Perineal Pain: Causes & Reasons

Possible Causes for Perineal Pain

Clinical findings Pain at the base of the penis, perineal and perianal, urgency, burning with urination, fever, malaise, penile discharge; other findings include chills, painful [medical-dictionary.thefreedictionary.com]

In one report, of 600 men diagnosed with prostatitis, 5% had bacterial prostatitis, 64% had nonbacterial prostatitis, and 31% had pelvic-perineal pain syndrome or prostatodynia [emedicine.com]

pain, or irritation with micturition or ejaculation. [med-ed.virginia.edu]

Chronic Prostatitis

Perineal pain Lower Abdominal Pain Scrotal Pain Pain in penis Pain in inner thighs Absent Symptoms (Contrast with Acute Prostatitis ) Systemic symptoms rare Obstructive urinary [fpnotebook.com]

Symptoms can include: Perineal discomfort Pain with ejaculation Lower back discomfort Orchalgia Urinary frequency Difficulty initiating a urine stream Burning with urination [smithinstituteforurology.com]

Symptoms (sudden onset) Irritative urinary symptoms (Mild to Moderate) Dysuria Urinary Frequency Urinary urgency Ejaculatory pain Hematospermia Referred pain Low pack pain [fpnotebook.com]

Prostatic Abscess

Symptoms Common symptoms include Urinary frequency Dysuria Urinary retention Perineal pain, evidence of acute epididymitis, hematuria, and a purulent urethral discharge are [merckmanuals.com]

Symptoms of Prostate Abscess Common symptoms include Urinary frequency Dysuria Urinary retention Perineal pain, evidence of acute epididymitis, hematuria, and a purulent urethral [msdmanuals.com]

Diagnosis Prostate ultrasonography and possibly cystoscopy Abscess is suspected in patients with persistent perineal pain and continued or recurrent UTIs despite antimicrobial [merckmanuals.com]

Osteitis Pubis

The presentation is typical with varying degrees of pelvic and/or perineal pain, reproduced on hip adduction. [radiopaedia.org]

This pain may occur in the perineal, testicular, suprapubic or inguinal areas. Patients may also experience postejaculatory scrotal or perineal pain. [aafp.org]

It may cause pain localized to the pubic, groin or abdominal areas. The patient may experience pain with activity. [aafp.org]

Seminal Vesiculitis

Haematospermia and lower abdominal (or perineal) pain and discomfort are the most common clinical manifestations. [journals.sagepub.com]

Symptoms of seminal vesiculitis can include vague back or lower abdominal pain; penile, scrotal, or perineal pain; irritative and obstructive voiding symptoms or impotence [streetarticles.com]

Symptoms of seminal vesiculitis can include vague back or lower abdominal pain; penile, scrotal, or perineal pain; painful ejaculation; hematospermia ; irritative and obstructive [en.wikipedia.org]

Trichomonas Prostatitis

[…] or painful urination Perineal pain Joint and muscle pain Blood in urine Painful ejaculation Infection of Prostate The home treatment for prostatitis fights against infection [prostatitischina.com]

Perineal or pelvic pain, Cloudy urine - VERY tender prostate - Enlarged, firm, warm prostate What defines chronic prostatitis Prostatitis > 3 mo (May exist for several years [quizlet.com]

He complained of urethral discharge, dysuria and a recent onset of perineal and ejaculatory pain. [ncbi.nlm.nih.gov]

Rectal Trauma

Rectal analgesia for pain from perineal trauma following childbirth Rectal suppositories give short‐term pain relief for perineal trauma after childbirth. [cochranelibrary.com]

Persistent pain and discomfort from perineal trauma may also cause urinary retention and defecation problems. [mdedge.com]

2013/6/3/213/115350 A 38-year-old male presented to emergency department complaining of rectal bleeding accompanied by dull pelvic and perineal pain. [onlinejets.org]

Perineal Fistula

On day 4 after admission, however, fever and perineal pain recurred, and the patient developed signs of septicaemia. Physical examination revealed a penile oedema. [nature.com]

pain. [dovepress.com]

Pain medications, stool softeners and E-collar are needed during the recovery WHAT IS THE PROGNOSIS FOR PERINEAL FISTULAS? [drtomasinfernuso.com]

Prostatic Calculus

Such prostatic calculi may cause pelvic or perineal pain and dysuria and a certain degree of urinary obstruction. 3D ultrasound images of large prostate calculus- case-2 in [ultrasound-images.com]

pain. [6], [7] Occasionally, calcifications can be passed through the urethra and present as prostatic urethral calculi. [9] Silent asymptomatic prostatic calculi or calcification [urologyannals.com]

Acute bacterial prostatitis is a febrile illness with sudden onset; pain in the lumbar and perineal regions, dysuria with frequency of urination, urgency, and nocturia urination [wordinfo.info]

Bulbourethral Gland Abscess

Cowperitis This is inflammation of the bulbourethral glands and presents with fever, malaise, and in some cases severe perineal pain. [kenhub.com]

The patient complains of pain in the lower abdomen and in the perineal region with irradiation to the tip of the penis. [gfmer.ch]

Urethral Carcinoma

It usually manifests in the fifth decade of life. urethral bleeding palpable urethral mass obstructive voiding symptoms perineal pain The histologic types are transitional [radiopaedia.org]

pain Palpable suprapubic mass (advanced cases) Features of uremia Constitutional symptoms : anorexia, weight loss, fatigue Metastatic symptoms Enlarged lymph nodes Liver [amboss.com]

[…] gross hematuria throughout micturition (most common) Irritative voiding symptoms ( dysuria, urinary frequency, urgency ) Bladder outlet obstruction (rare) Suprapubic/rectal/perineal [amboss.com]

Vaginitis

[…] area, mainly due to an excess of immune cells dysuria, which is pain or discomfort when urinating painful sexual intercourse, known as dyspareunia foul or fishy vaginal odor [medicalnewstoday.com]

Pain during intercourse Light vaginal bleeding or spotting If you suspect you may have vaginitis, pay close attention to your vaginal discharge. [premiermedicalhv.com]

irritation of the genital area discharge that may be white, gray, watery, or foamy inflammation, leading to redness and swelling of the labia majora, labia minora, and perineal [medicalnewstoday.com]

Carcinoma of the Prostate

In the locally invasive stage, the illness causes incontinence, nocturia, hematuria, hematospermia, painful ejaculation, suprapubic and perineal pain, impotence, rectal tenesmus [symptoma.com]

The patient also developed severe constipation with deep seated pelvic and perineal pain. [ncbi.nlm.nih.gov]

Seventeen months after surgery, he developed perineal pain. [karger.com]

Cauda Equina Syndrome

A 36-year-old Greek male, HIV-positive patient presented with perineal and left hemiscrotal numbness, lumbar pain, left-sided sciatica, and urinary incontinence. [ncbi.nlm.nih.gov]

Postoperatively the patient's perineal numbness, bladder incontinence, and associated pain complaints resolved. [ncbi.nlm.nih.gov]

[…] if the back pain is deteriorating and when there may be bilateral leg pain, and loss of perineal sensation is uni- or bi-lateral). [bjgp.org]

Urethritis

[…] and scrotal pain referred to both lower limbs intermittently predominantly during and after micturition-simulating features of bilateral intermittent testicular torsion. [ncbi.nlm.nih.gov]

Perineal pain, scrotal masses. Difficulties initiating and maintaining stream. [canada.ca]

[…] urethritis secondary to double concentrate orange squash of a famous brand in a 3-year-old boy who developed bilateral urethro-ejaculatory reflux (UER) and severe urethral, perineal [ncbi.nlm.nih.gov]

Cystitis

In men with lower UTI symptoms, prostatitis must be ruled out especially when associated with fever, malaise, perineal pain, and obstructive urinary symptoms. [ncbi.nlm.nih.gov]

(abdominal, urethral, vaginal or perineal). [womhealth.org.au]

Some people feel the pain in other areas besides the bladder. The pain may be felt in the lower abdomen, lower back, urethra, or the pelvic or perineal area. [emedicinehealth.com]

Rectal Prolapse

Since perineal procedures are associated with a higher recurrence rate, an abdominal approach is commonly preferred. [ncbi.nlm.nih.gov]

CASE REPORT A 39-year-old mentally retarded woman presented with a painful, recurrent, strangulated sigmoid prolapse following a perineal recto-sigmoidectomy (Altemeier's [ncbi.nlm.nih.gov]

Internal rectal prolapse can lead to obstructed defecation, faecal incontinence and pain. [ncbi.nlm.nih.gov]

Acute Epididymitis

[…] or painful/burning urination (from infection of the bladder, called cystitis); fever, perineal pain, urinary frequency, urinary urgency or painful/burning urination (from [brandywineuc.com]

If patients present with prostatitis-like symptoms (eg, perineal pain/discomfort), consideration may be given to proceeding with lower urinary tract localization studies, [ncbi.nlm.nih.gov]

Common symptoms from the original source of the infection include: urethral discharge and urethral pain or itching (from urethritis); pelvic pain and urinary frequency, urgency [brandywineuc.com]

Hemorrhoids

Twenty-eight hours after surgery, the patient demonstrated signs of soft-tissue perineal necrosis associated with progressive pain and fever. [ncbi.nlm.nih.gov]

The recurrence rate after 2 years was 18.3%, and complications included pyrexia, low blood pressure, perineal pain and rectal ulcers, but those were mild [ 17 ]. [ncbi.nlm.nih.gov]

RESULTS: The results showed improvement in symptoms of pain, swelling, bleeding, itching and discomfort in both the test and control groups. [ncbi.nlm.nih.gov]

Perianal Abscess

A 61-year-old man was admitted to our hospital complaining of perineal pain and was found to have a perianal abscess. [ncbi.nlm.nih.gov]

It is important to exclude other organic causes that may cause perineal or anal pain ( Causes of anal pain ). [surgwiki.com]

A note from Cleveland Clinic A perineal abscess is an annoying and painful condition caused by a clogged anal gland. [my.clevelandclinic.org]

Traumatic Urinary Bladder Rupture

Postpartum or puerperal retention of urine occurs due to painful episiotomy, perineal injury during delivery. [jfmpc.com]

The common clinical presentation of such injury in children can be distension of abdomen due to urinary ascites, lower abdominal pain, inability to void and perineal ecchymosis [ijhas.in]

If the patient is stable, apply ice to the perineal area, the scrotum, or the penis to help relieve pain and swelling. [medical-dictionary.thefreedictionary.com]

Bladder Neck Obstruction

Albany Medical Center Bladder Outlet Obstruction Neuropathies: Peripheral Pain, Pelvic/Perineal Abstract 362 Open Discussion ePosters 2 Scientific Open Discussion ePoster [ics.org]

High Prevalence of Bladder Neck Obstruction Suggested in Patients with Chronic Pelvic Pain and Small Fiber Polyneuropathy Video coming soon! 1. [ics.org]

Anorectal Fistula

Anorectal Pain Anorectal pain may be caused by a fissure, an abscess, thrombosed external hemorrhoids, proctitis, perineal sepsis, or proctalgia fugax. [aafp.org]

Examination may be limited by pain, stricture, or induration of the perianal and perineal tissues. Examination under anesthesia can also overlook the lesion. [insights.ovid.com]

life-threatening perineal sepsis may develop • Patients with fistula-in-ano may have pain and bloody discharge • Exam findings may include tender perianal or rectal mass [accesssurgery.mhmedical.com]

Infarct of the Prostate Gland

pain, dysuria, and hematuria. [radiologykey.com]

[…] demonstrate patchy hypointense areas in the PZ representing chronic prostatitis ( arrows ) Prostatic Abscess Symptoms of prostatic abscess include fever, chills, urgency, perineal [radiologykey.com]

Carcinoma of the Rectum

Severe pelvic and perineal pain may be improved by a variety of nerve block procedures. [surgwiki.com]

Laparoscopic surgery offers the advantages of faster recovery time and less pain, compared with open surgery. [emedicine.medscape.com]

Anal and perineal pain, initially on defecation and later continuous, occurs with low rectal cancer invading the anal sphincters. [surgwiki.com]

Endometriosis

Pelvic and perineal pain Micrograph showing endometriosis (H&E stain), a common cause of chronic pelvic pain in women. Pelvic pain is pain in the area of the pelvis. [en.wikipedia.org]

Anal Fissure

Perineal Sepsis Pain in the perineal area, fever and inability to void form the classic triad of signs of perineal sepsis. [web.archive.org]

Usually, a diagnosis of anal fissure can be made with the combination of a gentle perineal examination and the history. [symptoma.com]

Both surgical and nonsurgical treatments are available for the pain of anal fissure. [web.archive.org]

Pelvic Fracture

Vaginal bleeding Intestinal or rectal injuries can cause Abdominal or pelvic pain Rectal bleeding Later development of peritonitis Neurologic injuries can cause Weakness [msdmanuals.com]

Intestinal or rectal injuries due to pelvic fractures include abdominal pain, rectal bleeding, and peritonitis. [symptoma.com]

Signs of genitourinary and/or gynecologic (usually vaginal) injuries include Blood at the urethral meatus Scrotal or perineal hematoma Hematuria Anuria A high-riding prostate [msdmanuals.com]

Urethral Trauma

CVA tenderness, upper quadrant mass, perineal lacerations DRE: sphincter tone, position of prostate, presence of blood scrotum: ecchymoses, lacerations, testicular disruption [medbullets.com]

[…] swelling of the scrotal and perineal areas, and tender enlargement in the suprapubic region due to a full bladder. [aibolita.com]

If the patient is stable, apply ice to the perineal area, the scrotum, or the penis to help relieve pain and swelling. [medical-dictionary.thefreedictionary.com]

Condylomata Acuminata

The mass was painless initially but had become painful more recently. [ncbi.nlm.nih.gov]

We report a case of a 42-year-old man who presented to the department of surgery with a two-year history of a perineal tumour. [ncbi.nlm.nih.gov]