Pain In The Lower Abdomen In Men : Causes, Symptoms, Diagnosis & Treatment

• Causes Of Pain In The Lower Abdomen In Men
• Prostate Diseases
• Cystitis
• Sexually Transmitted Infections
• Urolithiasis Disease
• Tumors Of The Genitourinary System
• Irritable Bowel Syndrome
• Inflammatory Bowel Disease
• Appendicitis
• Inguinal Hernia
• Intestinal Infections
• Rare Causes
• Diagnostics
• Treatment
• Help Before Diagnosis
• Conservative Therapy
• Surgery

Pain in the lower abdomen in men occurs with diseases of the prostate (acute and chronic prostatitis, adenoma, cancer), diseases of the urinary organs (cystitis, KSD), sexually transmitted infections. Other common causes: IBS, intestinal infections, inflammatory and surgical pathologies of the intestine. The diagnostic plan for pain in the lower abdomen includes ultrasound, radiography with contrast, endoscopic techniques. Laboratory tests of blood, urine and feces are used. For therapeutic purposes, antibiotics, NVPS, alpha-blockers, immunocorrective and cytostatic drugs are used, and surgical interventions are performed.

Causes of pain in the lower abdomen in men

Prostate diseases

The defeat of the prostate is the most common cause of pain in the lower abdomen in men. Depending on the type of pathology and the duration of the process, pain can be dull and aching, cutting, stabbing. Painful sensations radiate to the scrotum, groin, and hip area. They are combined with urination disorders, sexual dysfunction. The diseases that are most often manifested by pain in the lower abdomen include:

• Acute prostatitis. At the initial stages of the inflammatory process, there are pains of moderate intensity, aggravated at night and during urination. The launched process is characterized by sharp throbbing pains in the lower abdomen, in the perineum, which radiate into the rectum. To alleviate the symptoms, the patient lies with the legs pulled up to the body.
• Chronic prostatitis. Men are worried about constant dull pain in the pubic region, which becomes more intense at the beginning and at the end of urination. With prolonged abstinence from intimacy, the pain syndrome increases, but in some patients there is an inverse relationship - severe discomfort in the lower abdomen is felt at the time of ejaculation.
• Abscess of the prostate. With a volumetric purulent process, very severe pains in the lower abdomen, which are pulsating in nature, are noted. Often they have one-sided localization, which corresponds to the affected lobe of the prostate gland. There is irradiation of painful sensations in the perineum and rectal area.
• BPH. The development of pain syndrome is typical for the subcompensated and decompensated stages, which is associated with urinary retention. Men experience dull, arching pains above the pubis; when this area is felt, the symptoms intensify. After urination, the condition is relieved.
• Prostate cancer. With a malignant tumor, unlike prostate adenoma, pain appears much earlier. They are constant, dull or aching, aggravated by ejaculation and urination. In the later stages, men develop extremely intense pain that is not stopped by standard analgesics.

Cystitis

In acute cystitis, patients experience pain and a feeling of heaviness over the pubic joint. There are painful imperative urges to urinate, and at the end of the act of urination, intense cramps in the lower abdomen disturb. Patients notice that the urine becomes cloudy, acquires a sharp unpleasant odor. In the chronic form of cystitis, the pain is not intense, usually they occur in men only before urination.

Sexually transmitted infections

STIs include chlamydia, gonorrhea, ureaplasmosis, mycoplasmosis. Such infections in men are acute, accompanied by severe pain in the lower abdomen, radiating to the groin and penis. In addition to pain, patients complain of burning and itching in the urethra. Gradually, the symptoms subside, aching pains in the suprapubic zone disturb the man only in the morning. Another specific symptom of STIs is profuse purulent or mucous urethral discharge.

Urolithiasis disease

Severe pain in the lower abdomen with irradiation to the inguinal region occurs when stones are localized in the ureter. At the same time, patients behave restlessly, trying to find a position in which the pain will not be so intense. The symptom is combined with nausea and vomiting, reflex retention of defecation and urination, which further aggravates the pain syndrome in men.

Pain in the lower abdomen in men

Tumors of the genitourinary system

The appearance of pain in the lower abdomen is typical for cancer of the bladder, urethra, germ and non-germinogenic testicular tumors. Malignant neoplasms cause a pain syndrome that worries men constantly, does not change during urination and sexual intercourse. At the initial stage of the tumor process, the sensations are aching, not intense. The growth of neoplasia leads to increased pain, which becomes unbearable.

irritable bowel syndrome

IBS is manifested by pains in the lower abdomen, varied in nature and intensity, in combination with flatulence. Unpleasant symptoms are most pronounced in the morning after waking up. Men complain of cramping pain, usually localized on the left. Against the background of the pain syndrome, there are painful urges to defecate, after emptying the intestines, the state of health improves.

Inflammatory Bowel Disease

Pain in the lower abdomen on the left is characteristic of non-specific ulcerative colitis, on the right - for Crohn's disease. The intensity of the pain syndrome depends on the stage of the process: during an exacerbation, men are disturbed by strong dull or paroxysmal painful sensations. In the period of remission, there is a slight discomfort in the abdomen. Symptoms are accompanied by increased stools, the appearance of impurities of mucus and blood in the feces.

Appendicitis

In classic cases of inflammation of the appendix, intense pain is localized in men in the lower abdomen on the right. Soreness is aggravated by pressure in the indicated area and a sharp release of the hand. With an atypical location of the appendicular process, pain is felt in the suprapubic zone. Sometimes pain in the rectum, dysuric disorders are possible. A change in the nature of pain and their spread throughout the abdomen is a prognostically unfavorable sign.

Inguinal hernia

First, periodic dull pains in the lower abdomen are observed, accompanied by the appearance of a tumor-like protrusion in the groin. Soreness is localized on the side of the lesion. Often there is irradiation of pain in the lumbosacral region, perineum, their intensification during straining and physical exertion. As the hernia grows, the pain syndrome becomes permanent. Acute cramping pains indicate the formation of a strangulated inguinal hernia.

Intestinal infections

With dysentery, escherichiosis, campylobacteriosis and some protozoal infections (amebiasis, balantidiasis), patients feel severe cramps and pain in the lower abdomen, more on the left side. Simultaneously with the pain syndrome in men, there are painful urges to defecate, which are false. Diarrhea develops up to 10-15 times a day with the release of a small amount of feces with mucus and blood streaks. After defecation, the intensity of pain decreases.

Rare Causes

• Inflammation of the urinary organs : paracystitis, vesiculitis.
• Blunt abdominal trauma.
• Vascular pathologies : varicose veins of the small pelvis, Leriche's syndrome.
• Rare types of hernias : perineal, Spigelian line, postoperative.
• Syndrome of chronic pelvic pain.

Diagnostics

Examination of men with complaints of pain in the lower abdomen is carried out by a urologist or gastroenterologist. Examination begins with superficial and deep palpation of the abdomen to reveal local pain and muscle tension. Then a digital examination of the prostate through the rectum is performed - the size and consistency of the gland are determined, a pain reaction is detected. To find out the cause of the pain syndrome, a full range of diagnostic methods is selected, which includes:

• Ultrasound . During ultrasound of the prostate gland, its shape and size are evaluated, local or diffuse changes in the structure are determined. Doppler ultrasound visualizes blood flow in the prostate. Ultrasound of the abdominal cavity is necessarily performed - to exclude inflammatory or tumor processes of the digestive tract.
• Endoscopy . In chronic pathologies of the urinary tract, the results of ureteroscopy and cystoscopy are indicative. For a detailed visualization of the condition of the large intestine, sigmoidoscopy, colonoscopy are performed. With endoscopic examination, it is possible to take a biopsy from suspicious areas of the mucosa.
• X-ray studies . If men are suspected of having urological diseases, urethrography, cystography are recommended. With symptoms of intestinal damage, irrigography is prescribed. For the diagnosis of volumetric neoplasms and chronic inflammatory processes, CT of the pelvic organs is informative.
• Histological examination . To verify prostate cancer, a transrectal targeted biopsy is indicated, the material of which is studied under a microscope. Analysis of the microstructure of the intestinal wall is important for the differential diagnosis of UC and Crohn's disease, and for the detection of intestinal tumors in men.
• Laboratory Methods . A urethral culture is required to confirm the diagnosis of an STI. Clinical and bacteriological examination of urine helps to establish cystitis and urethritis. With dyspeptic disorder, a coprogram is mandatory. For possible prostate cancer, a PSA blood test is done.

Urologist's consultation

Treatment

Help before diagnosis

Considering that pain in the lower abdomen in men can have a different origin, self-medication and self-administration of painkillers is not recommended. To relieve symptoms, you should regularly empty your bladder and intestines, and avoid prolonged sexual abstinence. Severe pain syndrome, combined with a deterioration in well-being, is an indication for seeking emergency medical care.

Conservative therapy

In order to prevent polypharmacy, treatment of men with lower abdominal pain begins only after the diagnosis is verified. Therapy of most mild and moderate forms of diseases is carried out on an outpatient basis, and in severe and complicated diseases, hospitalization is necessary. The treatment regimen includes several groups of drugs, the main of which are:

• Antibiotics . Medicines are prescribed for the treatment of acute and chronic prostatitis, STIs, intestinal infections. The selection of the drug is carried out empirically, the drug regimen is adjusted after receiving the results of the antibiogram.
• Alpha blockers . Medicines relieve spasm of smooth muscles in men, facilitate the excretion of urine, so the pain syndrome decreases. With prostate adenoma, therapy is supplemented with 5-alpha-reductase inhibitors.
• Non-steroidal anti-inflammatory drugs . NSAIDs have a powerful analgesic effect, therefore they are used both in the pathogenetic and symptomatic treatment of pain in the lower abdomen in men.
• Immunomodulators . Medicines that stimulate the immune system are necessary for chronic inflammatory and infectious processes. They prevent exacerbations, accelerate the process of treating men.
• Cytostatics . The drugs are effective in inflammatory bowel disease to control symptoms and reduce the frequency of flare-ups. Cytostatics are included in the chemotherapy of oncological diseases of the genitourinary organs in men.

In chronic prostatitis, prostate massage is widely used, which is necessary to eliminate congestion in the organ. For urological pain, physiotherapy methods are carried out: laser exposure, ultrasound and electromagnetic therapy, therapeutic microclysters. With IBS associated with psychoemotional disorders, psychotherapy techniques give a good effect.

Surgery

In the presence of prostate adenoma, several types of operations are used: transurethral resection, adenomectomy, laser vaporization of the prostate. In complicated forms of prostatitis, a puncture is performed with drainage of cysts and abscesses. Men with prostate cancer require radical intervention, which includes prostatectomy and lymphadenectomy.

For the treatment of urolithiasis, endoscopic operations (contact cystolithotripsy and ureterolithotripsy) and laparoscopic methods (nephrolithotomy, ureterolithotomy) are used. For inguinal hernias, hernioplasty is performed with the installation of mesh allografts. In case of appendicitis, sparing laparoscopic or classical laparotomic appendectomy is indicated.