Pain in the perineum in men is observed with inflammatory diseases of the genital organs, STIs, non-specific infectious processes, volumetric formations, pelvic congestion. It can be found in coccygodynia, proctological and urological pathologies. The cause of the symptom is established by the results of a survey, rectal examination, ultrasound, laboratory tests. Treatment includes antibiotics, immunomodulators, antispasmodics, NSAIDs, hormones, anticoagulants, physiotherapy, prostate massage, surgical techniques.
Pain in the perineal area is a constant sign of prostatitis, combined with increased urination, sexual disorders, discharge from the urethra, pain in the genitals, rectal area. Features of the clinical picture are determined by the form of prostatitis:
A serious complication of acute prostatitis is a prostate abscess. The man's condition is rapidly deteriorating, severe intoxication, chills, hectic fever, and sometimes impaired consciousness are observed. The pains are unilateral, sharp, pulsating, correspond to the localization of the abscess, give to the perineum, rectum. Urination and bowel movements are difficult due to pain.
Chronic inflammatory lesions of the urinary or genital organs are sometimes complicated by prostatocystitis. The manifestations of the disease are variable. There are pains in the lower abdomen, scrotum, perineum, aggravated by defecation, physical activity, alcohol consumption. Men complain of cramps, frequent urges, feeling of incomplete emptying of the bladder, lethargy of the jet. In half of the cases, sexual dysfunction is detected.
Cooperitis develops as a result of injuries, sexual excesses, inflammatory and venereal diseases. Painful sensations occur with total involvement of the Cooper glands. The symptom is aggravated by sitting. Dysuria, weakness, fever are found. In some men, aching or pulling pain in the perineum appears with orchitis.
The symptom is due to urethritis and prostate involvement. It is observed with ureaplasmosis, mycoplasmosis, chlamydia, and other infections. The typical clinical presentation of an STI includes pain and burning in the urethra during urination, and pain and discomfort in the perineum, which is worse when sitting. Discharge from the urethra is noted, mainly in the morning.
Pain in the perineum in men
The most formidable oncological cause of pain is prostate cancer. There are no specific symptoms, the clinical picture is due to concomitant pathology - prostate adenoma or prostatitis. A man is concerned about burning during urination or ejaculation, aching pain in the pelvis, perineum and above the pubis, erectile dysfunction. Pain in the lower back indicates the development of hydronephrosis, in the ribs and spine - the formation of metastases.
Large prostate cysts are accompanied by pain in the perineum during sexual intercourse. With immune disorders against the background of concomitant pathologies, suppuration of the cyst with transformation into an abscess is possible. The pain intensifies to unbearable, there are chills, severe hyperthermia. A similar clinical picture is found with rapid growth or suppuration of dermoid pararectal cysts located in the perineal region.
Stagnation of blood in the veins of the small pelvis develops due to insufficient physical activity, pathologies of the portal vein, tumors, and connective tissue dysplasia. Some sexual habits play a significant role: too frequent masturbation, delayed ejaculation, lack of regular ejaculation, leading to the development of orgasmic dysfunction, pain in the perineum.
Against the background of prolonged stagnation of blood, the walls of the veins of the small pelvis expand, and varicose veins (VRVMT) develop. Men complain of moderate aching pain in the perineum, lower abdomen, aggravated by walking, lifting weights, sexual intercourse. A distinctive feature is the increase in the symptom with a change in body position. Visually, some swelling of the scrotum and perineum can be detected.
CPPS is a polyetiological condition that develops with ischemia, congestion, inflammation, after operations on the pelvic organs. The clinical manifestations are reminiscent of prostatitis. Pain in the pelvis, genitals, perineum, and lower back can be constant or intermittent, ranging from dull, aching to sharp, intense, and appear at rest or with movement.
Pathology develops gradually. Initially, an elastic protrusion is formed in the perineum. Periodic pulling pains are observed. Subsequently, the pain syndrome becomes constant, accompanied by irradiation to the leg or lower back. Large perineal hernias cause discomfort when walking. Other manifestations are determined by the contents of the hernial sac. When the bladder is involved, dysuria occurs, when it enters the protrusion of the rectum, chronic constipation is noted.
Pain in the perineum often develops against the background of diseases of the pelvic organs and the lumbar region, can be provoked by the following pathologies:
Diagnostic measures are carried out by an andrologist. If necessary, a urologist, proctologist, and other specialists are involved in the examination. During the conversation, the doctor establishes the circumstances of the appearance of pain, the presence of other signs, changes in symptoms over time. To clarify the nature of the pathology, the following methods are used:
Urologist's consultation
Men with uncomplicated inflammatory diseases are observed on an outpatient basis. Severe intoxication, sharp pains indicate the formation of a purulent process, are an indication for immediate hospitalization. With chronic urinary retention, catheterization is performed. The treatment regimen for inflammatory and infectious pathologies includes techniques such as:
The tactics of treating CPPS in men is determined by the genesis of the pathology. For infections, antibiotics, antifungals, or antivirals are prescribed. In aseptic inflammation, NSAIDs, alpha-blockers, testosterone and antioxidants are used. For neuropathic pain, neuroprotectors, B vitamins are recommended, for myogenic pain - muscle relaxants.
Men with mild VRVMT are prescribed phlebotonics, vitamins and anticoagulants. Patients are advised to eliminate provoking factors, conduct dynamic monitoring. Cancer patients may require radiotherapy, chemotherapy, hormone therapy. For inoperable cancer, drugs are used as the main method of treatment, for operable tumors, drugs are prescribed after surgery.
Acute urinary retention of various origins is considered as an indication for the installation of a cystostomy. Taking into account the etiology of the pain syndrome, men undergo the following operations: