as you suspect the symptoms might be due to chronic prostatitis or a similar entity chronic prostatic pain syndrome. it needs a per rectal examination. per rectal examination is not that painful as you suspect. urine culture after a per rectal examination will turn to be positive if it is chronic prostatitis. it needs a 4 week course of trimethoprim alpha blocker drugs and anti-inflammatory drugs. it has to be treated with trimethoprim or levofloxacin. the probable causes:secondary to uti (urinary tract infection). differential diagnosis:chronic prostatic pain syndrome. regarding follow up:for further queries consult an urologist online. ---> <link>
does chronic constipation lead to prostatitis?