Lower Left Abdominal Pain: Causes and Next Steps - Urology

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Understanding lower left abdominal pain can be quite complex, especially when there is a history of surgical procedures such as varicocele repair. In your case, the pain localized around the inguinal area, particularly near the surgical scar from 20 years ago, raises several considerations.

Firstly, it is indeed possible for adhesions to develop after any abdominal surgery, including varicocele repair. Adhesions are bands of scar tissue that can form between abdominal tissues and organs, leading to pain or discomfort, especially during movement or certain positions. However, the likelihood of adhesions causing pain can vary significantly from person to person, and not all patients who undergo surgery will experience this complication.

Given that you have already undergone a thorough evaluation, including a colonoscopy and ultrasound of the bladder, and that these tests returned normal results, it is essential to consider other potential causes of your symptoms. The fact that you experience pain when standing up, bending, or moving suggests that the issue may not solely be related to the internal organs but could also involve the musculoskeletal system.

Muscle strain or injury is a common cause of localized abdominal pain, particularly if the pain worsens with certain movements or positions. The pain you describe when sitting and then standing could indicate a strain in the abdominal or pelvic muscles, particularly if you have been engaging in activities that might have overexerted these muscles. Additionally, conditions such as hernias, even if previously ruled out, can sometimes present with similar symptoms, especially if there is a history of surgical intervention in the area.

Since your symptoms have persisted for over three months without significant improvement, it may be beneficial to pursue further diagnostic imaging, such as a CT scan or MRI of the abdomen and pelvis. These imaging modalities can provide a more detailed view of the abdominal structures and may help identify any adhesions, hernias, or other potential sources of pain that were not visible on previous tests.

Moreover, consulting with a specialist in pain management or a physical therapist could also be advantageous. A physical therapist can assess your movement patterns and provide exercises to strengthen the abdominal and pelvic muscles, potentially alleviating pain associated with muscle strain or weakness. They can also guide you through stretches and techniques to improve your posture and reduce discomfort when transitioning from sitting to standing.

In summary, while adhesions from your previous surgery could be a contributing factor to your left lower abdominal pain, it is essential to explore all potential causes, including musculoskeletal issues. Further imaging studies and consultations with specialists may provide additional insights and lead to a more effective treatment plan. It is crucial to communicate openly with your healthcare providers about your ongoing symptoms and any changes you experience, as this will help guide the diagnostic process and ensure that you receive appropriate care.