Pain in the pubic area in men is observed with injuries and diseases of the musculoskeletal system, some andrological and urological pathologies. Occurs suddenly or progresses gradually. It can be dull, sharp, weak, intense, aching, pressing, pulling. Sometimes it is accompanied by swelling of the pubic symphysis zone, the lower abdomen. To establish the etiology of the pain syndrome, data from a survey, examination, radiography, and ultrasound are used. The tactics of treatment is determined by the cause of pain, immobilization, drug therapy, physiotherapy, and surgical interventions are possible.
Pain in the pubis in men is observed with bruises in the symphysis area, fractures of the pubic bone. In the first case, the pain syndrome is not pronounced, the edema is local, insignificant or moderate, the functions of the lower extremities are not impaired. An isolated fracture of the pubic bone is characterized by increased pain during palpation, leg movements, and lateral compression.
Damage to the anterior pelvic half ring is accompanied by pain in the pubis, perineum. Pain is aggravated by compression from the side and in the anteroposterior direction, movements of the lower extremities. A rupture of the symphysis, a fracture near the pubic joint, is manifested by a forced position - the man's legs are brought together, slightly bent. When trying to spread the limbs, severe pain occurs. A typical sign of fractures is the inability to raise the straightened leg on the side of the lesion in the supine position.
Osteomyelitis of this localization in most cases has an exogenous origin, occurs against the background of open injuries, operations, the spread of inflammation from nearby tissues. At the initial stage, there is an increase in edema, skin hyperemia, the appearance of purulent discharge from the wound. The intensity of the symptom increases rapidly, the pain becomes jerking, tearing. Fever, severe intoxication are noted.
The pelvic bones, including the pubic one, are quite often affected by neoplasms originating from bone and cartilage tissue. Benign osteochondromas, osteomas and chondroblastomas are characterized by slow growth, are asymptomatic or with minor local pain. With malignant chondrosarcomas and metastasis of tumors of other localizations, the pain is initially not intense, pulling or aching. They grow fast. Become strong and permanent.
Sometimes pain in the pubic area in men is caused by prostatitis. The symptom is most often detected with a calculous variety of the disease, combined with soreness in the perineum, scrotum, sacrum, coccyx. It has a dull aching character, aggravated by sexual intercourse, bowel movements, physical exertion, prolonged walking. Complemented by prostorrhea, hematospermia, hematuria, urination disorders.
With other forms of prostatitis, pain in the perineal region prevails, pain in the pubis is observed infrequently. Other possible causes of pain in the projection of the pubis in men are large prostate adenomas and prostate cancer. The symptom occurs due to compression of the urinary tract, the spread of a malignant tumor to nearby structures.
Pain in the pubic region in men
The first manifestation of bladder cancer, as a rule, is hematuria, which is subsequently joined by dysuric phenomena, pain in the pubis, sacrum, and inguinal region. Initially, painful sensations are noted only with a full bladder. After germination of the wall of the organ and surrounding tissues, the pain syndrome becomes permanent, increases, and reaches a high intensity.
For acute cystitis, pain is typical above the pubis, in the scrotum, groin, and penis. When urinating, to the listed symptoms are added cramps, burning in the urethra. Dysuric phenomena, turbidity of urine, terminal hematuria are found. In severe forms, oliguria, general hyperthermia, intoxication syndrome are observed. In men with chronic cystitis, the manifestations are erased.
Tuberculosis of the bladder is formed a second time against the background of urogenic or lymphogenous spread of infection from the kidneys. Constant pain in the suprapubic region, stranguria, pollakiuria, imperative urges, periodic gross hematuria are detected. General well-being disorders include low-grade fever, fatigue, malaise, progressive weight loss. Pain in the lumbar region is possible.
With bladder stones, the symptom is due to the contact of the calculus with the walls of the organ, irritation of the mucous membrane, or the creation of an obstruction to the outflow of urine. Men complain of soreness above the pubis and lower abdomen, in the penis. At rest, there is little pain. When urinating, changing the position of the body, the intensity of the pain syndrome increases sharply, sometimes there is irradiation in the genitals, perineum, upper thighs.
The choice of a diagnostician is determined by the localization of the pathological focus. Patients with diseases and traumatic injuries of the musculoskeletal system are examined by an orthopedic traumatologist. Diseases of the genitourinary organs are under the jurisdiction of the urologist-andrologist. During the survey, the specialist finds out when and under what circumstances the symptom appeared, establishes the duration, frequency, nature of pain in the pubic area, and identifies other complaints. The survey plan may include procedures such as:
Urologist examination
A pelvic fracture is a serious injury requiring urgent first aid measures. The man should be kept calm by laying his back on the shield in the frog position (with legs slightly bent, spread apart and a pillow under the knees) and covered with a blanket. The pelvis must be fixed by wrapping a sheet or scarf around it to prevent displacement of fragments. If the patient is conscious, an analgesic can be given. Plentiful warm drink is recommended for the prevention of traumatic shock.
Tactics of conservative treatment depends on the etiology of pubic pain. For men with injuries, anesthesia of the fracture zone or intrapelvic anesthesia is performed. The nature of immobilization is determined by the characteristics of the damage. Isolated fractures are fixed with a hammock or shield. For complex injuries, skeletal traction is applied. Prescribe analgesics. Perform blood transfusions. In the recovery period, massage, exercise therapy, physiotherapy are carried out.
Patients with osteomyelitis are shown massive antibiotic therapy. To correct rheological parameters, activate local circulation and reduce the severity of intoxication, albumin, hemodez and plasma are transfused. According to the indications, hemo- and lymphosorption is carried out. The wound is washed with antibacterial solutions and proteolytic enzymes.
Treatment of acute prostatitis involves taking antibacterial drugs, selected taking into account the sensitivity of the pathogen. In chronic pathology, the treatment regimen additionally includes prostate massage and physiotherapy. The list of recommended physiotherapeutic techniques includes ultrasound, laser exposure, electromagnetic oscillations. Medicinal microclysters may be used.
Men with cystitis are prescribed antimicrobial agents, antispasmodics, NSAIDs, herbal uroseptics. According to the indications, the bladder is washed with antiseptic solutions, various types of blockades are performed. After the inflammation subsides, they give a referral to ultrasound, UHF, electrophoresis, inductothermy, magnetotherapy. In tuberculosis, anti-tuberculosis drugs, angioprotectors, NSAIDs are used.
Taking into account the causes of pain in the pubic area, men perform the following operations: