Pelvic pain refers to any pain or discomfort in the lower abdomen.
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.
When a male complains of pelvic pain, the healthcare professional may ask: when did the pain starthow long the pain has existed, or when it stoppedwhen and how often does the pain occurwhat type of pain is it -- dull, sharp, steady, or crampywhere is the pain locateddoes anything lessen the pain or make it worseare there any other symptoms, such as fever, fatigue, malaise, nausea, vomiting, changes in bowel movements, or trouble urinatingis the man sexually active, and does he use protection such as condomswhat medications, drugs, or herbs the man takes, if anyis there a history of any other medical problems or surgeries
Other questions may also be asked, depending on the history and physical findings.
Pelvic pain in males has many causes, including: pelvic adhesions, which are fibrous bands that hold together parts that are usually separatesexually transmitted infections, such as gonorrhea or chlamydia peritonitis, an inflammation of the lining of the abdominal cavity, usually caused by an infectionurinary tract infection prostate inflammation or infection, such as acute prostatitis infection of the urethrahernia, a bulging of internal organs or tissues through an abnormal opening in the muscle walltesticular torsion, that is, twisting of the testiclesepididymitis, that is, inflammation of the tubes that drain the testiclescolon cancer diverticulosis, in which small sacs form in the walls of the intestinesirritable bowel syndrome, a disorder of the gastrointestinal tractgastroenteritis, that is, infection in the digestive tractkidney stone abscess, or pus pocketappendicitis, the inflammation of the appendixmuscular skeletal disorders, such as a shifting of the pelvic bonespsychological factors like stress
Other causes are also possible. In some cases, the cause is never found.
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.
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 stonea complete blood count, or CBC, to help diagnose an infectionx-ray imaging, such as ultrasound, CT scan, or MRI scan
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.
Pelvic pain itself is not contagious and poses no risk to others. If the cause is an infection, such as gonorrhea, the infection may be contagious.
Treatment for pelvic pain depends on the cause of the pain. Treatment may include: antibioticsnonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (i.e., Advil, Motrin) or naproxen (i.e., Naprosyn, Aleve, Anaprox, Naprelan)pain medicationsurgeryrelaxation exercisesphysical therapy
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. Surgery can be complicated by bleeding, infection, and reactions to anesthesia.
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.
Any new or worsening symptoms should be reported to the healthcare professional. Other monitoring depends on the cause of the pelvic pain.
Harrison's Principles of Internal Medicine, Fauci et al, 1998
The Merck Manual of Medical Information, 1997
Professional Guide to Diseases, 1998