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Abdominal pain in men

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction There are many factors that cause small abdominal pain in men, and most are related to inflammation associated with the male reproductive system. The prostate is located at the bottom of the pelvis, with the bladder above it, the urethra below, the pubis in the front, and the rectum in the back. The doctor can touch the prostate forward during the rectal examination. The left and right sides of the prostate are fixed by a number of ligaments and fascia, which determine the hidden features of its position. Located below the bladder neck, surrounding the bladder mouth and the urethra, this part of the urethra is therefore called the "urethral prostate", which means that the duct formed in the middle of the prostate constitutes the upper part of the urethra. It can be said that the prostate is guarding the upper urethra, and the reason why the prostate is ill in the first place is affected.

Cause

Cause

First, small abdominal pain after sex

After sexual life, abdominal pain is usually caused by inflammatory infections of the genitourinary system such as: chronic prostatitis, epididymitis, orchitis, and varicocele can also be triggered. According to your situation, you can go to the Department of Reproductive Infections and conduct a related examination under the guidance of a doctor to confirm the diagnosis and targeted treatment. This symptom is more common in patients with chronic prostatitis, so a detailed examination of the prostate can be performed. Also pay attention to regular life.

Second, prostate pain

In recent years, doctors have found that patients with chronic prostatitis symptoms are very difficult to diagnose and treat. Their urine and prostatic fluid culture can not find bacteria, prostatic fluid can not see pus cells and white blood cells under the microscope, but there are different degrees of frequent urination, urgency and dysuria, especially perineum and scrotum pain, some people even sit It hurts.

Some doctors have carefully examined and studied these patients and found that the patient does not have prostatitis, but is similar to the urethral muscles, prostate muscles, or muscle spasm of the perineum and pelvic floor. Discomfort of chronic prostatitis. When doing anal finger examination for such patients, the prostate palpation is normal and there is no tenderness, but the levator ani muscles on both sides of the anus have obvious tenderness. Therefore, clinicians named this disease prostate pain.

The treatment of prostate pain is more difficult. First of all, it is difficult to diagnose the diagnosis. It often takes several times for prostatic fluid microscopy and culture to find abnormalities to diagnose. Therefore, in general, patients often have normal prostate due to symptoms similar to chronic prostatitis. Inflammation treatment, the effect is naturally poor. Third, acute abdominal pain

Refers to the patient's sudden abdominal pain, often caused by intra-abdominal or extra-abdominal organ diseases, the former is called visceral abdominal pain, often paroxysmal with a series of related symptoms such as nausea, vomiting and sweating, abdominal pain by Visceral nerve conduction; while the latter abdominal pain is transmitted by the somatic nerves, so it is called somatic abdominal pain, often persistent, mostly without nausea and vomiting symptoms.

Fourth, urinary system stones

Urinary system stones in addition to typical lumbar abdominal cramps and nausea and vomiting, the majority of patients may have dysuria, dysuria and other symptoms, the pain often from the waist to the ipsilateral groin or perineal reflex, more common in male patients. It is worth noting that the right ureteral calculi are sometimes difficult to distinguish from acute appendicitis, because the former can also exhibit persistent right lower abdominal pain, and there is local tenderness and rebound tenderness, but usually no fever. In addition to the waist and abdomen pain, the patient often has fever and chills. The ribs and lower abdomen may have tenderness, and the tenderness is deep. There is little rebound pain. Usually there is urinary tract irritation. ball.

Examine

an examination

Related inspection

Abdominal plain film

More common are chronic prostatitis, seminal vesiculitis and so on.

The pain of chronic prostatitis is not limited to the urethra and perineum, but also radiates to the vicinity, with abdominal pain, lower abdomen, and low back pain. In addition, the penis, spermatic cord, testicular scrotum, lower abdomen, groin area (thigh root), thigh, rectum, etc. can be affected. It should be pointed out that the low back pain caused by chronic prostatitis is in the lower back, and it is easy to be confused with orthopedic causes of low back pain such as myofascial inflammation and lumbar muscle strain, but the latter is mostly near the belt, which is lower than the location of lupus caused by prostatitis. High, can be identified.

Seminal vesiculitis: Acute abdominal pain can be seen and involves the perineum and bilateral groin. In chronic cases, there may be pain in the suprapubic area and accompanying genital discomfort. Pain symptoms are significantly exacerbated during ejaculation. Some men will have penis and abdominal pain after sexual intercourse. First of all, you don't have to be afraid. This is a normal phenomenon. The penis is hyperemia after erection, and some men have weaker blood return function, resulting in higher penis and lower abdomen after sexual intercourse. It hurts (usually lasts 1 to 3 hours), which is not a big problem.

Common male genital infections are mainly "five inflammations", namely orchitis, urethritis, prostatitis, non-bacterial prostate, epididymitis.

1, orchitis: caused by a variety of pathogenic bacteria and viruses through the blood, lymphatic vessels and vas deferens or epididymal infection, of which orchitis caused by mumps is the most common. Mumps is an acute infectious disease caused by a virus. It is easy to develop orchitis after mumps in adults. In the acute phase, the patient presents with redness and swelling of the scrotal skin and a significant bulging sensation when walking. If it is not treated properly in the acute phase, it can be converted to chronic orchitis.

2, epididymitis: due to urethral stricture, benign prostatic hyperplasia, urethritis and tuberculosis and gonorrhea, caused by retrograde spread. The epididymis is closely attached to the posterolateral side of the testicle. It consists of an epididymis tube that is bent back. It has an important role in promoting sperm maturation, storing sperm and absorbing sperm. Therefore, the epididymis may cause infertility when there is lesion. Symptoms manifested in the acute phase are swelling and pain of the scrotum, which can involve the lower abdomen and the roots of the thighs, and it is inconvenient to walk. In the acute phase, the treatment can be converted to chronic epididymitis, so the treatment in the acute phase must be thorough.

3, prostatitis: caused by the direct spread of urethritis, or other tissues and organs acute inflammation caused by blood and lymphatic infection, is a common disease in young and middle-aged men. Acute prostatitis is anxious, mostly manifested as general weakness, waist pain, perineal and anal discomfort, accompanied by dysuria, frequent urination, urgency, and even hematuria. Some people have decreased sexual desire, premature ejaculation or impotence.

4, non-bacterial prostatitis: frequent urination, urgency, sexual dysfunction and other symptoms, but laboratory tests can not find bacteria. Mainly due to excessive sexual life, sexual excitement for too long or due to factors such as cycling, horse riding and pelvic congestion.

5, urethritis: multiple retrograde infection, that is, the bacteria directly invade the urethra. In the acute phase, the patient presented with urethral mucosal congestion, edema, or ulceration, urethral redness, mucus or purulent secretion, urethral tenderness and hardening; severe cases may affect epididymis and spermatic cord.

Diagnosis

Differential diagnosis

Differential diagnosis of male abdominal pain

(1) Severe episodes of severe pain in the upper abdomen after eating and drinking, should consider perforation of the stomach and duodenum.

(2) Paroxysmal cramps in the right upper quadrant are radiated to the right shoulder, mostly cholecystitis and cholelithiasis.

(3) Severe abdominal pain in the upper abdomen of the upper abdomen, accompanied by vomiting, pain, persistent pain, paroxysmal aggravation, radiation to the lateral waist, acute pancreatitis should be considered.

(4) began to pain in the upper abdomen, a few hours later transferred to the right lower quadrant pain, accompanied by nausea, vomiting, mostly acute appendicitis.

(5) Paroxysmal cramps in the flank or lower abdomen, radiated to the lower back, perineum, accompanied by frequent urination, hematuria for ureteral stones.

(6) Abdominal pain with diarrhea, infectious diseases such as enteritis, dysentery, and paracholera should be considered.

(7) Sustained abdominal pain with vomiting may be intestinal obstruction.

(8) There is no prostatitis, but urinary tract muscles, prostate muscles, or discomfort similar to chronic prostatitis caused by muscle spasm of the perineum and pelvic floor. When doing anal finger examination for such patients, the prostate palpation is normal and there is no tenderness, but the levator ani muscles on both sides of the anus have obvious tenderness. It can be judged that this is prostate pain.

More common are chronic prostatitis, seminal vesiculitis and so on. The pain of chronic prostatitis is not limited to the urethra and perineum, but also radiates to the vicinity, with abdominal pain, lower abdomen, and low back pain. In addition, the penis, spermatic cord, testicular scrotum, lower abdomen, groin area (thigh root), thigh, rectum, etc. can be affected. It should be pointed out that the low back pain caused by chronic prostatitis is in the lower back, and it is easy to be confused with orthopedic causes of low back pain such as myofascial inflammation and lumbar muscle strain, but the latter is mostly near the belt, which is lower than the location of lupus caused by prostatitis. High, can be identified. Seminal vesiculitis: Acute abdominal pain can be seen and involves the perineum and bilateral groin. In chronic cases, there may be pain in the suprapubic area and accompanying genital discomfort. Pain symptoms are significantly exacerbated during ejaculation.

Some men will have penis and abdominal pain after sexual intercourse. First of all, you don't have to be afraid. This is a normal phenomenon. The penis is hyperemia after erection, and some men have weaker blood return function, resulting in higher penis and lower abdomen after sexual intercourse. It hurts (usually lasts 1 to 3 hours), which is not a big problem.