Groin Pain In Men : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 06/07/2022

Pain in the groin in men is observed with an inguinal hernia, inflammation of the regional lymph nodes against the background of STDs, diseases of the genital organs and urinary system, some injuries, and orthopedic pathologies. It can be acute, dull, weak, intense, constant, periodic. Sometimes it is supplemented by edema, hyperemia. Local external deformations are possible. The cause of the symptom is established on the basis of the data of the survey, external examination, ultrasound, radiography, laboratory tests. In some cases, biopsy sampling is required. Treatment includes painkillers and antimicrobials, physical therapy, and surgery.

Why do men get pain in the groin

Inguinal hernia

Inguinal hernias are the most common type of hernial protrusion, occurring in men 6 times more often than in women. The disease develops acutely or gradually. The patient complains of the presence of a tumor-like formation, periodic or constant pain in the groin, radiating to the sacrum, lower back. Involvement of the cecum is manifested by constipation, flatulence, bladder - dysuria, pain above the pubis.

Infringement of a hernia is characterized by a sharp increase in pain at the height of tension, physical effort. The intensity of the symptom is so great that the patient cannot find a place for himself, groans. Due to pain shock, pallor, hypotension, tachycardia occur. The clinic of intestinal impassability is possible or probable. Severe pain persists for several hours, then subsides due to the development of necrosis and the death of nerve endings.

Some men develop recurrent inguinal hernia after hernioplasty. The manifestations are the same as with a normal hernia. A protrusion is formed in the area of ​​the postoperative scar, aching and pulling pains in the projection of the groin are disturbing. There may be discomfort while walking. As education increases, dyspeptic disorders or dysuria phenomena join.

Inguinal lymphadenopathy

Pain in the groin against the background of an increase in the inguinal lymph nodes, as a rule, indicates the presence of an infectious process, most often appear with STIs:

  • Chlamydia. The acute form develops more often in men. Accompanied by bilateral inguinal lymphadenopathy. Palpation of the nodes is slightly painful. The skin is not changed. There are pains in the lower abdomen, mucopurulent discharge from the urethra.
  • Gonorrhea. Enlargement of lymph nodes is often bilateral. Soreness on palpation, slight redness of the skin is revealed. Purulent urethral discharge in the morning, dysuric disorders are characteristic.
  • Mycoplasmosis and ureaplasmosis. With moderate inflammation, the skin of the groin is not changed, with intense inflammation it is hyperemic. Palpation of the lymph nodes is painful. Patients complain of mucopurulent discharge, cramps, pain during urination.

A special form of damage to the lymph nodes is inguinal lymphogranulomatosis - a disease that is caused by chlamydia, occurs mainly in warm countries. In Russia, it is diagnosed in sailors, travelers, military personnel. Regional lymphadenitis occurs 2-4 weeks after infection. It is manifested by soreness and enlargement of the lymph nodes, local edema, hyperemia. The nodes transform into lumpy large tumors, solder with the surrounding tissues, become immobile, and then melt with the formation of fistulas and ulcers.

In addition, inguinal lymphadenitis is accompanied by balanitis, Fournier's gangrene, and some other infectious and inflammatory processes. The nodes are enlarged, painful, mobile on palpation. Lymphadenopathy can also be observed in oncological diseases of the external genital organs, but pain in such cases is not always disturbing, it occurs due to compression of nearby nerves.

Man's groin pain

 

Andrological diseases

Men complain about the presence of a symptom in the following pathologies of the genital organs:

  • Orchitis. There is pain in the testicle, perineum, inguinal zone. In the acute form, the pain is intense, the testicle is sharply swollen, weakness, weakness, and general hyperthermia are observed. In patients with chronic orchitis, the sensations are aching or pulling, the general condition is not disturbed.
  • Testicular torsion. The development of pathology is evidenced by an acute sudden sharp pain in the scrotum, radiating to the groin and perineum. The symptom is so pronounced that it provokes collapse, nausea, and vomiting.
  • Funicular. A cyst of the spermatic cord in young men is often asymptomatic, large formations cause discomfort in the groin. In old age, aching pains can be observed.
  • Varicocele. Pain in the scrotum, groin area occur at stage 2 of the disease, vary from mild to sharp, burning or shooting. Initially, there is a connection with physical activity. At stage 3, the connection is lost, the symptom becomes permanent.

Manifestations of epididymitis, epididymo-orchitis and vesiculitis resemble the clinical picture of orchitis and may also be accompanied by pain in the groin. Soreness is found in the syndrome of edematous scrotum, provoked by ischemia, trauma, infectious diseases. With prostatitis, pain in the perineum often radiates to the groin. In men suffering from BPH, the symptom appears in the later stages, due to complications from the urinary system.

Diseases of the urinary tract

Acute pain in the groin area is sometimes caused by a low-lying calculus. The symptom appears suddenly, differs in considerable intensity. Pain in the lumbar and inguinal regions radiate to the external genitalia and bladder, combined with frequent urge to urinate, blood in the urine. Similar manifestations, but with less severe pain, are observed with sand in the kidneys against the background of its movement along the urinary tract.

The list of other pathologies of the urinary system with pain in the groin, taking into account the level of the lesion, includes:

  • Urethra: urethritis.
  • Bladder: cystitis in men, bladder cancer, malacoplakia.
  • Ureters: ureteritis, hydroureter.
  • Kidneys: adenocarcinoma, hydronephrosis.

Appendicitis

With a low location of the inflamed appendix, acute appendicitis is manifested by paroxysmal pain in the right inguinal and iliac regions. The clinical picture is supplemented by nausea, vomiting, diarrhea, fever. In men with chronic appendicitis, pain is dull, aching, persistent, or arising under the influence of provoking factors (diet disorders, physical activity).

Pathologies of the musculoskeletal system

ARS syndrome is diagnosed in men involved in sports, characterized by pain in the groin, radiating to the muscles of the thigh and lower abdomen from the side of the lesion. Manifestations are associated with physical activity, range from minor to intense. Soreness increases with palpation of tendons, ligaments, tension of the muscles of the anterior abdominal wall, hip abduction.

The symptom also occurs against the background of a sprain of the hip joint caused by a fall, a sharp abduction of the hip during sports activities, or an attempt to sit on the twine. Sometimes irradiation in the groin is the result of diseases and injuries of the hip joint and proximal femur, for example, coxarthrosis, arthropathy, or a fracture of the femoral neck.

Diagnostics

At the initial stage, the man is examined by a urologist-andrologist. If pain in the groin is not associated with diseases of the genitourinary system, the patient is referred to an abdominal surgeon or orthopedic traumatologist. With STIs, consultation with a venereologist is required. To clarify the diagnosis, the following procedures are carried out:

  • Diaphanoscopy. Performed during an objective examination, it helps to differentiate a hydrocele and an increase in the scrotum of a different etiology (with neoplasia, soft tissue edema, inflammation of the membranes and epididymis, inguinal hernia). Due to the low information content, it is used as an indicative study for choosing further diagnostic measures.
  • Ultrasonography . Taking into account the expected localization of the pathological focus, a man may be prescribed an ultrasound of the prostate (prostatitis, prostate adenoma), an ultrasound of the scrotum (orchitis, epididymitis, testicular torsion) or lymph nodes (lymphadenopathy). To detect an inguinal hernia, ultrasound of the hernial protrusion is performed, to confirm the ARS syndrome - sonography of the pubic symphysis, to diagnose ICD - ultrasound of the kidneys and bladder.
  • X-ray diagnostics . Informative for hernias, some diseases of the urinary system. Depending on the localization of the focus, an overview urography, a CT scan of the kidneys, or an irrigography are prescribed. In orthopedic pathologies, an x-ray of the pelvis or hip joint may be indicated.
  • Biopsy of the lymph node. Recommended for lymphadenopathy of unknown origin. Morphological examination of the biopsy allows you to determine the nature of the pathological process. A large number of lymphocytes indicates inflammation. The detection of atypical cells indicates metastasis of a malignant neoplasm.
  • Laboratory tests . A complete blood count is performed to confirm inflammation, exclude lymphadenopathy in hemoblastosis. To determine the pathogens of STDs, PCR diagnostics are performed, RIF or ELISA are performed.

Urologist's consultation

 

Treatment

Help at the prehospital stage

The appearance of sharp pain in the groin indicates the possible presence of dangerous pathologies: the passage of stones in the ICD, strangulation of a hernia, or acute appendicitis. In these cases, an immediate call for an ambulance is required. Self-administration of painkillers is not indicated, as it can distort the symptoms and complicate the diagnosis. Before the arrival of the doctor, the man needs to ensure peace by laying him in a comfortable position.

Conservative therapy

Therapeutic tactics is determined by the cause of pain in the groin. The following treatment methods can be used:

  • Painkillers . To reduce the severity of the pain syndrome, analgesics, NSAIDs are used in short courses. Drugs are taken only as prescribed by a doctor.
  • Antibacterial therapy . Men with nonspecific inflammatory processes are first prescribed a broad-spectrum antibiotic. Then the drug is replaced taking into account antibiotic sensitivity. For mycoplasmosis, ureaplasmosis, fluoroquinolones, macrolides and tetracyclines are used, for gonorrhea - cefixime, ceftriaxone, ciprofloxacin.
  • Immunomodulators . To provoke sluggish sexual infections, suppositories with immunostimulants can be shown. In inflammatory processes against the background of a decrease in the body's defenses, drugs are needed to correct immunity.
  • Other medicines . Taking into account the genesis of the pathology, antispasmodics, diuretics, hormonal and desensitizing agents may be required. With pain of orthopedic etiology, resistant to drug therapy, blockades with hormones are possible.
  • Physiotherapy . The list of physiotherapeutic procedures includes electrophoresis, Bernard currents, magnetotherapy, laser therapy, ultrasound. In some andrological diseases, microclysters and prostate massage are effective. For orthopedic diseases, exercise therapy, massage, shock wave therapy are recommended.

Surgery

Men with pain in the groin perform the following surgical interventions:

  • Inguinal hernia : hernioplasty with own tissues or using a mesh prosthesis, Liechtenstein operation, elimination of the inguinal canal.
  • Andrological diseases : operations of Marmar, Palomo and Ivanissevich, embolization of varicocele, excision of funiculocele, epididymotomy, removal of prostate adenoma, operations for torsion of the spermatic cord, orchiectomy.
  • Pathologies of the urinary tract : contact or remote lithotripsy, pyelolithotomy, ureterolithotomy, ureteral stenting, ureteral plasty, nephrectomy.
  • Appendicitis : open or laparoscopic appendectomy.
  • Orthopedic diseases : operations for ARS syndrome, osteosynthesis of a fracture of the femoral neck, hip arthroplasty.

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