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What causes perineal pain?

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Posted on Tue, 5 May 2015
Question: Hi,
Im experiencing some disconfort on the left side of my perineum. I can feel a few swolen veins between anus and scrotum. I feel subtle pain and disconfort when I touch them.
doctor
Answered by Dr. T Chandrakant (56 minutes later)
Brief Answer:
Cellulitis - needs early causative diagnosis and proper treatment.

Detailed Answer:
Hi.
Thanks for your query.

To recapitulate: Young male / 27 - some discomfort on the left side of the perineum - can feel some swollen veins between anus and scrotum - tender.

The causes of such an appearance are:
- Local skin problems like an infected boil.
- Peri-anal cellulitis and may turn into an abscess.
- Fistula in ano also can present like this.

I would advise you the following in such a condition:
- To consult your Doctor and preferably a General Surgeon (He is the one well trained for such problems) for clinical evaluation, actual physical examinations, investigations and proper treatment.
- By this means a proper diagnosis is gotten as early as possible and hence the most proper treatment can be instituted at the earliest.

I hope this answer helps you, please feel free to ask for further relevant queries or if you feel that there is a gap-of-communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (47 minutes later)
Thank you for your answer.

There are a few details i forgot to mention. I feel dull ache/discomfort on perineum specially during erections, bloated intestines and after weightlifting.

Also I've been suffering from chronic anal fissure since i was a kid.

For the past 7 years i had a inguinal hernia mesh repair on both sides and one varicocele surgery on the left.

I have no idea if any of this can be related with my problem.

Thank you


doctor
Answered by Dr. T Chandrakant (15 minutes later)
Brief Answer:
Fissure in ano can / prostastitis should be ruled out.

Detailed Answer:
Thanks for your feedback.

The Chronic anal fissure may be related to the present problems as the infection can spread easily to the nearby structures.

Inguinal hernia and Varicocele surgery may not be related to the present problem.

The dull pain/ discomfort on perineum during erections, bloated intestines and after weight lifting is noted.

I just wanted to ask a few details:
- Since when have you got the problem of (I can feel a few swollen veins between anus and scrotum. I feel subtle pain and discomfort when I touch them.) this is the one you mentioned. Is this of a few days or a long duration?
- Any treatment / investigations / Surgeon's opinion taken?
- Ultrasonography for genito-urinary system particularly for prostate? Prostatitis can also mimic as a discomfort in the perineum.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (51 minutes later)
I first found the problem 1 - 2 years ago. In the beginning i was complaining about perineum spasms. Doctor told me it could be related to the fissure and prescribed me Faktu gel.
Prostate was fine during rectal exam. Blood/urine tests and semen culture were also fine. No sign of bacterial infection.
I did no Ultrasonography.
I only found the swolen veins recently after gaining some muscles on my legs from weightlifting, I started feeling some gelly masses rubbing between both legs during some movements. These masses feel like swolen veins along the entire perineum (similar to the ones i had under my left testicle with varicocele before surgery), they start close to the anus all the way until the scrotum.

Usually i feel no discomfort on my perineum during the morning after waking up. Same for the fissure.

Maybe both are related.

Thank you
doctor
Answered by Dr. T Chandrakant (24 minutes later)
Brief Answer:
Examination by a General Surgeon to get a confirmed diagnosis.

Detailed Answer:
Read your feedback.
The finding like the veins in the perineum is very very rare but possible since you have undergone a left varicocele surgery and possibly these may be collateral.

For this an actual visualization and palpation by a General surgeon would confirm what it is.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 15000 Questions

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What causes perineal pain?

Brief Answer: Cellulitis - needs early causative diagnosis and proper treatment. Detailed Answer: Hi. Thanks for your query. To recapitulate: Young male / 27 - some discomfort on the left side of the perineum - can feel some swollen veins between anus and scrotum - tender. The causes of such an appearance are: - Local skin problems like an infected boil. - Peri-anal cellulitis and may turn into an abscess. - Fistula in ano also can present like this. I would advise you the following in such a condition: - To consult your Doctor and preferably a General Surgeon (He is the one well trained for such problems) for clinical evaluation, actual physical examinations, investigations and proper treatment. - By this means a proper diagnosis is gotten as early as possible and hence the most proper treatment can be instituted at the earliest. I hope this answer helps you, please feel free to ask for further relevant queries or if you feel that there is a gap-of-communication.