Causes of Suprapubic Pain: A Brief Review
Suprapubic pain is usually caused by various factors such as pelvic floor disorders, cancer, pregnancy or endometriosis. There are many possible causes of suprapubic pain.
1) Vulvar vestibulitis – VVU (vulval vestibular ulceration) is a common cause of suprapubic pain.
It may occur due to vulvar polyp, lichen sclerosus, varicose veins or other conditions.
2) Pelvic inflammatory disease – PID (pelvic inflammatory disease) is one of the most common causes of suprapubic pain.
It may be due to bacterial vaginosis, trichomoniasis or another condition.
3) Herniated disk – HSD (herniation of the disc) is another common cause of suprapubic pain.
It may be due to a herniated disk, bulging vertebrae or other conditions.
4) Kidney disease – Kidney disease is a less common cause of suprapubic pain.
It may be due to an infection such as pyelonephritis, medullary sponge kidney or another condition.
5) Uterine cancer – Uterine cancer is a less common cause of suprapubic pain.
It may be due to endometrial hyperplasia, uterine sarcoma or another condition.
6) Testicular cancer – Testicular cancer is a less common cause of suprapubic pain.
It may be due to seminoma, teratoma or another condition.
7) Bladder cancer – Bladder cancer is a less common cause of suprapubic pain.
It may be due to squamous cell carcinoma, adenocarcinoma or another condition.
8) Ovarian cancer – Ovarian cancer is a less common cause of suprapubic pain.
It may be due to metastatic carcinoid tumor, granulosa cell tumor or another condition.
9) Uterine fibroid tumors – Uterine fibroid tumors are a less common cause of suprapubic pain.
They may be due to endometrial polyps, leiomyomas or other conditions.
10) Uterine sarcoma – Uterine sarcoma is a less common cause of suprapubic pain. It may be due to carcinosarcoma or other condition.
11) Kidney stones – Kidney stones are a less common cause of suprapubic pain. They may be due to calcium oxalate, uric acid or another condition.
12) Endometriosis – Endometriosis is a less common cause of suprapubic pain. It may be due to ovarian cyst, endometrial hyperplasia or another condition.
13) Gallstones – Gallstones are a less common cause of suprapubic pain. They may be due to cholesterol stones, pigment gallstones or another condition.
14) Oophoritis – Oophoritis is a less common cause of suprapubic pain. It may be due to oophoritis, ascending pelvic infection or another condition.
15) Ureteral stone – Ureteral stone is a less common cause of suprapubic pain. It may be due to kidney stones, papillary necrosis or another condition.
16) Urethritis – Urethritis is a less common cause of suprapubic pain. It may be due to infectious cystitis, urethral syndrome or another condition.
17) Carcinoid tumor – Carcinoid tumor is a less common cause of suprapubic pain. It may be due to non-infectious cystitis, papillary necrosis or another condition.
Classification of Suprapubic Pain
Suprapubic pain can be classified based on the duration and other disease characteristics such as associated symptoms and signs. The classifications of the condition include acute or chronic suprapubic pain.
One can also classify suprapubic pain based on its duration.
1) Acute suprapubic pain of less than 6 weeks – Acute suprapubic pain is a condition where you have sudden onset of severe sharp pain in your lower abdomen and/or pubic area.
The pain comes from bladder and/or urethra. This pain is often severe and may be accompanied by nausea, vomiting, fever and chills.
This condition can be caused by a number of conditions such as urinary tract infection, kidney stones, bladder cancer, kidney disease, sexually transmitted diseases, female genital diseases and other conditions. Acute suprapubic pain requires immediate medical attention.
2) Subacute or chronic suprapubic pain of more than 6 weeks – The subacute or chronic condition means that you have ongoing pain in your lower abdomen and/or pubic area for at least 6 weeks.
The pain may or may not be continuous.
3) Pain of unknown duration – Your physician cannot determine if the pain is acute or subacute based on the information you give.
This is most likely because your records are incomplete.
4) Pain of less than 6 weeks – This is pain that comes on suddenly but lasts less than 6 weeks.
Other classifications of suprapubic pain include pain location, associated signs and symptoms and what makes the pain better or worse.
1) Pain in lower abdomen and/or pubic area – The pain is located in your lower abdomen and/or pubic area.
It may or may not be accompanied by pain in your back, nausea, vomiting, fever and chills.
2) Associated signs and symptoms – You may have other symptoms such as bloody urine, burning sensation during urination, blood in urine, pain while having a bowel movement, lumps in your groin or other areas of your body.
3) Better or Worse – The pain may be better with sitting up or lying down.
Or it may be better with rest or activity.
Your physician diagnoses you based on your medical history, physical examination and the results of your tests. The diagnosis may follow a logical pattern.
For example, if you have symptoms of lower urinary tract infection and/or kidney stones, your doctor will diagnose you with acute pyelonephritis and/or left-sided kidney stones.
The diagnostic method may include a combination of the following:
• Medical history – Your doctor will ask you to describe your medical problems, including when they started and how long they have lasted. He may ask you about your family’s medical history and your lifestyle.
He may ask you if you use any medications, street drugs or alcohol. He may also ask you about your diet.
Your doctor may perform a complete physical examination. He may listen to your heart and lungs, and examine your abdomen.
He will look for scars, bruises, wounds or any other marks on your body.
Your doctor will take a urine sample and do a urinalysis. This will help him determine any abnormalities in the appearance of your urine.
In addition, he may also perform blood tests to check for signs of liver or kidney damage.
Imaging tests may be necessary to detect any abnormalities, such as stones in your kidneys or bladder, tumors or scars from prior surgeries. Your doctor may perform an ultrasound, computed tomography (CT) scan, intravenous pyelogram (IVP) or magnetic resonance imaging (MRI).
Your treatment depends on the cause of the pain. In addition to the usual treatment for the specific medical condition causing your pain, you may also need to seek treatment for any underlying psychological issues.
For example, if you are prone to anxiety attacks and have a fear of developing a serious illness, this may be causing your symptoms. Your doctor may refer you to a psychiatrist who can prescribe medications or other treatments to help you cope with your anxiety.
Acute complications of kidney stones or a kidney infection may require hospitalization. Your physician may place a narrow flexible tube, called a nephroscopy or cystoscopy, into your urethra to pass through your bladder and examine your bladder and urinary tract for stones or tumors.
Or he may use a scope passed through your urethra and into your rectum to examine your kidneys and ureters. If you have a stone stuck in your urinary tract, he may try to break it up with ultrasound or laser beams. If a stone is still stuck after this procedure, your doctor may decide to perform a procedure called a percutaneous nephrolithotomy. For this, he makes a small cut in your back and passes a specialized scope with a grasper device through your skin into your kidney to remove the stone. If you have an infection, your doctor may open your bladder to allow better drainage and healing of the urinary tract.
If you have a more serious kidney infection or your symptoms do not improve with treatment, your doctor may recommend surgery to remove your infected kidney. If you already have only one kidney, you will need to take special precautions to prevent infection in the remaining one.
If you have an underlying condition causing your kidney stones, such as hyperparathyroidism or cystic diseases of the kidneys, you may need to undergo treatment for that condition.
The medical term for pain in the kidney area is renal colic. Renal comes from the word “renal” which means to do with the kidneys.
Colic is from the old Greek word “koleos” which means “suffering.”
To prevent kidney stones:
Drink plenty of fluids. The type of fluid is not as important as just making sure you get enough.
Eat a high-fiber diet. This helps prevent constipation, which can lead to the formation of kidney stones.
Limit your intake of animal protein. Animal protein increases the concentration of waste products in your urine, which could contribute to the formation of kidney stones.
If you take vitamin or mineral supplements, choose those that contain magnesium rather than calcium. Taking too much calcium increases your risk of developing kidney stones.
Take any prescribed medicine exactly as your doctor has instructed.
Everything in Moderation
In healthy people, the kidneys maintain the right concentration of substances such as sodium, potassium, and oxalate in the blood. Changes in diet, infections, and some medical conditions may cause the levels of these substances to rise or fall outside of the normal range.
If high levels of oxalate and other substances called phosphate binders are present in your urine, this can also increase your risk of developing stones.
Your doctor may ask you to change the amount of food you eat. He may also recommend ways for you to limit your fluid intake, especially if you tend to form calcium-containing stones.
But if you cut back on your fluid intake, it is very important to drink enough fluids to avoid becoming dehydrated.
Some people are more likely than others to develop kidney stones. If either or both of your parents had a history of kidney stones, you may also be at risk.
The same is true if you are over the age of 40 and have experienced recurrent attacks of urinary tract infections.
Listed below are some factors that may contribute to the formation of stones in the kidneys:
Dehydration. It is important to drink enough fluids each day to prevent dehydration.
Dehydration is a risk factor, since it increases the concentration of substances in your urine, which may contribute to the formation of stones. Additionally, decreased urinary output also means that acidic urine remains in the bladder for longer periods of time, which can increase your risk of developing certain types of stones.
Food additives. People who eat a lot of food with certain types of artificial coloring have a higher risk of developing kidney stones.
Some studies show that drinking lots of soda also increases your risk. This may be because the phosphoric acid and high levels of sugar in many sodas can cause an increase in the levels of phosphate in the urine, which is a potential risk factor for the formation of certain types of stones.
Excess animal protein. High protein consumption may increase the amount of calcium and oxalate in the urine.
Excess dietary potassium. Some studies have found that people who consume more potassium have a lower risk of developing stones, while other studies suggest that high amounts of potassium increase the risk.
High levels of potassium can contribute to elevated calcium levels in the urine, which may contribute to the formation of stones.
Excess alcohol. Drinking too much alcohol on a regular basis can raise your risk of developing stones.
Besides increasing the amount of uric acid in the urine, alcohol consumption can also dehydrate you, which can lead to increased calcium levels in the urine.
Excess vitamin C. Studies suggest that people who consume large amounts of vitamin C on a regular basis have an increased risk of developing kidney stones.
Although the reason for this link is not yet entirely clear, it may be due to high levels of oxalate in the urine.
Obesity. Being overweight can place excess pressure on your kidneys, which may contribute to an increased risk of developing kidney stones.
Diabetes. People who have diabetes are more likely to develop stones than people who don’t have this condition.
Diabetes may cause kidney damage that contributes to the development of stones, and it may also increase the risk of forming stones due to other, as-yet unknown, factors.
Family history. If kidney stones run in your family, you are more likely to develop them yourself.
Kidney disease. People who suffer from chronic kidney disease are more likely to develop kidney stones.
This may be due to the fact that such people tend to produce larger quantities of certain types of stones, such as calcium stones, than people with healthy kidneys.
If you have had recurring attacks of kidney stones in the past, your doctor may recommend various preventive measures that you can take on a daily basis to reduce your risk of future attacks. These may include:
Drinking lots of water every day.
Cutting down on your salt intake. Most experts recommend restricting your daily salt intake to no more than 2,000 milligrams (1 teaspoon), although some may recommend lower amounts.
Check food labels to see how much salt is in the foods that you eat. Try cutting down on processed and prepared foods, since these tend to contain higher levels of sodium than home-prepared foods.
Eating a diet rich in calcium. Foods that contain high levels of calcium include dairy products, dark green vegetables, soybeans and rhubarb.
Talk to your doctor about how much calcium you need and how to make sure you get enough in your diet. Calcium supplements are also available at most drugstores.
Taking vitamin D supplements. This vitamin helps the body to absorb calcium, which reduces the likelihood of developing kidney stones.
Most doctors recommend a daily supplement of 400 IU of vitamin D3.
Cut down on the amount of meat that you eat. People who eat large quantities of meat (especially red meat), tend to develop more kidney stones.
Try substituting some vegetarian meals for meat meals throughout the week.
Cutting down on the amount of sugar-sweetened beverages you drink. Sugar contributes to an increase in urinary acid, and people who consume large quantities of sugar-sweetened beverages have been found to have a higher risk of stone formation.
These drinks include sodas (both regular and diet), fruit punches, lemonade and many other drinks you might not consider “soda” or “fruit punch.”
Drinking six to eight glasses of liquid per day, but no more. Some people believe that drinking excessive amounts of liquid helps prevent kidney stones from forming.
While it is true that it’s better to drink excessive amounts of liquids than not enough, there is no evidence that people who drink excessively have a lower risk of stone formation.
Scheduling an appointment with a urologist. A urologist is a doctor who specializes in the urinary tract and male reproductive system.