Hello and thank for your enquiry,

It is good to hear that you have been well since your 2024 diagnosis, and that your PSA remains stable at 4 with a normal urine flow test. Because you are managing low-grade (grade 1) prostate cancer, your new symptoms of lower abdominal and testicular pain mean you should contact your hospital urologist or GP promptly to have these changes evaluated. While your stable PSA is good, a medical doctor must investigate any new pain to ensure your cancer has not changed and to rule out other treatable causes.

Possible medical explanations might include, Prostatitis or Epididymitis which is an inflammation or mild infection of the prostate gland or the tubes surrounding the testicles can cause a dull, radiating ache in both the lower abdomen and the scrotum. This pain often changes based on physical positioning and pelvic pressure.

A muscle strain in the pelvic floor, a hidden inguinal hernia, or a compressed nerve in the lower back/pelvis can cause referred pain to the testicles. Lying down can sometimes alter pelvic alignment or increase pressure on specific nerves, mimicking urological pain. Sometimes bowel discomfort and pressure, such as chronic constipation or trapped gas, frequently refers pain directly down into the groin and testicles. Walking helps move the digestive tract, which might explain why your "burden" decreases when you are up and moving.

I hope that this helps, and you get help with this soon,

Best wishes,

Vanda