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Prostate pain
Last reviewed: 04.07.2025

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The role of the prostate is to produce substances that facilitate the process of sperm maturation with the maintenance of an active state of spermatozoa. The gland communicates with all organs of the small pelvis by means of nerve pathways, which often causes pain in the prostate.
The difficulty of access to the prostate is due to its anatomical location - below the bladder, covering the initial areas of the urethra, limited at the back by the rectum. The gland is located in the center of the male pelvis and has three lobes: left, right and median. The prostate gland is lined with smooth muscle and glandular tissue, and the fibrous capsule surrounding it contains septa of connective tissue. The superior and inferior arteries are responsible for supplying the prostate with blood.
Causes of Prostate Pain
The following causes of prostate pain can be identified:
- acute or chronic prostatitis;
- presence of stones in the gland;
- cancerous tumors;
- diseases of the rectum (eg hemorrhoids);
- development of cystic neoplasms;
- inflammation of the paraurethral glands.
Prostatitis can be infectious and non-infectious. The causative agents of infectious prostatitis are most often staphylococci and streptococci, which are present in various organs of every healthy person, manifesting themselves only when the body's protective functions are reduced. Pathogenic flora (chlamydia, gardnerella) accounts for a third of all cases of the disease.
The flu and herpes viruses cause illness in 20% of men.
The development of prostatitis depends on the patient's age. In young people, the disease is observed against the background of previous urethritis or with a mixed infection. Middle-aged and older men become infected in a descending manner - with age-related difficulty in urine outflow.
Fungal prostatitis occurs in weakened patients due to incorrect therapy.
The cause of blood stagnation is physiological disorders or changes in sexual activity. Deliberate delay of ejaculation causes stretching of some parts of the reproductive system, as well as the prostate. Regular use of this method leads to pathological changes in the gland and blood stagnation.
Prostate pain can occur due to dysfunction of neighboring organs as a result of prolonged constipation, poor diet, consumption of large amounts of fatty, spicy foods, and alcohol abuse.
The risk group includes male truck drivers who receive constant trauma to the perineum while driving. The amplitude and force of the blow are small, but the regular impact of the entire muscle mass of the body on the prostate develops "Scythian disease". This is how pain, problems with urination, and impotence appear.
Doctors identify causes of painful sensations that are not subject to human will:
- a peculiarity of the structure of the venous system of the prostate itself, as a result of blood stagnation;
- the anatomical structure of the gland, which can lead to stagnation of secretion;
- interaction of the neuroreflex activity of the bladder and rectum;
- hormonal imbalance;
- changes in the prostate with age involving hormones;
- low immunity from birth.
Pain in the prostate area
Pain syndrome varies in intensity, character and localization. The most common complaints are related to unpleasant sensations during urination, sexual intercourse, ejaculation or immediately after sexual contact.
Pain in the prostate area can be concentrated in a specific place or be vague, when it is difficult to determine the source of the pain. Most often, discomfort spreads to the genital area, pubic area, radiates to the scrotum, lower abdomen, lower back, sacrum and anus.
The period of exacerbation may occur with promiscuous sexual life and, conversely, due to prolonged abstinence. Factors that provoke pain in the prostate are:
- hypothermia;
- excessive physical or mental stress;
- predominance of a sedentary lifestyle;
- uncontrolled alcohol consumption.
Symptoms of Prostate Pain
The clinical manifestation of prostatitis is characterized by more than a hundred symptoms. Of course, they do not occur together, but are distributed depending on the stage of the disease, the level of changes in hormonal levels, the patient's age, and are often combined with nervous system disorders.
General symptoms, as a rule, do not attract the attention of a man: weakness, sleep problems, mood swings, severe fatigue, decreased performance, etc. All this is attributed to life's troubles.
At the second stage, vegetative disorders join in: increased sweating, itching in the buttocks and perineum. The picture is complemented by bouts of irascibility, aggression, sullenness, sometimes even tearfulness and faintheartedness.
Local symptoms of pain in the prostate appear much later in the form of unpleasant sensations in the lower abdomen during urination. Burning in the urethra, problems with erection and urination are noted. Very often the disease proceeds without symptoms or with one or two.
The intensity of pain varies from a constant nagging character to the strongest pain syndrome, requiring the use of painkillers. As a rule, the pain is concentrated in the testicles, less often it covers the lumbosacral region, imitating radiculitis pain.
The pain extends to the perineum and suprapubic area in a third of patients. Pain in the groin area, in the penis and rectum, coccyx, lower chest and kidneys is much less common.
Prostate cancer pain
Prostate cancer occurs in men aged 50-60. The causes may be genetic predisposition, prostate adenoma and carcinogenic factors.
Clinical symptoms are expressed by three main complaints: pain, urination disorders and hematuria (urine with blood). The intensity of pain manifestations directly depends on the stage of the disease.
At the first stage, prostate cancer pain is described as aching sensations in the perineum. The pain is caused by the pressure of the growing tumor on the capsule of the prostate gland and the compression of the nerve endings located in it. The fourth stage has a strong pain syndrome of a constant nature, the tumor grows into the capsule and nearby tissues of the organs. Pain relief occurs with the use of painkillers.
Problems with urination are detected more often at the third stage. If the tumor has grown into the bladder, hematuria appears. Symptoms similar to pyelonephritis are also noted when the ureteral orifices have grown. Penetration of the tumor into the rectum can cause blood in the stool.
Pain in prostate adenoma
In the early stages of prostate adenoma (benign tumor), there is no pain during frequent urination. Pain in prostate adenoma is typical in the later stages or with complications in the form of secondary cystitis, inflammatory disease of the prostate.
With prostate adenoma, an enlargement of the gland is observed. Common symptoms include: a feeling of incomplete emptying of the bladder, a weak stream, and an increase in the duration of urination. Urinary retention may occur, requiring emergency medical care.
The disease affects men who have reached forty years of age and older. Doctors call late fertility the main factor influencing the development of adenoma.
Pain after prostate adenoma removal
The surgical intervention is performed using the open adenomectomy method, which can lead to a number of complications:
- infectious-allergic type;
- functional nature;
- organic type.
The most severe consequences of surgical treatment are recognized as functional (urinary incontinence) and organic (structure of the urethra, presence of a “forebladder”) disorders.
A cavity called a "pre-bladder" may form at the site of the removed adenoma. Most patients do not experience any discomfort. Only a small percentage of men who have had urethritis report pain in the perineum after prostate adenoma removal. The pain may be so severe that it is impossible to sit.
Particularly severe manifestations are associated with the formation of a "forebladder" in urethral stricture. The patient suffers from frequent urination around the clock. The onset of urination is associated with severe pain and a pressing feeling in the perineum, after which a weak stream appears. The pain decreases with the onset of urine excretion literally drop by drop. Such conditions require excision of the "forebladder" according to Soloviev, in the second case with reconstruction of the urethra.
Pain during prostate massage
A properly performed procedure taking into account all contraindications does not cause pain in the patient. If after the third session there are no positive changes, the massage may not be for you.
Light massage of the prostate gland by a urologist helps to eliminate painful processes and relieve tension in the nerve endings of the prostate.
Intensive medical manipulations can cause not only pain during prostate massage, but also pose a threat to the patient's health. In the case of acute bacterial prostatitis, there is a high probability of blood poisoning. The presence of stones in the prostate can cause ruptures of cell membranes. An unqualified physician can personally cause damage to the tissues of the colon.
Excessive pressure also causes pain in the prostate, dangerous rupture of a short section of the urethra. Such a defect, leading to a violation of the structure of the urethra, is often not diagnosed. A poor-quality procedure is detrimental to the healthy flora of the urethra.
Some forms of prostatitis (chronic and bacterial) with an extremely enlarged prostate are characterized by pain in the prostate during massage.
Prostate pain during massage may be caused by psychological tension in a man, in which the muscles are in spasm. It is important for the patient to relax the abs, gluteal muscles and lower back.
Pain after prostate massage
Prostate massage is used as a treatment for prostatitis. The procedure can only be performed by a qualified doctor, as incorrect performance can lead to irreparable consequences for health.
Pain after prostate massage in the form of burning during urination can lead to irritation of the urethra and a burning sensation in the penis. The symptoms subside, but appear after the next session. In this case, the doctor should change the tactics of action, and the patient should wait with going to the toilet for about 20 minutes after therapy. During this period, the prostate ducts will close, there will be no irritation from contact with urine and a "fire" will not occur.
A urologist may recommend special means to help close the ducts. In order to facilitate the process of urine excretion, herbal preparations or uroantiseptics are prescribed.
Prostate pain after bowel movement
Pain in the prostate after defecation is associated with prostatitis, abscess or cancer of the gland.
Parenchymatous prostatitis proceeds rapidly with a clearly expressed clinical character. Along with general weakness, chills, loss of appetite, dysuria, a sharp increase in the prostate gland is detected. Constipation, localization of pain in the rectum of a pulsating nature are added to the complaints. Discharge from the anus may appear.
A type of acute prostatitis is an abscess, which develops against the background of pain in the perineum, during and after defecation, and is characterized by a state of weakness and severe intoxication. In the case of spontaneous opening of the abscess, the presence of pus in the urine and feces is noted.
Prostate pain during the development of cancer can involve the skeletal system. The initial stages are characterized by pain during urination and defecation. As the tumor grows, the pain becomes a constant symptom, localized in the rectum and perineum.
Prostate pain after sex
Pain in the prostate after sex during urination is a sign of chronic prostatitis.
The discomfort is localized in the perineum area, but can spread to the anus, suprapubic and inguinal area. Unpleasant sensations are also noted on the inner thighs and directly in the genitals.
Prostate pain is constant in nature, in the form of heaviness, often not associated with the release of urine. In some cases, there is a pronounced pain syndrome during urination, ejaculation or defecation after sexual intercourse.
A characteristic symptom of the chronic process will be itching of the genitals, anus and urethral canal. The disease progresses, leading to sleep disorders, decreased performance, general lethargy and loss of strength.
Aching pain in the prostate
The presence of stones in the prostate gland is expressed by discomfort in the perineum, head of the penis, pain during urination. Aching pain in the prostate increases during defecation, when sitting on a hard surface, during intimacy. Some patients note painful ejaculation during sleep.
Aching, pulling pain in the prostate is characteristic of chronic prostatitis and urethritis. The pain is accompanied by a burning sensation. The syndrome is permanent.
Couperitis (an inflammatory process in the bulbourethral gland) is described by aching pain that intensifies during defecation and in a sitting position. Most often, the disease is a consequence of urethritis.
Who to contact?
What to do if your prostate hurts?
If painful symptoms appear in the perineum, you should consult a urologist who will refer you for diagnostics:
- physical examination of the prostate;
- transrectal ultrasound;
- bacterioscopic study of gland secretion;
- urethral smear analysis;
- exclusion of sexually transmitted infections.
Of course, it is best to visit a doctor regularly for timely examination and disease prevention.
What to do if you have prostate pain? Don't panic. Prostate pain is an unpleasant phenomenon that may indicate banal nervous or physical overstrain.
Pain in the perineal area is associated with pelvic pain syndrome, which is chronic. No abnormalities are found during examination.
Treatment of prostate pain
For the treatment of benign hyperplasia of the gland, drugs are used that have a therapeutic effect in cases with pronounced symptoms.
Treatment of prostate pain in severe forms of the disease, when pharmacological drugs are unable to help, involves surgical methods.
Prostatitis is most often cured with antibiotics.
The fight against prostate cancer is a complex process that requires an individual approach. It is important to take everything into account: the patient's age, the nature of the disease, the general condition, and the specific symptoms. Complex treatment is used: chemotherapy, surgery.
Prevention of prostate pain
The body's natural aging process can affect prostate problems, so doctors recommend taking steps to slow down the process.
Prevention of prostate pain includes a diet based on fresh vegetables and fruits with a minimum of fatty foods. The mechanisms of occurrence and development of cancer of the gland are still unclear to modern medicine. Therefore, the diet extends to the prevention of cancer and adenoma of the prostate gland.
The main guarantee of health to this day remains - maintaining intimate hygiene. Scientific evidence has found the fact that clean representatives of the stronger sex suffer from prostatitis much less often.
Asymptomatic course of a number of male diseases requires systematic examinations by a urologist. Regular visits to the doctor allow timely detection of prostate problems and prescribing optimal treatment.
A standard consultation for prostate pain includes:
- conversation with a urologist;
- rectal examination;
- ultrasound examination;
- PSA blood test;
- analysis of prostate secretions and urethral discharge;
- if necessary – bacterial culture and biopsy of areas of the gland.
Prostate pain often indicates a chronic process in the gland. The disease can be aggravated by immune and neuralgic disorders, hormonal changes, allergic reactions, pelvic organ surgeries and other reasons.