Pain in the perineum as a reason to visit a urologist

Pain in the perineum is a common symptom that occurs due to various reasons: in both men and women, of any age. Since the perineum is a part of the body in which there is a complex of soft formations in the form of the external genitalia, urethra and rectal opening, pain symptoms in it are usually associated with pathologies of these organs. It is often supplemented by other clinical manifestations in the form of discomfort while walking or sitting for a long time, as well as severe itching and burning.

In order to find out the cause of the above manifestations, you need to seek professional medical help. Only a specialist, after an examination and diagnostic studies, will be able to say exactly why the perineum hurts and prescribe adequate treatment. Thanks to it, it is possible to eliminate the cause of the disease, and therefore the unpleasant symptoms that accompany it. If you want to be confident in the professionalism of doctors and that you will receive the best treatment, contact the multidisciplinary clinic CELT. We employ leading specialists who have everything necessary for an accurate diagnosis and effective treatment.

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Etiology of pain in the perineum

If your perineum hurts, hurry to make an appointment with a doctor. This clinical manifestation can be a sign of the development of a dangerous pathological condition, the correct and timely treatment of which will save you from more severe complications. Modern doctors identify a number of common causes of pain that are characteristic of both sexes. In addition, there are also exclusively “female” or “male” ones. All of them are presented in our table below:

Groin pain in men, causes

The appearance of leg pain in the groin in men is influenced by several reasons.

Pain in the left groin in men, causes:

1. Chronic cystitis. Pain in the left groin in men occurs with chronic cystitis. Bladder inflammation is characterized by fever up to forty degrees, general weakness, pain when urinating, nausea and vomiting. It has different localizations, but most often the painful place is the lower abdomen.
2. Bladder injuries. If the bladder is damaged, the patient suffers from temperature changes, panic and severe pain in the groin area.
3. Excessive physical activity. Excessive physical activity can cause muscle strain and damage to internal organs. Professional athletes and people who work in manual labor are familiar with this problem. Pain may indicate sore throat or soft tissue damage.
4. Hypothermia. When hypothermia occurs in the male body, an inflammatory process of the pelvic organs develops, which leads to serious consequences if left untreated.
5. Hormonal disorders. During adolescence, hormonal disorders occur in the male body, which are often accompanied by pain and other unpleasant symptoms.
6. Benign or malignant neoplasm of the urinary organs. Chronic groin pain in men, which is accompanied by other symptoms, sometimes indicates the presence of tumors. You should immediately contact a specialist.
7. Abscess and orchitis. Inflammation of the testicles appears as a result of hypothermia and infectious processes in the male body. Accompanied by fever, vomiting, and pain in the lower abdomen. Sometimes orchitis becomes a consequence of mumps. Severe swelling appears on the testicles. A sharp pain is felt in the scrotum, which intensifies with palpation. The gonads also become inflamed. An accompanying symptom is called intoxication of the body. The advanced stage of orchitis develops into an abscess.
8. Purulent inflammation. Purulent inflammations must be treated urgently, as they develop into sepsis.
9. Inflammation of the testicular appendages. After an infection, a man’s body often develops a pathology called epidymitis. The temperature rises, the appendages become inflamed, pain in the groin intensifies when walking and any movements.
10. Testicular torsion. Testicular torsion is also accompanied by severe cutting pain. The patient's temperature rises to forty degrees, nausea and vomiting are observed. The man is in panic, feels chronic fatigue and insomnia. If left untreated, testicular torsion will lead to necrosis and gangrene. The only solution to the problem is surgery and removal of the seminal gland.
11. Prostatitis. Pain in the left groin in men with chronic prostatitis. Signs of this disease include problems with urination, nausea, vomiting, and fever. Prostatitis is caused by an infection of the genital organs that has not been treated correctly. The disease also affects other healthy organs.
12. Cystitis. Accompanied by fever and chills.
13. Infections that are sexually transmitted.
14. Stones in internal organs.
15. Formation of salts in the kidneys. The temperature rises.
16. Varicocele. When the veins in the testicles dilate, a man feels a stabbing pain that intensifies with movement.
17. Inflammation of the appendix. If a man feels severe pain in the right lower abdomen, then we are talking about the appendix. You should urgently call an ambulance and conduct an examination in a hospital.
18. Penetration of bacteria into the genitals.
19. Leg injuries. Leg injuries also affect other body systems, namely the pelvic organs. There is unbearable pain, which is accompanied by fever.
20. Fungal infections. Fungal infections are accompanied by pain in the groin area, pulling sensations in the lower abdomen and other unpleasant symptoms. To avoid the development of the disease, consult a specialist.

Pain in the perineum in pregnant women

Patients often come to the gynecological department of our clinic with the question of why the perineum hurts during pregnancy and how dangerous it is. Normally, such symptoms are associated with the growth of the fetus and its descent. It is typical for the 3rd trimester - it is during this period, due to the development of the child, that there is an impact on the ligaments, nerves and muscles of the mother’s body, which are stretched. However, the occurrence of such symptoms in the early stages may be a sign that there is a high risk of miscarriage.

It is not uncommon for the fetus to put pressure on the nerve that runs nearby. The pain that occurs in this case limits movement and does not stop until the fetus changes position. Modern medicine cannot help in this case.

Perineum hurts before childbirth

Severe pain symptoms that occur over a long period of time are a sign that labor is approaching. It is caused by the expansion of the pelvic bones and other processes of preparation for the process, along with the approach of the fetus to the birth canal.

Perineum hurts after childbirth

Painful symptoms are felt by almost all women afterward, although its strength may vary. It depends on the presence/absence of injuries during childbirth. So, it goes away 3-4 days after birth when it occurs due to swelling and stretching of tissues, and persists much longer with ruptures of the perineum and sutures.

Classification of pain in the perineum

The identification of different groups, categories or classes of pain symptoms occurring in the groin is based on various parameters. All of them are presented in our table below.

Causes of itching

When itching appears in the intimate area, a woman immediately begins to suspect that she has some kind of disease. But unpleasant sensations do not always occur against the background of sexually transmitted infections or other pathological conditions. Discomfort can be caused by external factors.

Non-medical reasons

Some habitual actions can cause itching in the intimate area. Exogenous causes of discomfort are easy to eliminate and no special therapy is required. Safe causes of itching in the intimate area in women:

1. Mechanical damage. Microtraumas of the skin and genital mucosa occur during shaving, depilation, and sex. To avoid cracking and irritation, it is necessary to use lubricants and moisturizers before and after hair removal in the intimate area.
2. Underwear made from artificial materials. Synthetics interfere with normal breathing and often chafe the skin. It is enough to choose underwear made from natural materials - cotton, silk - to get rid of itching.
3. Violation of hygiene rules. You need to wash the groin area every day, using special hypoallergenic products. Change tampons, panty liners and sanitary pads every 4 hours.
4. Reaction to intimate area care products. Peeling, itching and dry skin occur when using products with a high pH level.
5. Ovulation. In the middle of the cycle, the discharge becomes abundant and watery. Due to increased humidity, the labia and inguinal folds begin to itch. Normally, unpleasant symptoms disappear within a few days.
6. Prolonged sexual intercourse with insufficient natural lubrication. If the itching is due to non-medical reasons, there are no other dangerous symptoms. The temperature is normal, there are no uncharacteristic vaginal discharge, rashes, or abdominal pain. If such manifestations occur, you should consult a gynecologist.

Diseases

Most often, burning and irritation in the intimate area occurs against the background of inflammatory and infectious processes. But there are non-infectious pathologies that cause discomfort. Many of them are difficult to diagnose, which leads to the development of complications.

Main diseases:

1. Lichen sclerosus of the vulva or kraurosis. The disease often occurs in women of reproductive age. The reason is degenerative processes in the mucous membrane. The peculiarity of the disease is constant itching in the intimate area without odor, the discomfort intensifies at night, after a hot shower and physical activity. Without timely treatment, tissue sclerosis develops and the external genitalia become deformed.
2. Leukoplakia of the vulva. The clinical picture is in many ways similar to kraurosis. But with kraurosis, atrophic and sclerotic processes are more pronounced. With leukoplakia, pronounced hyperplasia of the epithelium is observed - tissue structures rapidly increase, extending beyond the boundaries of the organs. But the itching is just as unbearable and debilitating.
3. Climax. Burning, discomfort in the intimate area in women without discharge or odor is one of the main signs of menopause. The reason is hormonal changes, decreased synthesis of estrogen and progesterone. The balance of vaginal microflora is disrupted; instead of beneficial lactobacilli and bifidobacteria, pathogenic microorganisms begin to multiply on the mucous membrane. This leads to the development of vulvovaginitis, vaginitis. Additionally, during menopause, the production of natural lubrication decreases, the regeneration process slows down, and the mucous membrane atrophies. All these factors lead to unpleasant sensations - dryness, a feeling of tightness.
4. Vulvovaginal candidiasis or thrush. The disease develops against the background of the active growth of yeast-like fungi, which are classified as opportunistic microorganisms. The main reason is a decrease in the body's protective functions. Characteristic symptoms are curdled discharge with a sour smell, itching in the perineum, a bolt in the lower abdomen. Unpleasant sensations intensify a few days before or during menstruation.
5. Neuroses, stress, psychogenic diseases. Nervous itching is common in women.
6. Eczema. Severe itching is localized in the pubic area, labia, and perineum. Reddened areas, cracks, and weeping wounds form on the skin; a violation of the integrity of the skin is accompanied by pain.
7. Itching in the intimate area can be caused by fungal infections of the skin - inguinal candidiasis, epidermophytosis, ringworm. Spots or a rash appear, inflamed tissues turn red and swell, and pain in the groin area bothers you.
8. Bartholinitis is an inflammation of the gland, which is located in the thickness of the labia. Soreness and burning occur on one side. Unpleasant sensations intensify when wearing tight underwear, after sexual intercourse. The affected tissues swell and block the entrance to the vagina. As the disease progresses, the temperature rises and general weakness worries.
9. Diseases of the genitourinary system - cystitis, urethritis. Signs: burning and pain when urinating, pain in the lower abdomen. The urine becomes cloudy, acquires an unpleasant odor, and sometimes contains blood.
10. Oncological pathologies. Itching is not the main symptom; it mainly occurs in the later stages, with the addition of secondary bacterial infections. Itching in the genital area may be the first sign of endocrine disorders - diabetes, hypothyroidism, hyperthyroidism. Discomfort occurs due to a disruption in the nutrition of nerve endings. Unpleasant sensations occur with diseases of the liver and gall bladder. Bile acids appear in the blood, which irritate skin receptors, and any part of the skin can itch.

Sexual infections

Sexual infections are one of the most common causes of discharge and itching in the intimate area. The disease is accompanied by other symptoms - pain in the lower abdomen, discomfort when urinating, fever, rashes on the genitals. Sexual infections that are most often accompanied by itching:

• trichomonas colpitis;
• genital herpes;
• mycoplasmosis;
• chlamydia;
• syphilis;
• gonorrhea.

Genital warts are a consequence of infection with the human papillomavirus during sexual intercourse. The disease has a chronic course and worsens with decreased immunity. Due to frequent trauma, genital warts often degenerate into malignant neoplasms. If infectious pathologies are not treated in a timely manner, dangerous complications develop. Consequences - endometritis, inflammation of the appendages and fallopian tubes, infertility and miscarriage, disorders of intrauterine development of the fetus.

Age-related changes

With age, atrophic processes in the genital organs occur, which leads to itching in the intimate area in women. The skin becomes thinner, the mucous membranes dry out due to a decrease in the amount of secretion.

Pregnancy

Minor itching in the groin area often occurs in pregnant women due to hormonal changes in the body, the sensitivity threshold decreases. Another reason is the exacerbation of candidiasis and bacterial vaginosis due to a natural decrease in immunity.

Allergy

Irritation in the intimate area in women is one of the manifestations of allergic dermatitis. The pathology is accompanied by rashes, redness and swelling of the tissues, the nature of the discharge does not change. Allergic manifestations in the groin area occur with urticaria, eczema, and dermatitis.

Pediculosis pubis

Pediculosis pubis or phthiriasis is a parasitic skin disease. Occurs when infested with pubic lice during sexual intercourse. The disease is not considered dangerous; often to get rid of parasites, it is enough to remove pubic hair and armpit hair. In addition to lice, scabies mites and pinworms can cause itching in the groin area.

Symptoms of pain in the perineum

The clinical picture that complements pain in the perineum in women and men may be different, since it depends on the pathology that caused it. This means that symptoms vary. The most common ones are:

• Discharge from the urethra or vagina;
• Radiating pain to the pelvis, lumbar region and lower abdomen;
• Increased pain during physical activity;
• Frequent urge to urinate;
• Pus and blood in urine and semen;
• Increased pain during sexual intercourse;
• Sensation of a foreign object in the rectum;
• Increased body temperature.

Clinical manifestations characteristic of a particular disease are presented in our table below:

Prevention of itching of the labia

To avoid the development of inflammatory processes and irritation in the groin area, you must follow a few simple rules. Prevention methods:

• observe the rules of intimate hygiene, use products with a neutral pH;
• do not wear tight, synthetic underwear;
• If itching occurs, do not scratch the skin, wash with cool water and consult a doctor;
• thoroughly moisturize the skin after shaving;
• identify and eliminate allergens;
• strengthen the immune system - take vitamins, eat right, give up bad habits, do not forget about regular moderate physical activity;
• change sanitary pads every 4 hours;
• try to avoid stress, psycho-emotional stress, hypothermia;
• avoid casual sex, do not forget to use a condom;
• do not overuse douching;
• Visit a gynecologist every 6 months.

Itching and odor in the intimate area are not an independent disease, but a sign of various pathological conditions. Self-medication is dangerous; without proper therapy, diseases become chronic and dangerous complications develop.

Our doctors

Khromov Danil Vladimirovich

Urologist, Candidate of Medical Sciences, doctor of the highest category

35 years of experience

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Mukhin Vitaly Borisovich

Urologist, Head of the Department of Urology, Candidate of Medical Sciences

34 years of experience

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Perepechay Dmitry Leonidovich

Urologist, Candidate of Medical Sciences, doctor of the highest category

40 years of experience

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Kochetov Sergey Anatolievich

Urologist, Candidate of Medical Sciences, doctor of the highest category

34 years of experience

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What diagnostics are performed for pain in the perineum?

Often, when pain symptoms occur in the perineum, the patient does not know which doctor he needs to see. First of all, you should make an appointment with a therapist who, depending on the situation, will give a referral to a urologist, gynecologist, proctologist or surgeon. Diagnostic methods in all cases are specific, the main ones are the following:

• interviewing the patient to determine the nature of the pain and the presence of additional symptoms;
• physical examination by a gynecologist or urologist;
• careful history taking;
• general and biochemical blood test;
• general urine analysis;
• bacterioscopy in women, urethral flora smear in men;
• radiography;
• ultrasonography;
• intestinal colonoscopy;
• examination of the rectal mucosa;
• computed and magnetic resonance imaging;
• X-ray of the colon of the bladder with the introduction of a contrast agent into it.