genitourinary disorders
Prostatitis
Symptoms and Signs of Prostatitis
Symptoms vary by category but typically involve some degree of urinary irritation or obstruction and pain. Irritation is manifested by frequency and urgency, a sensation of incomplete bladder emptying, a need to void again shortly after voiding, or nocturia. Pain is typically in the perineum but may be perceived at the tip of the penis, lower back, or testes. Some patients report painful ejaculation. Acute bacterial prostatitisoften causes such systemic symptoms as fever, chills, malaise, and myalgias. The prostate is exquisitely tender and focally or diffusely swollen, boggy, indurated, or a combination. A generalized sepsis syndrome may result, characterized by tachycardia, tachypnea, and sometimes hypotension. Chronic bacterial prostatitismanifests with recurrent episodes of infection with or without complete resolution between bouts. Symptoms and signs tend to be milder than in acute prostatitis. Chronic prostatitis/chronic pelvic pain syndrometypically has pain as the predominant symptom, often including pain with ejaculation. The discomfort can be significant and often markedly interferes with quality of life. Symptoms of urinary irritation or obstruction also may be present. On examination, the prostate may be tender but usually is not boggy or swollen. Clinically, inflammatory and noninflammatory types of chronic prostatitis/chronic pelvic pain syndrome are similar. Asymptomatic inflammatory prostatitiscauses no symptoms and is discovered incidentally during evaluation for other prostate diseases when white blood cells are present in the urine. 