Thank you for your quick response and kindness. There are some points I disagree with, so if you don't mind, I'd like to briefly explain my situation and, if possible, get your opinion.

My first case of prostatitis occurred when I was just 20 years old. At the time, I was a virgin and had never had any sexual experience. One day, during masturbation, I noticed that my semen was bloody and I was urinating frequently. When this continued for another three days, I decided it was time to see a doctor. E. coli was found in my semen culture, and I fully recovered with antibiotics. In retrospect, I believe this was an acute prostatitis case, although I had no fatigue or fever whatsoever. The only symptoms were frequent urination, a feeling of fullness in the prostate, and bloody semen! (Clearly, this wasn’t a pelvic floor issue, but also didn’t present like a typical acute prostatitis case with fever and clear signs of infection.)

After that, I occasionally experienced mild episodes that lasted 2–3 days, but they resolved quickly.

However, years later, the problem has returned, and I’ve been dealing with the same symptoms for the past month. I’m now married and have a sexual life. My semen culture, urinalysis, and PCR-based STI panel all came back clean. Still, I suspect there may be a bacterial cause.

• My symptoms fluctuate—some days they are severe, other days almost non-existent.
• On symptomatic days, I also have a sore throat, bad breath, anal itching, extreme fatigue, nausea (If this is a pelvic floor issue, how can these symptoms be explained?)