A man complains of acute onset of malaise, fever, chills, and perineal, rectal, or low back pain. He also may have dysuria, urinary urgency and frequency, and signs of obstruction to urinary flow, ranging from a weak stream to urinary retention. There may be painful ejaculation and hematospermia. On gentle examination, the prostate is swollen, hot, and exquisitely tender. The infection may spread from or into the contiguous urogenital tract (epididymis, bladder, urethra) or the bloodstream.

 

Patients with chronic bacterial prostatitis will have similar recurrent symptoms without fever and with a more normal but possibly tender prostate.