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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for pain in perineum area

I am a 35 yo male, generally healthy and in good shape. For the past 2-3 years i suffer from pain (feels inflammatory) in the perineum area, that comes and goes. I think the first symptoms started after a long period (about a year) of very intense sexual activity. During this time i am sure i had some kind of injury due to very frequent ejaculation, and since then my perineum area feels very tight.

About 2 years ago i noticed a small lump (smaller than a pea) between my scrotum and anus. This lump is immobile and feels hard. i can’t really be sure of its internal size but i have not noticed any growth.

During the last 3 months i have the following symptoms:
-The perineum pain got worst and would not go away after a few days like it used to. I had to take anti-inflammatory drugs that did the trick.
-frequent nerve tingling in the perineum area
-mild ed / lost of libido (might be because of stress)
-low semen volume and reduced ejaculation force
-feeling i can't empty my bowels completely (mild)
-tightness/stiffness in my perineum area

Those symptoms get worst if i sit on a chair for a long period of time and after intense sexual activity.
I went to my doc and he thinks its prostitis. i have scheduled some sperm cultures and std tests for next week but i already had a perineum MRI to check out the lump. The mri diagnosis reports to a varicose problem but regarding the perineum area nothing notable was found, which me and my urologist find strange since we both can feel the small lump... Unfortunately my doctor cannot read the MRI so i am still worried about that lump.

I would appreciate any ideas/ suggestions about this problem

Thanks in advance
Thu, 1 Oct 2020
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Radiologist 's  Response
Hi,

You might have a peri-anal abscess or fistula. Please get the MRI scan images reviewed.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Vivek Chail, Radiologist
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Suggest treatment for pain in perineum area

Hi, You might have a peri-anal abscess or fistula. Please get the MRI scan images reviewed. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Vivek Chail, Radiologist