Pain Above the Groin: Possible Causes and Next Steps - Urology

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Understanding pain in the area above the groin can be quite complex, as it may stem from various underlying conditions. Based on your description, it seems you are experiencing discomfort in the suprapubic region, which is the area just above the pubic bone, and you have noted symptoms such as pressure pain when bending, a sensation of fullness, and occasional urinary urgency. Given that you have already consulted with a gastroenterologist and a urologist without a definitive diagnosis, let's explore some potential causes and next steps.


Possible Causes of Your Symptoms
1. Musculoskeletal Issues: Given your prolonged sitting and the nature of your pain, it is possible that you are experiencing a musculoskeletal issue, such as a strain in the abdominal or pelvic muscles. Conditions like myofascial pain syndrome can cause localized pain and discomfort, especially after prolonged periods of inactivity.

2. Interstitial Cystitis (IC): This condition, also known as painful bladder syndrome, can cause chronic pelvic pain, pressure, and urinary symptoms such as urgency and frequency. The discomfort you feel when bending or stretching could be related to bladder irritation.

3. Urinary Tract Issues: Although your urine tests came back negative for infection, conditions like bladder stones or even mild forms of cystitis could still be present. These conditions can lead to discomfort and urinary symptoms.

4. Prostate Issues: In men, prostate conditions such as benign prostatic hyperplasia (BPH) or prostatitis can lead to pelvic discomfort and urinary symptoms. The sensation of your penis and testicles feeling "shrunken" could be related to pelvic tension or discomfort.

5. Gastrointestinal Issues: While you have seen a gastroenterologist, gastrointestinal conditions such as irritable bowel syndrome (IBS) or other functional gastrointestinal disorders could also manifest as abdominal discomfort and bloating.


Next Steps for Evaluation
1. Follow-Up with Urologist: Since you have already seen a urologist, it may be beneficial to return for further evaluation if your symptoms persist. They may consider additional tests such as a cystoscopy, which allows direct visualization of the bladder, or imaging studies like an ultrasound to assess for any abnormalities.

2. Pelvic Floor Assessment: A referral to a physical therapist specializing in pelvic floor dysfunction could be beneficial. They can assess for any muscular imbalances or tension that may be contributing to your symptoms.

3. Consider a Gastroenterologist Re-Evaluation: If gastrointestinal symptoms persist, a follow-up with a gastroenterologist may be warranted. They might suggest further testing, such as an abdominal ultrasound or a colonoscopy, depending on your symptoms.

4. Pain Management: If your pain continues to be bothersome, discussing pain management options with your healthcare provider could be helpful. This may include medications, physical therapy, or alternative therapies such as acupuncture.

5. Lifestyle Modifications: Given your work involves prolonged sitting, consider incorporating regular breaks to stand and stretch. Staying hydrated and avoiding bladder irritants (like caffeine and alcohol) may also help alleviate some urinary symptoms.


Conclusion
Your symptoms warrant further investigation, especially if they persist despite initial treatments. It is essential to maintain open communication with your healthcare providers and advocate for further testing if necessary. Conditions like interstitial cystitis or pelvic floor dysfunction can be challenging to diagnose, but with the right approach, you can find relief and improve your quality of life. Remember to keep track of your symptoms, as this information can be invaluable for your healthcare team in determining the best course of action.