Medically reviewed by Dr. Paul Song M.D
Similar Conditions to Prostatitis
It is time to put on your detective hat and follow the clues and what they could mean. The following list contains similar conditions to prostatitis and diseases that most often get mistaken for prostatitis. They may be wrongly misdiagnosed when you do in fact have prostatitis. Plus, you can’t rule out the idea that you possibly have multiple issues going on. Could it be prostatitis AND one of these other issues? And just to keep things interesting, some of these conditions can actually cause prostatitis. If you have both (or if one is causing the other), treating both conditions can give you the best shot of relieving your prostatitis symptoms.
Reactive arthritis is an autoimmune condition that also goes by Reiter’s syndrome. An infection in another part of the body causes it to develop. This tricky condition can cause symptoms in various body parts like the urinary system or eyes. In fact, Reiter’s can usually be traced to a urinary, genital, or bowel infection. It can also cause arthritis symptoms (swelling, pain, redness, and heat) in the joints. There are no specific criteria for diagnosing reactive arthritis, so it has that aspect in common with chronic pelvic pain syndrome (CPPS). What is interesting is that chronic prostatitis is one of the classic symptoms of Reiter’s disease.
Sometimes after a genital infection, such as Chlamydia, reactive arthritis shows up. Even though a number of areas of the body can be affected by reactive arthritis, it can also inflame the bladder and prostate. How else are these two conditions related? Recent evidence shows that CPPS is an immunologically driven inflammatory disease that may occur with other tissue inflammation in the body. Both reactive arthritis patients and CPPS patients may tend to test positive to the same antigen. Hopefully further research can shed some light on how these two conditions may be connected.
Urethral stricture is one of the possible causes of prostatitis, and patients who have urethral stricture appear to have higher incidence of prostatitis. Prostatitis is considered a possible cause of urethral stricture, and urethral strictures may lead to prostatitis. It sounds like a classic case of which came first: the chicken or the egg?
What is a urethral stricture? It is a narrowing of the urethra that can cause painful urination and make the patient unable to empty the bladder. This can lead to urinary tract infections, and, in fact, it is common for a urinary tract infection to be present when diagnosed. A urethral stricture can be a lifelong condition and problem for some men.
How does a urethral stricture cause prostatitis? Well, it may have to do with how fluids travel. In a normal urethral structure, fluid should travel from the prostate to the urethra only during ejaculation. However, with a urethral stricture, the high-pressure voiding can force urine to flow into the prostate ducts, causing inflammation or an infection. A urethral stricture can be diagnosed by cystoscopy—a flexible scope inserted into the urethra and bladder. There are several surgical treatments for urethral stricture, and if is determined to be the cause of the prostatitis, treating the stricture may relieve the symptoms of prostatitis.
There are several causes of urethral stricture including scarring, trauma, infection, procedures involving the urethra (such as catheters, surgery, or cystoscopy), or even an enlarged prostate. In about one-third of the cases, they cannot find a specific cause for the condition.
Post-Vasectomy Pain Syndrome
Chronic pain can appear after a man has a vasectomy. Doctors do not know why, but some men experience chronic pain after their vasectomy. Post-vasectomy pain likely affects less than 6% of the 500,000 men who undergo vasectomies every year. It is defined as chronic testicular pain that lasts longer than three months after the procedure. The pain may also radiate to the groin or occur along the vas deferens. There can be pain upon physical exertion, when achieving an erection, when having intercourse, or when ejaculating. It is usually treated with medication, a nerve block, or even a reverse vasectomy. If you have pelvic pain and have recently had a vasectomy, this is something to discuss with your physician because it could be related.
Chronic fatigue syndrome is actually the name for a group conditions characterized by persistent fatigue and other symptoms that include muscle and joint pain. Chronic fatigue may be related to CPPS or even increase the likelihood of having CPPS. As with CPPS, chronic fatigue affects a man’s quality of life. Also like CPPS, nobody really knows what causes this frustrating condition and there are not any specific laboratory tests for it besides ruling out other causes. Some researchers think that it could be related to fibromyalgia.
Men who suffer from chronic fatigue syndrome may also suffer chronic pelvic pain. One study on 127 pairs of twins found a connection. Researchers discovered that if one twin had chronic fatigue but the other did not, the twin with chronic fatigue was also much more likely to have CPPS as well.
Stress-Related Pelvic Pain
Unmanaged stress is one of the largest contributors to chronic pelvic pain. Many men do not recognize how much their emotional state has an effect on their overall health. Each person handles stress differently, and it is common for people to focus their tension in another part of the body. Some men might clench their jaw, causing TMJ problems, while others tighten their neck and shoulder, leading to headaches and neck problems. In the case of CPPS, some men do not realize that they squeeze their pelvic muscles when stressed, and this can lead to chronic tension in the pelvic area—kind of like a headache in the pelvis.
Studies have found that stress affects the myofascial trigger points found in muscles in the pelvic floor. Men with stress-related CPPS may benefit from trying myofascial release or trigger point release therapy for prostatitis. It is important to consider various ways to manage stress and emotional health. Stress-reducing activities such as yoga, tai chi, exercise, and cognitive behavioral therapy for prostatitis may be helpful in these cases. Because this pain might have developed slowly over time, treatment at relieving stress-related pelvic pain can take some time and patience as well.
Pudendal Nerve Entrapment
A pudendal nerve entrapment can cause pain the pelvic area and number of other problems. This pelvic region nerve can become compressed by or in between the ligaments, muscles or bone canals in the pelvis, causing pain. Trauma, birth defects, pelvic tumors, surgical scar tissue, or prolonged and regular cycling can all lead to a pudendal nerve entrapment. Symptoms may include including urinary and bowel trouble, sexual problems (such as painful intercourse, erectile dysfunction, ejaculatory dysfunction, and numbness of genitals), and neurological symptoms (such as sharp stabbing, burning, aching, a prickling sensation, and sensitivity to pain in the genitals). The good news about this unpleasant problem is that it can be easier to identify than prostatitis because all the symptoms get worse when the person is sitting, but they improve when the person is standing up or lying down.
Pelvic Joint Dysfunction
Pelvic joint dysfunction is a condition that can be linked to chronic pelvic pain syndrome. With pelvic joint dysfunction the ligaments that normally keep the pelvis firm get stretched out and cause pain. The condition stems from abnormal motion and usually results in inflammation of the sacroiliac joint. This condition can be debilitating with symptoms including pain in the lower back, butt, hips, and groin plus sciatic leg pain. Other symptoms may include urinary frequency and tingling or prickling that comes and goes. There are a number of traditional and alternative treatments to help relieve this pain.
BPH (benign prostatic hyperplasia)
Benign prostatic hyperplasia (BPH) is more commonly known as enlarged prostate. This prostate condition commonly affects aging men, and does share some urinary symptoms with prostatitis. About 70% of men experience BPH symptoms by age 70. Symptoms vary, but the many men experience a weak urinary stream, frequent urination, having to wait for urine, urinary flow issues (like bad rush-hour traffic), nighttime urination forcing the man to wake up several times a night to urinate, incontinence, urinary tract infections, and not emptying the bladder when urinating. Men can visit their doctor for tests to diagnose or rule out BPH.
Pelvic Trauma and Prostatitis
When the prostate area gets injured or irritated it can cause chronic pelvic pain syndrome. A blunt trauma to the perineum—the area between the scrotum and anus—or pelvic area can result from injuries related to cycling, a karate kick, getting hit with a hockey stick, or another accidental injury to the area. Heavy lifting, horseback riding, or even having workplace issues such as driving a truck or operating machinery apply powerful vibrations to the prostate area can irritate the prostate area.
Prostate Cancer and Prostatitis
Researchers have been studying the connection between prostatitis and prostate cancer. Prostatitis may be one of the risk factors for prostate cancer. Because inflammation and an elevated PSA level are both associated prostatitis and prostate cancer you should keep your eye on your PSA level. Men who have prostatitis should monitor their prostate health. That means getting PSA checked regularly and getting digital rectal exams to stay up to date on their prostate health. Prostatitis, which can affect younger men, may be an early sign that something is not right with the prostate, so men should use that as a precaution to take measures through diet and lifestyle to lower their risks for prostate cancer. Early prostate cancer usually has no symptoms so being proactive can help with early detection.
Nobody is a fan of testicular pain, which occurs when either one or both testicles hurt. It can include pain in the scrotum. There are acute and chronic types of testicular pain, just like with prostatitis. Chronic scrotal pain and testicular pain lasts for more than three months. What causes testicular pain? Several underlying conditions can be to blame, including prostatitis, inflammation, a tumor, inguinal hernia, infection, hydrocele, surgery, trauma, and other conditions. There are a number of tests a doctor can perform to determine the source of the testicular pain. Sometimes pain can linger after a man has a vasectomy, and this is called post-vasectomy pain syndrome.
Co-morbidities are different conditions that can occur at the same time. Many men who have prostatitis also commonly have co-morbidities, further complicating the diagnostic process. One condition that some prostatitis patients also have is irritable bowel syndrome (IBS). Irritable bowel symptoms include cramping, abdominal pain, bloating, gas, diarrhea, and constipation. You can be control IBS through managing diet, lifestyle, and stress.
Sometimes the co-morbidities have other co-morbidities that can lead to prostatitis. Take the case of IBS and leaky gut. Many patients who have IBS also have leaky gut. This is caused by the body’s intolerance to certain foods or ingredients. With leaky gut, the intestinal lining leaks some large proteins from the intestinal tract enter the blood stream into the circulating blood. These leaked proteins travel to different areas of the body and become lodged in different places. If they get caught in the joints, they may lead to arthritis; sometimes they lodge in the prostate and possibly cause prostatitis.
Another prostatitis co-morbidity is food allergy and/or food intolerance. Different food allergies can cause prostatitis symptoms—that’s why allergy testing and following an elimination diet can really help with managing prostatitis. Pay attention to the foods you eat to see if something in your diet could trigger prostatitis symptoms. Naturopathic urologists often recommend that patients try following a wheat-free or gluten-free diet to reduce chronic inflammation in the body as a wheat allergy or gluten sensitivity can cause CPPS symptoms.
Sinusitisis is inflammation of the paranasal sinuses. It is also called rhino sinusitis and is commonly caused by infection, allergies, or autoimmune issues. You may be thinking to yourself how can sinus problems be related to prostate and pelvic health? There are a few similarities. As with prostatitis, there are both acute cases (usually stemming from an upper respiratory tract infection) and chronic cases of sinusitis that last longer than three months. Chronic sinusitis is more of an inflammatory disorder rather than one related to persistent bacterial infection. Sinusitis can also have other causes such as structural abnormalities (like a deviated septum), viruses, bacteria, allergies, fungi, dental issues, food allergies, or problems with the Eustachian tubes.
Even though sinusitis affects a very different part of the body than the prostate, it has some things in common with prostatitis. It can be frustrating to figure out what is causing either of these conditions, and both conditions can be challenging to treat. Both conditions can be painful, and both greatly affect the sufferer’s quality of life. Plus, some men can suffer from both sinusitis and prostatitis at the same time. What is interesting is that the two conditions might flare up at the same time, which makes one wonder if they share the same triggers.
Every year between 7,500 and 8,000 men in the U.S. learn that they have testicular cancer. Testicular cancer symptoms may include feeling heavy in the scrotum, a sharp pain or dull ache in the scrotum or lower abdomen, a lump in one testis (the lump may or may not be painful), breast enlargement, and low back pain. Men between 25 and 40 years old are the most common ages to discover they have testicular cancer. Prostatitis and testicular cancer do share some similar pain and discomfort symptoms. That’s why it’s smart to get a scrotal ultrasound and run other tests to rule out testicular cancer.