Pubic pain in men

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, tugging. Sometimes it is accompanied by swelling of the zone of the pubic articulation, the lower abdomen. To establish the etiology of the pain syndrome, survey data, examination, radiography, ultrasound are used. Treatment tactics are determined by the cause of pain, immobilization, drug therapy, physiotherapy, surgical interventions are possible.

Why men have pain in the pubic area
Traumatic injuries
Osteomyelitis of the pubic bone
Tumors of the pubic bone
Andrological diseases
Urological pathologies
Diagnostics
Treatment
Assistance at the pre-hospital stage
Conservative therapy
Surgical treatment
Prices for treatment
Why men have pain in the pubic area
Traumatic injuries
Pubic pain in men is observed with bruises of the symphysis area, fractures of the pubic bone. In the first case, the pain syndrome is not clearly expressed, the swelling 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 groping, foot movements, lateral compression.

Damage to the anterior pelvic semicircle is accompanied by pain in the pubis, perineum. The pain increases with compression from the side and in the antero-posterior direction, movements of the lower extremities. A rupture of the symphysis, a fracture near the pubic joint are manifested by a forced position – the man’s legs are brought together, slightly bent. When trying to dilute the limbs, severe soreness occurs. A typical sign of fractures is the inability to raise the straightened leg on the side of the lesion in the prone position.

Osteomyelitis of the pubic bone
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, hyperemia of the skin, the appearance of purulent discharge from the wound. The intensity of the symptom increases rapidly, the pain becomes twitching, tearing. Fever, severe intoxication are noted.

Tumors of the pubic bone
Pelvic bones, including the pubic, are often affected by neoplasms originating from bone and cartilage tissue. Benign osteochondromes, osteomas and chondroblastomas are characterized by slow growth, are asymptomatic or with minor local soreness. With malignant chondrosarcomas and metastasis of tumors of other localizations, the pain is initially non-intense, dragging or aching. They are growing rapidly. They become strong, permanent.

Andrological diseases
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, increases during sexual acts, bowel emptying, physical exertion, prolonged walking. It is supplemented with prostatorrhea, hematospermia, hematuria, urination disorders.

With other forms of prostatitis, pain in the perineum prevails, pain in the pubis is observed infrequently. Other possible causes of soreness 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.

Pubic pain in men
Pubic pain in men
Urological pathologies
The first manifestation of bladder cancer, as a rule, becomes hematuria, which is subsequently joined by dysuric phenomena, pain in the pubis, sacrum, groin area. At first, painful sensations are noted only with a full bladder. After the germination of the organ wall and surrounding tissues, the pain syndrome becomes permanent, increases, and reaches a high intensity.

For acute cystitis, pain over the pubis, in the scrotum, groin, and penis are typical. When urinating, the following symptoms are added to the pain, burning in the urethra. Dysuric phenomena, turbidity of urine, terminal hematuria are detected. 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 lymphogenic spread of infection from the kidneys. Constant pain in the suprapubic region, stranguria, pollakiuria, imperative urges, periodic macrohematuria are revealed. Disorders of general well-being include subfebrility, fatigue, malaise, progressive weight loss. There may be pain in the lower back.

With bladder stones, the symptom is caused by the contact of the concretion with the walls of the organ, irritation of the mucous membrane or the creation of an obstacle to the outflow of urine. Men complain of soreness above the pubis and in the lower abdomen, in the penis. At rest, the pain is insignificant. 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.

Diagnostics
The choice of the 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 a urologist-andrologist. During the survey, the specialist finds out when and under what circumstances the symptom appeared, determines the duration, frequency, nature of pain in the pubic area, identifies other complaints. The examination plan may include procedures such as:

External inspection. The doctor examines the pubis and adjacent areas, detects the presence of edema, hyperemia, purulent foci, discharge from wounds. An important role in compiling the list of further studies is played by the precise determination of the localization of pain, palpatory determination of changes (bone deformities, pathological mobility, volumetric formations).
Radiography of the pelvis. If a fracture is suspected, men perform an overview radiography, with osteomyelitis and neoplasms, an X-ray examination of the pubic bones is performed.
Other methods of X-ray diagnostics. To detect concretions, an overview urography or CT is performed, cystography, lymphadenography and pelvic venography are prescribed to detect neoplasms of the bladder, assess the involvement of the lymphatic system and pelvic veins.
Ultrasonography. Prostate ultrasound is informative for prostatitis, adenoma, prostate cancer. Ultrasound of the bladder is used to visualize tumors of the urinary tract. With neoplasms in the neck of the organ, the study is carried out transrectally. Sometimes transurethral endoluminal echography is used.
Endoscopic techniques. Cystoscopy is performed to clarify the size and localization of the tumor, to assess the condition of the ureteral mouths. During the study, a biopsy sample is taken to clarify the morphological structure of neoplasia.
Laboratory tests. They allow to confirm the presence and severity of inflammation, to clarify the type of pathogen, to determine its sensitivity to antibacterial drugs.
Urologist’s examination
Urologist’s examination
Treatment
Assistance at the pre-hospital stage
A fracture of the pelvic bones is a serious injury requiring urgent first aid measures. A man should ensure peace by laying his back on the shield in the frog pose (with slightly bent, legs apart and a pillow under his knees) and covering with a blanket. The pelvis must be fixed by wrapping a sheet or handkerchief around it to prevent the displacement of fragments. If the patient is conscious, you can give an analgesic. It is recommended to drink plenty of warm water to prevent traumatic shock.

Conservative therapy
The tactics of conservative treatment depends on the etiology of pubic pain. For men with injuries, anesthesia of the fracture zone or intra-phase anesthesia is performed. The nature of immobilization is determined by the features of the damage. Isolated fractures are fixed with a hammock or a shield. With complex injuries, skeletal traction is applied. Analgesics are prescribed. Blood transfusions are performed. In the recovery period, massage, physical therapy, physiotherapy are performed.

Patients with osteomyelitis are shown massive antibiotic therapy. To correct rheological parameters, activate local blood circulation and reduce the severity of intoxication, albumin, hemodesis 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 case of chronic pathology, prostate massage and physiotherapy are additionally included in the treatment regimen. The list of recommended physiotherapy techniques includes ultrasound, laser exposure, electromagnetic vibrations. Medicinal microclysms can be used.

Men with cystitis are prescribed antimicrobials, 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, a referral is given for ultrasound, UHF, electrophoresis, inductothermy, magnetotherapy. In tuberculosis, anti-tuberculosis drugs, angioprotectors, NSAIDs are used.

Surgical treatment
Taking into account the causes of pain in the pubic area , men perform the following operations:

Pelvic fractures: osteosynthesis of the anterior semicircle.
Osteomyelitis: autopsy, drainage of a purulent focus, removal of sequesters.
Bone tumors: excision of benign neoplasia, pubic bone resection, pelvic bone resection, ilio-abdominal resection.
Andrological pathologies: laser vaporization of the prostate, transurethral resection of the prostate, trans-bubble or posadilon adenomectomy, laparoscopic and radical prostatectomy, cryoablation and FUZ-ablation of the prostate gland.
Urological diseases: cystolithotomy, cystolithotripsy, cystolithoextraction, partial and radical cystectomy, cystoprostatectomy, kidney resection or nephrectomy in tuberculosis.

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