What is the difference between the symptoms of prostatitis and benign prostatic hyperplasia (BPH)?

Prostatitis and benign prostatic hyperplasia (BPH) differ primarily in the nature of their symptoms and underlying causes. While prostatitis is often a condition associated with inflammation or infection that causes pelvic pain, BPH is a non-cancerous enlargement of the gland associated with aging, which mainly leads to urinary flow obstruction due to pressure on the urethra [3].

Distinctive Symptoms of Prostatitis

Prostatitis is more common in men under the age of 50 [1]. Its symptoms vary based on the type of inflammation:

• Acute bacterial prostatitis: Symptoms appear suddenly and severely, including fever, chills, body aches, burning during urination, difficulty starting urination, and pain in the lower abdomen, perineum, or genital area [3].
• Chronic bacterial prostatitis: Characterized by symptoms similar to acute bacterial prostatitis, but they come and go or worsen slowly over months, with a potential for recurring urinary tract infections [3].
• Chronic pelvic pain syndrome: Causes persistent pain for more than three months in the pelvic or genital area, which may be accompanied by urination difficulties [3].

Symptoms of Benign Prostatic Hyperplasia (BPH)

Unlike prostatitis, BPH is very common in men over the age of 50, and symptoms rarely appear before the age of 40 [2]. Symptoms here focus on urinary disturbances resulting from the increased size of the gland and include:

• Increased frequency of urination, especially at night [3].
• A weak, slow, or intermittent urinary stream [3].
• Difficulty starting urination or the need to strain/push to urinate [3].
• A feeling of incomplete bladder emptying [3].

Fundamental Differences and Diagnosis

The most notable difference is that prostatitis often causes acute or chronic localized pain in the pelvis or genitals and may be accompanied by systemic symptoms such as fever, whereas BPH focuses on lower urinary tract obstructive symptoms and does not usually cause fever or acute pain [1]. For more details on these conditions, you can review Common Prostate Diseases: BPH, Prostatitis, and Cancer (Arabic).

When Do Symptoms Require Emergency Medical Attention?

Seek immediate medical care if urinary symptoms are accompanied by a complete inability to urinate, as this is considered a medical emergency [2]. It is also advised to consult a doctor if you notice blood in the urine, severe and persistent pain, or signs of infection such as fever and chills [3]. Diagnosis depends on medical history, a physical examination (including a digital rectal exam), and certain laboratory tests such as a urinalysis or PSA test to ensure other conditions are ruled out [1].

Medical references

• Prostate Diseases
• Prostate Problems
• Understanding Prostate Changes and Conditions