Surgeon Urologist - Andrologist
Greek English

Symptoms of chronic prostatitis

The following presentation of chronic prostatitis symptoms will be done in a manner completely practical based on many years of my experience with a vast number of young and old patients. I believe it is crucial to improve the understanding of those who daily search for a solution to this major problem, since many remain undiagnosed for several years despite the number of visits to urologists.

There is a number of symptoms that if they occur either individually or some of them simultaneously, and persist regardless of their intensity, should put us in thought such as:
  • Changes in the frequency of urination / micturition: That is, while the normal number of micturition is 3-4 times during the day and none during the night, during chronic prostatitis such frequency begins to rise gradually; it becomes that of 6-8 or more times and it slowly becomes a habit. Thus such a symptom may trick our perception and awareness of something happening. In addition, we may begin to wake up at night to urinate (i.e. nocturia symptom), with a frequency of once per night which can increase to 4 or even 5 times.

  • Reduced urination power / flow: That is, the radius of the urination begins to decrease gradually losing the curve it naturally had, and many times the chronic prostatitis patient ends up pressing their belly to boost or even accomplish urination.

  • Feeling of incomplete emptying of the bladder: The patient feels that they have not finished urinating and there is an amount of urine still remaining in the bladder. In many cases this creates the sensation of the need for a second urination after a short while, in order to feel that the bladder is completely emptied.

  • Sensation of heaviness or numbness: In cases of chronic prostatitis, sensations of heaviness, numbness or even pain in the lower abdomen occur as well as over the genitals, in the center or the sides.
  • Pain, sense of burning or numbness in one or both testicles: It is often the case that patients suffering from chronic prostatitis will also suffer from problems in the veins of the testes (varicoceles), which complicates the diagnosis. If despite the surgical treatment of the varicocele(s) the feeling of pain in the testicles does not subside, then this is a strong indication of the existence of chronic prostatitis.

  • Feeling of burden or pain in the lumbar or lower spine: There have been many chronic prostatitis cases that the patients had needlessly gone through with CT and MRI examinations for diagnoses such as hollow intervertebral disc or kidney lithiasis (stones). Some falsely went through clinical interventions to solve the aforementioned misdiagnosed symptoms when in fact they suffered from chronic prostatitis which generated pain reflexes in those areas.

  • Feeling of rapid fatigue of the body: Rapid fatigue (generally of the body) without a specific cause could be because of chronic prostatitis. There are more than a few cases of patients suffering from chronic prostatitis who underwent a plethora of clinical and biochemical examinations, without being able to find the cause – the only result was the psychological, among others, encumbrance of these patients.

  • Feeling of fatigue or pain in the thighs: Tiredness (fatigue), or pain or grip in the thighs, which is not justified by daily workload.
  • Vertigo or headaches: Vertigo or headaches with remissions and exacerbations where clear causes are not recognized by the standard tests.

  • Light and periodical instantaneous burning of the urethra (burning sensation) or of the head of the penis during the urination or even outside the urination: In some cases, the burning pain in the perineal area or along the penis is very strong and almost unbearable, particularly when the patient sits for hours in the saddle of the bicycle, the motorcycle or the car’s seat.

  • Changes to the time of the ejaculation: In chronic prostatitis premature or delayed ejaculation occurs as a symptom.
  • Balanoposthitis: Inflammation of the glands and the prepuce of the penis usually of fungal causes that do not subside or easily relapse after treatment.

  • Pain or burning during or immediately after the ejaculation.

  • Hematospermia: Appearance of dark brown semen or pure blood in semen, with periods of remission and exacerbation.

  • Changes in sexual behavior: During chronic prostatitis there is also observed decrease in sexual desire or decrease in penile erections. The morning erections are fewer or do not reach the quality of hardness they should, while the evoked erections do not reach the desired quality of the hardness. Alternatively, even if the erections reach the desired hardness initially it is subsequently lost during the contact, or there are many instantaneous transitions during the intercourse.

  • Difficulty in childbearing: When the examination results of the female partner are normal, semen appears to be responsible for more than 50%-60% of these cases, since the toxic effect of the chronic inflammation drastically reduces the number of the sperms or the sperm mobility. Many times the chronic prostatitis coexists with varicocele(s) which may cause the dysfunction of sperm, but the main cause remains the chronic inflammation of the prostate.

  • Change of defecation habits: In a few cases, the chronic inflammation of the prostate is associated with very intense constipation and this is because when the urogenital system suffers (as is the case in chronic prostatitis), because of the common innervation to gastrointestinal system, serious malfunctions in defecation are created.

  • Appearance of blood in the fecal: Hemorrhoids often coexist and are intensified by the chronic inflammation of the prostate.

  • Outflow of synovial fluid: During the defecation, the effluence of a usually pale or slightly turbid or even sometimes purulent fluid (due to the pressure of the fecal during their pass through the intestine onto the puffed inflammatory prostate) can also be observed.

  • History of urinary tract infections or acute prostatitis: There have also been chronic prostatitis cases where patients report that they had previously underwent treatment for acute prostatitis (as (mis)diagnosed by the urologists they visited at the time) – after that treatment many of the symptoms largely subsided. A few years later, when these patients were tested in my clinic, 90% of these cases were indeed acute inflammatory situations but in the background of a chronic inflammation of the prostate gland (that had obviously not been properly cured).