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Lower Abdominal Pain - Pelvic Pain in Males


Overview, Causes, & Risk Factors

Pelvic pain refers to any pain or discomfort in the lower abdomen.

What is going on in the body?

Pelvic pain in males is often related to the intestines or urinary tract. Psychological factors can make the pain seem worse, or even cause a sensation of pain where no physical problem exists.

Pelvic pain can range from mild discomfort or cramping, to severe, intense pain. This pain may be acute, when it occurs suddenly, or chronic, when the pain lasts for a long period of time.

What are the causes and risks of the condition?

Pelvic pain in males has many causes, including:

  • pelvic adhesions, which are fibrous bands that hold together parts that are usually separate
  • sexually transmitted diseases, such as Neisseria gonorrhoeae\ bacteria. The infection is usually acquired through sexual contact. ',CAPTION,'Gonorrhea in Males');" onmouseout="return nd();">gonorrhea or Chlamydia trachomatis.\ Sexually transmitted disease refers to any contagious disease transmitted from one person to another during sexual contact. In men, the infection normally involves the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body. ',CAPTION,'Chlamydia Infection in Males');" onmouseout="return nd();">chlamydia
  • peritonititis, an inflammation of the lining of the abdominal cavity, usually caused by an infection
  • urinary tract infection
  • prostate infection, such as acute prostatitis
  • infection of the urethra
  • hernia, a bulging of internal organs or tissues through an abnormal opening in the muscle wall
  • testicular torsion, or twisting of the testicles
  • epididymitis, or inflammation of the tubes that drain the testicles
  • colon cancer
  • diverticulosis, in which small sacs form in the walls of the intestines
  • irritable bowel syndrome, a disorder of the gastrointestinal tract
  • gastroenteritis, an infection in the digestive tract
  • kidney stone
  • abscess, or pus pocket
  • appendicitis, or inflammation of the appendix
  • muscular skeletal disorders, such as a shifting of the pelvic bones
  • psychological factors like stress
  • Other causes are also possible. In some cases, the cause is never found.


    Symptoms & Signs

    What are the signs and symptoms of the condition?

    When a male complains of pelvic pain, the healthcare provider may ask:

  • when did the pain start
  • how long the pain has existed, or when it stopped
  • when and how often does the pain occur
  • what type of pain is it -- dull, sharp, steady, or crampy
  • where is the pain located
  • does anything lessen the pain or make it worse
  • are there any other symptoms, such as fever, fatigue, malaise, nausea, vomiting, changes in bowel movements, or trouble urinating
  • is the man sexually active, and does he use protection such as condoms
  • what medications, drugs, or herbs the man takes, if any
  • is there a history of any other medical problems or surgeries
  • Other questions may also be asked.


    Diagnosis & Tests

    How is the condition diagnosed?

    Diagnosis of pelvic pain begins with a history and physical exam. Tests that may be done include:

  • a urinalysis and urine culture to rule out an infection or kidney stone
  • a complete blood count, or CBC, to help diagnose an infection
  • x-ray imaging, such as ultrasound, CT scan, or MRI scan

  • Prevention & Expectations

    What can be done to prevent the condition?

    Prevention of pelvic pain may or may not be possible, depending on the cause. For example, practicing safer sex may decrease the risk of epididymitis. Early treatment for infection of the genital tract is important in decreasing the risk of pelvic pain.

    What are the long-term effects of the condition?

    Long-term effects are related to the cause of the pelvic pain. For example, irritable bowel syndrome may make a person uncomfortable and even depressed, but poses no serious long-term health risks. A small kidney stone may pass by itself and have no long-term effects. A large kidney stone may require surgery to remove it.

    Appendicitis and cancer may lead to death if treatment is unsuccessful. If untreated, testicular torsion can lead to the loss of the testicle and increase the risk of infertility.

    What are the risks to others?

    Pelvic pain itself is not contagious and poses no risk to others. If the cause is an infection, such as Neisseria gonorrhoeae\ bacteria. The infection is usually acquired through sexual contact. ',CAPTION,'Gonorrhea in Males');" onmouseout="return nd();">gonorrhea, the infection may be contagious.


    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment for pelvic pain depends on the cause of the pain. Treatment may include:

  • antibiotics
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen
  • pain medication
  • surgery
  • relaxation exercises
  • physical therapy
  • What are the side effects of the treatments?

    Side effects of treatments depend on the treatment used for the pelvic pain. There may be stomach upset, diarrhea, or allergic reaction to antibiotics. There may be stomach upset, ulcers and bleeding, or allergic reaction to NSAIDs. Treatments that require surgery pose a risk of bleeding, infection, and allergic reactions to anesthesia.

    What happens after treatment for the condition?

    What happens after treatment depends on the success of the treatment and the cause. For example, a person who passes a kidney stone or has it removed may not need any further treatment. Someone with cancer may need long-term treatment for the cancer and may die if treatment is unsuccessful.

    How is the condition monitored?

    Any new or worsening symptoms should be reported to the healthcare provider. Other monitoring depends on the cause of the pelvic pain.


    Attribution

    Author:Gail Hendrickson, RN, BS
    Date Written:
    Editor:Duff, Ellen, BA
    Edit Date:10/09/00
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:07/05/01

    Sources

    Harrison's Principles of Internal Medicine, Fauci et al, 1998

    The Merck Manual of Medical Information, 1997

    Professional Guide to Diseases, 1998


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