Post-Urination Groin Pain After Hemorrhoid Banding: Causes and Solutions

Pain in the groin area near the bladder after urination?

Hello Doctor: After undergoing three rubber band ligation procedures for internal hemorrhoids in January, I began to experience a sensation of incomplete bladder emptying after urination, which requires some effort to fully void.
This is accompanied by a dull pain in the bladder and groin area.
A urinary tract infection test came back negative (no infection), and this is a condition I had never experienced prior to the hemorrhoid ligation treatment.
I kindly ask for your guidance.
Thank you.

Mr. Hsu, 20~29 year old female. Ask Date: 2021/03/27

Dr. Cai Zhuorong reply Urology

Bowel movements can indeed affect urination, and many elderly individuals experience urinary issues due to constipation.
This is primarily because the rectum is anatomically close to the prostate.
If symptoms persist, temporary pharmacological treatment may be considered.

Reply Date: 2021/03/27

More Info

Post-urination groin pain after hemorrhoid banding can be concerning, especially when it is a new symptom that arose after the procedure. While hemorrhoid banding primarily targets the rectal area, it is not uncommon for patients to experience referred pain or discomfort in nearby regions, including the groin or bladder area.

Possible Causes
1. Referred Pain: The pelvic region is interconnected, and pain can often be referred from one area to another. The nerves that supply the rectum and the bladder can overlap, leading to sensations of discomfort in the groin area after a procedure that affects the rectum.

2. Pelvic Floor Dysfunction: After hemorrhoid banding, some patients may experience changes in pelvic floor muscle function. This can lead to issues such as pelvic pain or discomfort during urination, especially if there is tension or spasms in the pelvic floor muscles.

3. Bladder Irritation: The act of straining to urinate or feeling residual urine can irritate the bladder. This irritation can manifest as a dull ache in the groin area, particularly if the bladder is not emptying completely.

4. Postoperative Changes: Any surgical procedure can lead to temporary changes in surrounding tissues. Swelling or inflammation in the pelvic region post-surgery could contribute to discomfort during urination.

5. Nerve Irritation: Surgical procedures can sometimes lead to irritation of nearby nerves, which may cause pain or discomfort in areas that are not directly involved in the surgery.

Solutions and Recommendations
1. Pelvic Floor Physical Therapy: Engaging in pelvic floor therapy can help address any dysfunction or tension in the pelvic muscles. A trained physical therapist can provide exercises and techniques to alleviate pain and improve bladder function.

2. Hydration and Diet: Ensure adequate hydration and a diet rich in fiber to prevent constipation, which can exacerbate discomfort in the pelvic region. Avoiding irritants such as caffeine and spicy foods may also help reduce bladder irritation.

3. Warm Compresses: Applying warm compresses to the pelvic area may help soothe discomfort and relax any tense muscles.

4. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain. However, consult with your healthcare provider before starting any medication.

5. Follow-Up with Your Doctor: Since you have already ruled out a urinary tract infection, it is essential to follow up with your healthcare provider. They may consider further evaluation, such as an ultrasound or urodynamic studies, to assess bladder function and rule out any other underlying issues.

6. Monitor Symptoms: Keep track of your symptoms, including the intensity and frequency of the pain, as well as any changes in urination patterns. This information can be helpful for your healthcare provider in determining the next steps.

In conclusion, while post-urination groin pain after hemorrhoid banding can be distressing, it is essential to understand that it may be related to various factors, including referred pain, pelvic floor dysfunction, or postoperative changes. Engaging in pelvic floor therapy, maintaining a healthy diet, and following up with your healthcare provider are crucial steps in addressing this issue. If symptoms persist or worsen, further investigation may be necessary to ensure there are no other underlying conditions contributing to your discomfort.

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