Pubic pain

Pain in the pubic area can be caused by a number of reasons, many of which are not associated with pathologies or injuries. Mons pubis - the so-called pubic tubercle, which is in both men and women. Pubis is located above the genitals and slightly protrudes above the surface of the lower body, as it has a fat layer. The boundaries of the pubic zone are at the top - the pubic sulcus and at the hips - hip furrows. The structure of the pubic tubercle includes both soft tissues and bones, and cartilage. Inside the lower body, under the pubis are two pubic bones, a joint or symphysis, they are connected by a disk consisting of cartilage tissue.

Most often, pain in the pubic area provokes disease, injury or displacement of the bones, the 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 when bruised, hit, or dropped. A possible fracture displaces the bones, pain appears in the pubic area. The pubic bone is the two branches and the body of the bone itself, which forms the zone of the acetabulum located in front. The acetabulum, in turn, consists of the pubis, ilium and sciatic, and serves as a surface for an important hip joint. The branches of the pubic bone are connected by a symphysis. This whole 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 the diagnosis of fractures, they are confirmed by examinations, palpation and X-ray examination.

In addition to the painful sensations that are aggravated by physical activity, especially when walking or exercise on the legs (squats, bending, climbing stairs), urination is disturbed. A characteristic symptom is difficulty in raising the legs in the prone position - a symptom of Gorinev or a symptom of a sticky heel, which is also characteristic of a hip fracture.

If the diagnosis of the fracture of the pubis is confirmed, the therapy consists of an anesthesia stage (injecting painkillers), strict bed rest and placing the leg, from which the fracture of the labial branch is determined, into the Beller splint (for skeletal stretching and muscle unloading). If the fracture is diagnosed as bilateral, the victim is in a typical frog position 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 complex of physical therapy, physiotherapy sessions, symptomatic and vitamin therapy is carried out.

Pain in the pubic area can also be triggered by gynecological pathologies, often developing in a latent form. Endometritis, adnexitis, endometriosis, reaching the acute stage, are often accompanied by pain in the lower abdomen, localized in this place. The 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 exacerbation of a serious illness. In women, pain in this area may indicate the beginning of the process of spontaneous abortion (miscarriage), especially if they are accompanied by bleeding, in men - an exacerbation of prostatitis. 

Pain in the pubic area can be one-sided. No matter the right or left localized pain, they indicate a hidden ovarian tumors or swollen bladder. The nature of the pain depends on the stage in which the disease is located. If the cancer process has just begun its development, the pain can be pulling, weak. If the process becomes inflammatory, the tumor is large, the pain can be sharp, unbearable, accompanied by discharge. 

Ectopic pregnancy, which is a threatening pathology, can also manifest pain in the pubic zone. Pain in the pubic area, just like any other pulling or cramping pain in the lower abdominal part, like atypical discharge, dizziness are alarming signals indicating tubal pregnancy. 

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

Pain in the pubic region, in its lower part, closer to the vulva, may be a sign of congenital pubic bone pathology when it is excessively extended and blocks the entrance to the vagina. Any sexual contact with this pathology provokes severe pain, because the bone presses on the urethral canal. 

Pain in the pubic area may be due to 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. And the bones of the pelvis, and the very pubic joint begin to move apart, providing an opportunity for the development of the fetus. Pathological softening and, accordingly, excessive mobility of the pubic bones in gynecological practice is called a symphysis. Besides the fact that the pubic bone periodically shifts, the soft tissue of the pubis swells noticeably. The symphysitis is externally manifested by a heavy gait, so characteristic of pregnant women (duck gait), difficulty in turning the body, climbing the stairs, and general motor “sluggishness”. Pain in the pubic area becomes unbearable, especially it is strong on palpation. The factors provoking a symphysitis can be calcium deficiency, congenital structural, anatomical anomalies of the pelvic bone system. As a rule, after the birth of a baby, when the body is gradually restored, all signs of the symphysitis subside. 

Symphysis disease is a pathological condition of the pubic bone after childbirth, which is accompanied by pain, fever. This is quite a serious disease that can develop during rapid delivery, when the pubic bones do not just diverge, but break in the place of articulation (symphysis). The reason for the gap can also be a large child and the narrow bones of the pelvis, or their insufficient divergence, “preparation” for the process of childbirth. 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 an exacerbation of chronic prostatitis. Hernia is not limited to pain, it radiates to the lower back or sacrum, sometimes even to the leg. 

Pain in the pubic region can be triggered by chronic osteomyelitis, which enters the inflammatory stage. At the same time, the symphysis (the pubic joint) inflames, the pubic tissues swell dramatically. The symptomatology of osteomyelitis of the pubis is extremely similar to the symptoms of symphysitis, of course, the presence or absence of pregnancy, as well as analytical blood tests and X-rays help to differentiate them.

What if there is pain in the pubic area?

Pain in the pubic region may be acute or chronic, persistent. In case of acute pain, the patient’s condition should be analyzed and, if the pains are accompanied by hyperthermia, general malaise, secretions, an ambulance should be called. If the symptoms manifest themselves in an erased form, you must visit the doctor yourself, be examined and begin treatment.