Why does my little brother have bouts of pain?

Paroxysmal genital pain in men may be caused by varicocele, prostatitis, urinary tract infection, testicular torsion, or chronic pelvic pain syndrome. The degree and duration of pain vary from individual to individual, and the cause needs to be determined based on specific symptoms.

1. Varicocele:

Abnormal dilation of the venous plexus in the scrotum may cause intermittent dull pain that worsens after standing for a long time or exerting exertion. Physical examination shows vermiform varicose veins on the scrotal surface, and ultrasound examination can confirm the diagnosis. Mild cases can be relieved by scrotal support, while laparoscopic high spermatic vein ligation should be considered for moderate to severe cases.

2. Prostatitis:

Bacterial or non-bacterial prostatitis can cause radiating pain to the perineum, often accompanied by frequent urination and urgency. Digital rectal examination revealed obvious prostate tenderness, and prostatic fluid examination revealed an increase in leukocytes. Treatment requires the selection of sensitive antibiotics based on the pathogen, combined with warm water sitz baths to relieve symptoms.

3. Urinary tract infection:

Pain caused by urethritis or cystitis is often accompanied by burning sensation during urination, and routine urine examination shows pyuria and bacteriuria. Common pathogenic bacteria include Escherichia coli and Staphylococcus aureus, which can be treated with quinolone antibiotics. At the same time, it is necessary to maintain a daily water intake of more than 2000ml.

4. Testicular torsion:

Sudden severe testicular pain accompanied by scrotal swelling is a urological emergency, which often occurs after strenuous exercise. Color Doppler showed that the testicular blood flow signal was weakened, and surgical reduction and fixation was required within 6 hours to avoid testicular necrosis. Adolescent patients should especially be wary of this disease.

3. Chronic pelvic pain:

Pelvic discomfort that lasts for more than three months may be caused by neuromuscular dysfunction, and the diagnosis needs to be made after ruling out organic diseases. Treatment includes pelvic floor muscle rehabilitation training, low-frequency pulse electrical stimulation and other physical therapies. In severe cases, sacral neuromodulation may be considered.

It is recommended to avoid riding or sitting for long periods of time, and wear loose cotton underwear to maintain local ventilation and dryness. Wash the vulva with warm water every day and reduce the intake of spicy and irritating foods. If the pain lasts for more than 48 hours or is accompanied by fever, hematuria and other symptoms, you should see a urology department immediately. Regular prostate-specific antigen testing and scrotal ultrasound examination can help detect potential lesions early. Men over 40 years old are recommended to complete a urinary system health examination every year.