urinary retention (inability to completely empty bladder)
• Pain with ejaculation
• Pain with bowel movement

• Blood in the urine
• Increased urinary frequency or urgency
• Difficulty urinating
• Decreased force of urinary stream
• Testicle pain
• Blood in the semen
• Foul-smelling urine

Your health care provider may perform a physical examination to assess the prostate (warm, soft, swollen, or tender), the groin lymph nodes (enlarged or tender), the scrotum (swollen or tender), and the urethra (discharge).

Triple-void urine specimens may be collected for urinalysis and urine culture:

• #1 initial stream
• #2 mid-stream
• #3 after prostatic massage by examiner

Note: Your health care provider may choose not to perform prostatic massage if the prostate is obviously swollen and tender, because massage may potentially spread the infection and cause bacteremia or sepsis. These are potentially life-threatening infections in which bacteria are present in the bloodstream, rather than localized to one part of the body.

Urinalysis may reveal increased white blood cells (WBCs) and bacterial growth. Examination of prostatic secretions may also show increased levels of WBCs and concentrated bacterial growth upon culture.

Acute prostatitis may also alter the results of the following tests:

• CBC
• Urine analysis
• PSA
• Semen analysis