Perineal pain

Alternative names 
Pain - groin; Lower abdominal pain; Genital pain; Groin pain

Considerations
The area where the abdomen ends and the legs begin is called the groin. For males, the terms “groin” and “testicle” are sometimes used interchangeably. But what causes pain in one won’t necessarily do so in the other.

Common Causes

     
  • Hernia       o Occurs when the local support tissues weaken, allowing loops of the bowel to slip from the abdomen into the groin       o Usually, but not always, seen as a bulge when standing upright, coughing, or bearing down (see groin lump)  
  • Enlarged lymph glands  
  • Testicular torsion  
  • Kidney stone  
  • Orchitis, infection/inflammation of the testicle  
  • Epididymitis, infection/inflammation of the epididymis  
  • Inflammation of the inguinal ligament  
  • Testicular tumor  
  • Superficial skin infection

Home Care
Home care depends on the cause. Follow your health care provider’s recommendations.

     
  • For groin pain caused by a hernia, a compression belt may help, surgery may be recommended in some cases.  
  • For groin pain caused by enlarged lymph glands, appropriate treatment will depend on the cause.  
  • For groin pain caused by a kidney stone, medical or surgical management may be required if the stone does not pass without intervention.  
  • Groin pain caused by orchitis and epididymitis can often be treated with oral antibiotics and anti-inflammatory medication.

Call your health care provider if

     
  • There is any persistent and unexplained groin pain, particularly if it is a burning pain.  
  • There is blood in the urine.  
  • There is pain isolated to one testicle for more than 3 hours.  
  • Any physical changes have occurred in the area (i.e., testicular mass or skin discoloration)

What to expect at your health care provider’s office
The medical history will be obtained, and a physical examination performed.

Medical history questions documenting groin pain in detail may include:

     
  • Has there been any injury recently?  
  • Has there been a change in activity, especially a recent strain, heavy lifting, or similar activity?  
  • When did it develop?  
  • Is it increasing?  
  • Is it always present?  
  • What other symptoms are also present? Is there a groin lump, pain in the groin, fever, swollen glands anywhere else in the body, blood in the urine, or other symptoms?  
  • Have you been exposed to any sexually transmitted diseases?

The physical examination will include examination of the groin area. A hidden hernia can be found by inserting one finger into the scrotal sac in men while asking the patient to cough. Coughing raises the pressure in the abdomen and pushes the loop of bowel into the hernia opening.

DIAGNOSTIC TESTS that may be performed include:

     
  • Urinalysis  
  • Routine blood tests such as a CBC or blood differential  
  • Ultrasound or other radiologic exam

If a diagnosis was made by your health care provider related to groin pain, you may want to note that diagnosis in your personal medical record.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

Medical Encyclopedia

  A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 0-9

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.