Pain in the pubic area

Pain in the pubic area can be caused by a number of reasons, many of which are not related to pathologies or injuries. Mons pubis is the name of the pubic tubercle, which is present in both men and women. The pubis is located above the genitals and protrudes slightly above the surface of the lower part of the body, as it has a fat layer. The boundaries of the pubic area are at the top - the pubic groove and at the hips - the hip grooves. The structure of the pubic tubercle includes both soft tissues and bones and cartilage. Inside the lower part of the body, under the pubic area, there are two pubic bones, an articulation or symphysis, they are connected by a disc consisting of cartilaginous tissue.

Most often, pain in the pubic area is caused by diseases, trauma or bone displacement; soft tissues of the pubis are damaged much less often.

[ 1 ], [ 2 ]

What causes pain in the pubic area?

Traumatic injury to the pubic bones due to a bruise, blow or fall. A possible fracture displaces the bones, causing pain in the pubic area. The pubic bone is two branches and the body of the bone itself, which forms the area of the acetabulum, located in front. The acetabulum, in turn, consists of the pubic bone, ilium and ischium and serves as a surface for the important hip joint. The branches of the pubic bone are connected by a symphysis. This entire complex structure is quite vulnerable and a strong blow can provoke a displacement or fracture of bone tissue. Pain in the pubic area is not specific for diagnosing fractures; they are confirmed by examinations, palpation and X-ray examination.

In addition to painful sensations that increase with physical activity, especially when walking or physical load on the legs (squatting, bending, climbing stairs), the process of urination is disrupted. A characteristic symptom is difficulty in raising the legs in a lying position - Gorinevskaya's symptom or the symptom of a stuck heel, also characteristic of a fracture of the femoral neck.

If the diagnosis of a pubic bone fracture is confirmed, the therapy consists of an anesthesia stage (injection of painkillers), strict bed rest and placing the leg on the side of which the pubic branch fracture is determined in a Beller splint (for skeletal traction and muscle unloading). If the fracture is diagnosed as bilateral, the victim is in a characteristic "frog" pose for four to five weeks, when the legs are bent, and the knees are moved to the sides, the feet touch each other. The patient is placed on a special orthopedic bed to avoid possible risks of bedsores. During hospitalization, a set of therapeutic exercises, physiotherapy sessions, symptomatic and vitamin therapy are carried out.

Pain in the pubic area can also be caused by gynecological pathologies, often developing in a latent form. Endometritis, adnexitis, endometriosis, reaching the stage of exacerbation, are often accompanied by pain in the lower abdomen, localized in this place. Pain in these diseases is almost never intense, it has a pulling, aching character with irradiation to the groin.

Severe pain in both men and women is a sign of an exacerbation of a serious disease. In women, pain in this area may indicate the onset of a spontaneous abortion (miscarriage), especially if accompanied by bleeding; in men, it is an exacerbation of prostatitis.

Pain in the pubic area can be one-sided. It does not matter whether the painful sensations are localized on the right or left, they indicate hidden ovarian neoplasms or bladder swelling. The nature of the pain depends on the stage of the disease. If the oncological process has just begun to develop, the pain can be pulling, weak. If the process becomes inflammatory, the neoplasms are large, the pain can be sharp, unbearable, accompanied by discharge.

An ectopic pregnancy, which is a threatening pathology, can also manifest itself as pain in the pubic area. Pain in the pubic area, as well as any other pulling or cramping pain in the lower abdominal area, as atypical discharge, dizziness are alarming signals indicating a tubal pregnancy.

Acute, intense pain in the pubic area, which is combined with bleeding, discharge after sexual contact may indicate torsion of the ovarian cyst stalk or rupture of the neoplasm. Rupture of the cyst has characteristic symptoms, which include dizziness, a drop in blood pressure, and a feverish state.

Pain in the pubic area, in its lower part, closer to the vulva, can be a sign of a congenital pathology of the pubic bone, when it is excessively elongated and blocks the entrance to the vagina. Any sexual contact with such a pathology provokes severe pain, since the bone presses on the urethral canal.

Pain in the pubic area may be associated with normal physiological causes during pregnancy. In addition to changes in the hormonal system, the pelvic bones begin to soften slightly, preparing for childbirth. This process occurs slowly, under the influence of a specific hormone called relaxin. Both the pelvic bones and the pubic symphysis itself begin to move apart, allowing the fetus to develop. Pathological softening and, accordingly, excessive mobility of the pubic bones in gynecological practice is called symphysitis. In addition to the fact that the pubic bone periodically shifts, the soft tissues of the pubis noticeably swell. Symphysitis is externally manifested by a heavy gait, so typical for pregnant women (duck gait), difficulty in turning the body, climbing stairs and general motor "clumsiness". Pain in the pubic area becomes unbearable, it is especially strong upon palpation. Factors that provoke symphysitis may be calcium deficiency, congenital structural, anatomical anomalies of the pelvic bone system. As a rule, after the birth of the baby, when the body gradually recovers, all signs of symphysitis subside.

Symphysioliosis is a pathological condition of the pubic bone after childbirth, which is accompanied by pain and fever. This is a fairly severe disease that can develop during rapid labor, when the pubic bones do not simply diverge, but rupture at the joint (symphysis). The cause of the rupture can also be a large child and narrow pelvic bones or insufficient divergence, "preparation" for the birth process. Treatment consists of local anesthesia, bed rest, usually a special fixing bandage is put on the pelvic bones.

Pain in the pubic area can also occur in men, most often due to the development of an inguinal hernia or exacerbation of chronic prostatitis. The hernia is not limited to pain, it radiates to the lower back or sacrum, sometimes even to the leg.

Pain in the pubic area can be caused by chronic osteomyelitis, which passes into the inflammatory stage. In this case, the symphysis (pubic symphysis) becomes inflamed, and the pubic tissues swell greatly. The symptoms of osteomyelitis of the pubic bone are extremely similar to the signs of symphysitis, of course, the presence or absence of pregnancy, as well as blood tests and X-rays help differentiate them.

What to do if you experience pain in the pubic area?

Pain in the pubic area can be acute or chronic, constant. In case of acute pain, the patient's condition should be analyzed and, if the pain is accompanied by hyperthermia, general malaise, discharge, an ambulance should be called. If the symptoms are latent, it is necessary to visit a doctor yourself, undergo an examination and begin treatment.