Right Groin Discomfort: Seeking the Right Specialist

Right groin?

Since last summer, I've been experiencing discomfort on the right side of my body.
Initially, there was pain that is hard to describe, located in the area to the right of my right testicle, the right side of the perineum, and the upper right side of the anus (it started with a feeling of tightness and swelling).
Up to today, I have visited: the Family Medicine Department at Yang Ming Hospital, the Urology Department at Yang Ming Hospital, where I underwent physical examination, urinalysis, and blood tests, and the doctors all said everything was normal (the pain had started by then).
I also went to the Rehabilitation Department and the Orthopedics Department at Yang Ming Hospital (where I had X-rays taken), and the doctors said the X-ray results looked normal (by this point, I had taken countless muscle relaxants but still felt very uncomfortable).
Additionally, I tried numerous acupuncture sessions with Dr.
Zhuo Qingfeng in Chiayi City, who believed the issue stemmed from my lower back (by this time, the pain had diminished).
A general surgeon at St.
Martin's Hospital also thought it was a muscle issue, while a neurologist at St.
Martin's Hospital believed it was internal hemorrhoids (after taking the medication prescribed by this doctor, the pain subsided).
When I returned to the general surgeon at St.
Martin's, he said it wasn't hemorrhoids and prescribed anti-inflammatory pain relief medication related to muscle issues along with Vitamin C.
Up to now, I still feel a sense of swelling, especially after exercising, and the discomfort feels like a muscle knot when I touch it, but this only occurs on the right side, not the left.

Doctor, which specialty should I consult? I have taken many muscle relaxants, and I truly believe this is not a muscle issue.
The uncomfortable area swells after exercise, similar to the feeling of holding back ejaculation during masturbation, but this sensation only occurs on the right side, not the left.
Please, I need some advice; I am really confused, especially since I will be enlisting after graduation.

stu10123, 20~29 year old female. Ask Date: 2012/05/06

Dr. Ke Fangxu reply Surgery

Chronic pain in the perineal area, aside from muscle strain, is more likely to be neuropathic pain.
Older patients may experience chronic pelvic pain, while this type of pain is less common in younger individuals.
In younger patients, chronic pain may be caused by issues related to the sacral nerves, unless repetitive muscle injuries occur due to prolonged activities.
Muscle-related issues are less likely to persist for such a long duration.
Hemorrhoids typically do not cause this type of pain.
Of course, there are limitations to making a diagnosis without a physical examination, but I personally lean towards the belief that the chronic pain is likely due to a neurological issue.
Determining whether this is the true underlying cause may require further investigation.

Reply Date: 2012/05/06

More Info

It sounds like you have been experiencing persistent discomfort in your right groin area, specifically around the right testicle and perineum, for quite some time now. Given the complexity of your symptoms and the various specialists you have consulted, it is understandable that you feel confused and frustrated.
From your description, it appears that you have undergone a thorough evaluation, including visits to family medicine, urology, rehabilitation, orthopedics, and even traditional Chinese medicine. You have had physical examinations, urine tests, blood tests, X-rays, and treatments with muscle relaxants and anti-inflammatory medications. Despite these efforts, you continue to experience a sensation of fullness or pressure, particularly after physical activity, which you describe as a "tight" feeling in the affected area.

The symptoms you describe could potentially be attributed to several conditions, and it is essential to consider a few possibilities:
1. Musculoskeletal Issues: Although you mentioned that you feel this is not a muscle-related problem, muscle tension or strain in the pelvic region can sometimes present as discomfort in the groin or perineum. This could be exacerbated by physical activity. A physical therapist specializing in pelvic floor dysfunction might provide valuable insights and treatment options.

2. Nerve Compression or Irritation: Conditions such as a herniated disc in the lumbar spine can lead to nerve compression, causing referred pain or discomfort in the groin area. A neurologist or a spine specialist could evaluate this possibility through imaging studies like an MRI.

3. Testicular or Epididymal Issues: While you have seen a urologist, it may be worth revisiting this specialist to rule out conditions such as epididymitis, varicocele, or even testicular torsion, which can sometimes present with vague symptoms. A scrotal ultrasound might be beneficial in this case.

4. Inguinal Hernia: An inguinal hernia can cause discomfort in the groin area, especially during physical activity. A general surgeon could perform a physical examination to check for signs of a hernia.

5. Pelvic Floor Dysfunction: This condition can lead to a variety of symptoms, including discomfort in the groin and perineum. A specialist in pelvic floor therapy could provide targeted exercises and treatments to alleviate your symptoms.

6. Psychosomatic Factors: Sometimes, chronic pain can have a psychological component, especially if the discomfort is persistent and has not been resolved through medical interventions. Consulting with a mental health professional who specializes in chronic pain management may also be beneficial.

Given your upcoming military service, it is crucial to address this issue promptly. I recommend returning to a urologist for a comprehensive evaluation, including a detailed history and possibly imaging studies if not already done. If they rule out any urological issues, consider seeking a referral to a physical therapist specializing in pelvic health or a neurologist for further assessment.

In summary, while you have seen multiple specialists, it may be beneficial to focus on a few specific areas: revisiting urology for potential testicular issues, consulting a physical therapist for musculoskeletal concerns, and considering a neurologist for nerve-related issues. Keeping a detailed record of your symptoms, including when they occur and any activities that exacerbate them, can also help your healthcare provider make a more accurate diagnosis.

Similar Q&A

Understanding Right Groin Pain: When to Seek Medical Attention

About a week ago, I started experiencing pain near the right groin close to the genital area (when pressed). Initially, it was a mild pain, but in the last two to three days, the pain has become more pronounced, and the area of discomfort seems to be increasing. The pain also occ...

Dr. Chen Sirong reply Oncology
Pearl Tapioca Girl / 34 years old / Female 1. Which department should I see? A: General Surgery or Obstetrics and Gynecology are both acceptable. 2. Is there any specific issue? A: Please consult a physician in person for a proper evaluation. Thank you for your inquiry. ...

Which Specialist to Consult for Groin Discomfort?

Hello Dr. Hsiao, 1. Three months ago, I started feeling a warm sensation in my left groin, and over the past month, the discomfort has become more pronounced when I squat, accompanied by a prickly, warm feeling. Additionally, I have been experiencing discomfort in my lower back ...

Dr. Xiao Yongxun reply Family Medicine
Dear Miss Xiao Ai, The conditions related to the groin area are generally consistent with the information you have searched for, although there are other possible diagnoses as well. I agree that you should first consult a gynecologist to discuss potential diagnoses; theoretical...

Understanding Groin Pain: Causes and Treatment Options for Relief

Hello Doctor: Recently, for the past two weeks, I have been experiencing sudden pain in my right groin extending to my right buttock, without any known cause such as a fall or collision. The pain feels similar to a muscle strain or a pulled ligament. I consulted an orthopedic doc...

Dr. Xiao Yongxun reply Family Medicine
Dear Mr. Wei: 1. Pain in the groin area can be attributed to various conditions. Common diagnoses include bursitis, tendinitis, myofascial pain syndrome, osteoarthritis, inflammatory arthritis, fractures, tumors, osteonecrosis or avascular necrosis, referred pain, septic arthrit...

Understanding Groin Discomfort: Symptoms and When to Seek Help

Hello Doctor: For the past couple of days, I've been feeling something unusual in my right groin area. It only hurts when I touch it, and it doesn't feel swollen when I palpate it. I don't feel anything unusual while walking, but when I lift my right leg, I feel a ...

Dr. Hong Yuanbin reply Internal Medicine
Hello, the first consideration for the location you described is a hernia. However, based on your age and gender, the incidence should be low. Other possibilities to consider include a muscle strain. I recommend that you consult a urologist. Thank you for your inquiry.