Pain between the legs. Why does pain occur in the perineum? Sharp pain in the perineum

Pain between the legs in women certainly causes justifiable concerns. First of all, the condition of the organs of the genitourinary system is of concern. However, is pain in the perineum always associated with diseases of this kind? To make an assumption regarding the nature of the resulting sensations, one should evaluate their features, the nature of localization, degree of intensity, etc. Pain itself cannot pose a danger; on the contrary, it should be treated as a signal indicating a problem. But it will depend on the problem whether in the current circumstances there is a threat to health or not. Possible causes that can cause pain in the perineum include:

Therefore, the degree of danger of pain between the legs should be considered in terms of the original causes. For example, pain that occurs during pregnancy should be considered an inevitable cost of this condition. Of course, in this case, the risks must be assessed by the doctor leading the pregnancy. After childbirth, similar symptoms may occur as a result of stretching. Like other injuries, these causes will go away on their own after some time. However, inaction and a wait-and-see attitude are not always the best tactics.

Possible diseases

Pain in the perineum in women can be a symptom of inflammation of any organ or gland located in the pelvic area. Therefore, the cause may be inflammation:

In this case, the intensity and nature of the pain will depend not only on the inflamed organ, but also on the stage of the inflammatory process. If we divide diseases according to the organ systems in which they can develop, then diseases of the following systems can lead to pain in the perineum:

• sexual;
• urinary;
• nervous;
• digestive;
• lymphatic;
• musculoskeletal.

Of course, most often we are talking about inflammatory processes in the organs of the urinary and reproductive systems. Typically, nagging pain between the legs in women occurs with sluggish and chronic inflammation. If the process becomes acute, the pain becomes stronger, and other symptoms are added to it, for example, increased body temperature, weakness, and sometimes traces of blood in the urine.

If the localization of pain is characterized by a clear displacement to one side, then it is likely that the cause lies in a disease of one of the ovaries. This can be either inflammation or rupture of the cyst, and possibly cancer. In the first two cases, the pain will intensify during sexual intercourse, prolonged sitting, walking, and will be aching and pulling. In the second, the pain is intense, permanent, and intensifies over time.

Sharp pain between the legs in women is most often the result of injury, as well as urolithiasis. If you experience pain of this nature, you should immediately undergo an examination. If there has been an injury, for example, a blow, it should be determined how deep the damage is, whether internal organs have been damaged, and whether there is a need to eliminate the consequences, for example, to open the hematoma and remove the blood clot.

If the cause lies in urolithiasis, then sharp pain indicates the seriousness of the situation. Most likely, a large calculus has formed in the organs of the urinary system, which must be removed in order to alleviate the woman’s condition and avoid mechanical injury to the urinary tract. Often, with timely treatment, it is possible to avoid surgical intervention by crushing the stone using conservative therapy. Smaller particles will subsequently be excreted in urine.

What do the symptoms indicate?

If we ignore various mechanical damage caused by friction, shock, compression, etc., the causes of which are usually well known, then we can concentrate directly on diseases characterized by a whole list of symptoms. We will also omit possible growths, warts, boils and other problems that are determined by visual inspection. It is important to evaluate what other symptoms accompany pain between the legs in women. Based on the general symptomatic picture, we can assume which disease caused the discomfort. The most common diseases from this point of view can be recognized by several characteristic symptoms, for example:

1. Cystitis. There is a frequent urge to urinate, and after the process there is a feeling that the bladder is not empty. Appears. Blood may appear in the urine, and in acute conditions the body temperature rises.
2. Urethritis. There is itching and discharge from the urethra (sometimes with pus and blood), aching pain in the lower abdomen.
3. Vaginitis, vulvovaginitis. Itching, burning in the area of ​​the external genitalia, swelling there, and sometimes fever.
4. Cancer of the uterus, ovaries. Discharge and sometimes blood, pain in the abdomen and during sexual intercourse, loss of appetite, weakness.

And each of the mentioned diseases, among other things, is accompanied by pain of varying degrees of intensity in the perineal area. Even a specialist cannot establish the cause without resorting to a number of diagnostic procedures. It is completely impossible to do this on your own. Meanwhile, in the overwhelming majority of cases, it is delay that leads to complications and long-term (and not always successful) treatment. Therefore, pain between the legs is not a danger, but a real assistant, allowing you to find out about an emerging problem in time and take appropriate measures.

There is a popular belief that this kind of symptoms manifests itself exclusively in the fair sex - this is not true at all! Any man can experience this kind of pain due to a number of diseases.

The most common cause in this case is prostatitis. As the disease develops, a special gland, present in the body of the stronger sex and responsible for the synthesis of sperm, becomes inflamed. Inflammation here is almost always caused by infections and often occurs in a chronic rather than acute form. In addition to pain in the perineum, the patient experiences problems with erection, discomfort during urination, constant urge to urinate, in some cases there is fever and even chills.

The second most common case of the formation of similar symptoms is considered to be a prostate abscess - an organic accumulation of pus in the above-mentioned organ. Usually abscesses are a consequence of untreated prostatitis. It is almost impossible to cure this condition with conservative therapy: mandatory surgical intervention is necessary.

Possible reasons

In addition to the above reasons, Perineal pain in men can be caused by:

1. Orchitis - inflammation of the testicles after they are damaged by specific pathogens
2. Urethritis is inflammation of the urethra.
3. Colliculitis is an inflammatory process in the seminal tubercle.
4. Cuperitis is suppuration of the urethral glands.
5. Broad spectrum oncology.

Among women

In the female half of the population, pain in the perineum is caused by a wider range of reasons.

1. Vaningitis is an inflammation of the walls of the genital organs, usually accompanied by severe radiating pain in the perineum.
2. Bartholinitis - inflammation of the glands of the genital organs also induces the above-mentioned symptoms.
3. Pinched nerves in the pelvic organs. In various situations, the nerve endings of the genital organs can be damaged, resulting in pain syndromes.
4. Violation of the epithelium in the rectal area: diseases such as hemorrhoids, paraproctitis, cracks in the walls of the anus and various inflammations can cause a wide range of pain syndromes.

Pain in the perineum during pregnancy

At some stages of fetal development, a pregnant woman may experience pain in the perineum - most often this is caused by physiological reasons, but in some cases this symptom shows negative trends in the body of the expectant mother.

In the last weeks before childbirth, this kind of pain is physiologically justified: the fetus has reached its maximum size and is moving towards the exit, expanding the hip joints, which in turn causes sharp pain in the perineum and even the legs. However, this kind of symptom in the early stages of pregnancy usually indicates a threat of miscarriage - therefore, you must urgently contact your doctor and inform him about your symptom.

The cause of unpleasant pain in the perineum in women can also be varicose veins in this area and loosening of ligaments. After childbirth, this symptom accompanies the fair sex for some time after delivery, especially if there are problems with the healing of sutures placed after ruptures.

Types of pain in the perineum

Drawing pain in the perineum

This symptom usually occurs with a variety of wide-spectrum chronic diseases. It is long-lasting, but has medium to low intensity, comes in waves and can have a continuous cycle even for several days.

Shooting pain

A dangerous symptom indicating that the cause (disease) has entered the acute phase. In this situation, internal damage to organs is possible, as well as various hemorrhages, including immediate hospitalization.

Stitching pain in the perineum

This type of pain is often caused by a variety of female ailments, especially inflammatory processes in the vagina and fallopian tubes, as well as cervical erosion. This symptom, among other things, in women is accompanied by low-quality discharge.

Sharp pain

Typically, this syndrome is caused by hematomas, cancer, acute stages of prostatitis, and purulent structures. The symptom increases significantly with defecation and urination, the temperature rises, stool retention is observed, and sometimes fainting occurs.

Useful video

Elena Malysheva about pain in the perineum.

Self-treatment can only aggravate the problem and accelerate the development of the disease. Most of the possible causes of the negative condition described above can only be eliminated surgically. Don't waste time and go to the doctor!

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Introduction

Since the perineum is the location of the external genitalia, the outlet of the urethra (urethra) and the anus of the rectum, pain in this area is associated with diseases or injuries of these organs. Specific reasons pain in the perineum enough.

Causes

Pain in the perineum can be caused by the following diseases and conditions:

• acute or chronic prostatitis;
• urethritis (inflammation of the urethra);
• cooperitis (inflammation of the bulbous-urethral gland);
• colliculitis (inflammation of the seminal tubercle in men);
• orchitis (inflammation of the testicles);
• vaginitis (colpitis) – inflammation of the vagina;
• bartholinitis - inflammation of the glands of the vestibule of the vagina;
• perineal trauma (including trauma during childbirth);
• pregnancy;
• pinched pudendal nerve;
• prostate abscess;
• prostate cancer;
• skin diseases: boils, condylomas, papillomas;
• diseases of the rectum: hemorrhoids, rectal fissures, proctitis (inflammation of the rectum), paraproctitis (inflammation of the tissue surrounding the rectum);
• chronic pelvic pain syndrome.

The nature of pain in the perineum in various diseases

Sharp pain

Sharp, acute pain in the perineal area in men is most often associated with acute prostatitis. With this disease, pain can radiate to the sacrum, to the head of the penis, to the anus. Acute urethritis also causes severe, sharp pain. This pain intensifies when urinating.

Sudden, sharp pain in the perineum is characteristic of pinched pudendal nerve. This pain is slightly reduced if the patient stands quietly. When walking, as well as in sitting and lying positions, the pain intensifies. A pinched nerve can cause a feeling of numbness in an area of ​​the inner thigh.

In some cases, sharp pain in the perineum may occur in pregnant women (see below).

Severe, sharp pain occurs with any perineal injury:

• subcutaneous muscle ruptures;
• gunshot wounds or wounds inflicted by knives.

Since the mass of nerve endings is concentrated in the perineal area, pain during injury can be so severe that the patient faints.

Drawing, aching pain

Pain of this nature occurs in the perineum with chronic prostatitis, chronic urethritis, colliculitis (inflammation of the seminal tubercle in men). Often, pain in these diseases is described by patients as a burning sensation in the perineum. These pains, although not too intense, can be long-lasting or even constant.

Constant aching pain in the perineum, aggravated by defecation and in a sitting position, is accompanied by cooperitis (inflammation of the bulbous-urethral gland in men). This disease is usually a complication of urethritis. Pain with cooperitis can sharply intensify if suppuration of the gland develops.

Postpartum pain in the perineum, associated with swelling and stretching of the birth canal, can also be aching.

Stitching pains

Pain in the perineum of a stabbing nature is more often observed in women, for example, with vaginitis (colpitis) - inflammation of the vaginal mucosa. These pains are combined with pain in the vagina itself, and with copious discharge from it.

Pregnant women may experience stabbing, rather intense pain in the perineum shortly before giving birth.

Perineal pain in men

In men, pain in the perineum is most often associated with diseases of the prostate gland - prostatitis, abscess, malignant tumor. They are accompanied by pain and inflammation of the seminal tubercle (colliculitis), as well as inflammation of the onion-urethral gland (cooperitis).

Perineal pain may be accompanied by a mysterious syndrome called chronic pelvic pain. This syndrome can occur in both men and women. The patient experiences pain in the lower abdomen, radiating to the perineum, but no signs of any disease can be identified. Such patients are prescribed symptomatic treatment.

Pain in the perineum in women

In addition to vaginal diseases and chronic pelvic pain syndrome, discomfort and pain in the perineal area are often observed in women during pregnancy.

During pregnancy

Pain in the perineum most often appears in pregnant women after the 35th week of pregnancy, when the growing fetus begins to descend, putting pressure on all surrounding tissues (nerves, muscles, ligaments). It is when the ligaments are sprained that a woman experiences stabbing pain in the perineum.

If such pain occurs in early pregnancy, you need to be wary of a possible miscarriage.

In the process of preparing the female body for childbirth, the pelvic bones move apart, which can also cause pain in the perineum.

Sometimes the fetus in the womb takes such a position that it compresses a nearby nerve (for example, the sciatic). At the same time, the woman experiences a sharp pain that makes all movements difficult and does not subside even with rest. Unfortunately, in this case, doctors cannot provide any help: the pregnant woman is forced to endure pain and wait for the position of the fetus to change.

Itching and painful sensations, described as a burning sensation, can occur in the perineum with various allergic reactions, diabetes mellitus, liver diseases (hepatitis, cirrhosis, etc.), and diseases of the genitourinary tract.

Such a seemingly insignificant factor as wearing synthetic underwear can cause painful itching and burning in the perineal area. In addition to an allergic skin reaction, synthetic underwear, due to the “greenhouse effect,” creates favorable conditions in the perineum for the development of all kinds of inflammatory and infectious diseases.

When urinating

Pain and burning in the perineum when urinating - symptom, characteristic of prostatitis, colliculitis, urethritis. Women in the postpartum period experience such pain when urinating, if during childbirth there was a rupture of the perineum and stitches were placed.

When walking

Pain in the perineum, which occurs or intensifies when walking, is felt by people with injuries to the coccyx (bruises, fractures). In men, difficulty walking, combined with pain in the perineum, occurs with inflammation of the testicles (orchitis) or their appendages (epididymitis), or with hydrocele.

During and after sex

In men, pain after sex in the perineum and testicles can be observed with varicocele (varicose veins of the testicle and spermatic cord). Such pain is not too intense, decreases when walking and intensifies when standing still. The duration of pain is several minutes, maximum – several hours. Then it disappears spontaneously.

Prostatitis can sometimes cause pain in the perineum during sexual intercourse.

In women, the cause of pain in the perineum during and after sex is most often bartholinitis - inflammation of the Bartholin glands. These glands are located in the vestibule of the vagina and produce its lubricant. The pain with bartholinitis is pulsating in nature and continues for several hours after sexual intercourse, then subsides.

Men with complaints of pain in the perineum should initially consult a urologist or proctologist. You may need help from a dermatologist or oncologist.

Which doctor should I contact for pain in the perineum?

Pain in the perineum is provoked by various tissue and organ structures located in the pelvis and the skin of this area of ​​the body. And since men and women have a number of identical organs in the pelvis (intestines, bladder, etc.), as well as a number of completely different genital organs, the causes of pain in the perineum can be both diseases common to men and women, and specific ones pathologies inherent in each sex separately. For example, diseases of the intestines, bladder, urethra, as well as boils or ulcers on the skin can provoke pain in the perineum in both men and women. But diseases of the prostate gland, testicle, epididymis, bulbo-urethral gland, seminal tubercle can provoke pain in the perineum only in men, since women do not have such organs. Accordingly, diseases of the Bartholin gland and vagina can provoke pain in the perineum only in women, since these organs are exclusively female, men do not have them. Given this state of affairs, we will consider separately:
1. In what cases should men and women see the same doctors if they have pain in the perineum, since the pain syndrome is caused by the pathology of organs present in both sexes?
2. In what cases should women and men contact doctors of different specialties for pain in the perineum, since the pain syndrome is caused by pathology of organs specific to the male or female sex.

So, women and men should contact doctors of the same specialty if pain in the perineum, together with other symptoms, indicates urethritis, perineal trauma, pinched pudendal nerve, boils, papillomas or condylomas in the perineal area, hemorrhoids, rectal fissures, proctitis, paraproctitis, allergic reactions, coccyx injuries.

If an injury has been caused to the perineum (bruise, blow, wound, rupture, etc.), then a sharp and very severe pain occurs. In such a situation, you should immediately call an ambulance and be hospitalized, since if the perineum is injured, various organs and tissues can be damaged so severely that without qualified medical care the person will die.

If pain in the perineum periodically occurs in a person some time after an injury (including after childbirth), then it is recommended to contact surgeon (make an appointment) And rehabilitologist (sign up) so that they jointly develop a plan for the necessary rehabilitation therapy.

If a woman or man has a boil or growth of condylomas/papillomas in the perineal area, then you should contact Dermatologist (make an appointment) to diagnose them, and then to a surgeon to remove them.

If a man or woman has sharp, sharp pain in the perineum, also felt in the coccyx, intensifies when walking and weakens when standing, appears after a traumatic impact on the coccyx area (for example, a blow, a fall, etc.), then this indicates coccyx injury. In this case, you should contact traumatologist (make an appointment) or a surgeon.

If a man or woman experiences pain in the perineal area, felt on the skin, and not deep in the tissues, combined with severe itching and swelling, and possibly rashes on the skin, then this indicates an allergic reaction, and in this case, you should speak to Allergist (make an appointment) and a dermatologist. A dermatologist should examine the skin to rule out the presence of any serious disease and confirm the allergic nature of the pain and pathological changes in the skin.

If a woman or man experiences severe pain and burning in the perineum when urinating, which is combined with frequent urge to urinate, urine mixed with turbidity and blood, then this indicates urethritis, and in this case you should contact urologist (make an appointment).

If a sharp pain suddenly occurs in the perineum of a man or woman, which is combined with a burning sensation, severe sensitivity and the sensation of a foreign body in the pelvic organs, and also causes numbness along the inner surface of the thigh, intensifies when walking, in sitting and lying positions, does not decrease with time, this indicates a pinched pudendal nerve, and in this case it is necessary to contact neurologist (make an appointment).

When pain in the perineal area in a man or woman is combined with pain in the anus or rectum, discomfort during bowel movements, possibly with discharge of mucus, blood or pus from the rectum, chills and high body temperature, terminal bowel disease is suspected ( hemorrhoids, rectal fissures, proctitis, paraproctitis), and in this case you should contact proctologist (make an appointment).

In all other cases, except for those described above, men and women who experience pain in the perineum should contact doctors of various specialties, since pain is provoked by diseases of specific genital organs.

When perineal pain occurs in women during pregnancy or after childbirth, you should contact gynecologist (make an appointment).

If pain in the perineum is combined with itching, inflammatory discharge from the genital organs (greenish, white, lumpy, etc.) or rashes in the area of ​​the external genitalia (pubes, labia, penis, etc.), then this is about sexual infection (sign up) (genital herpes (sign up), candidiasis), and in this case, representatives of both sexes can contact venereologist (make an appointment) and, in addition, women should see a gynecologist, and men should see a urologist.

If pain in the perineum is combined with pain in the lower abdomen, which does not have a clear localization, occurs periodically, goes away on its own, does not intensify over time, and is not combined with any other symptoms of the genital organs (inflammatory discharge, rashes, itching, bleeding and etc.), then chronic pelvic pain syndrome is suspected, and in this case women should consult a gynecologist, and men should consult a urologist or andrologist (make an appointment).

If in men pain in the perineum radiates or is simultaneously felt in the lower abdomen, in the rectum, combined with pain in the testicle, enlarged scrotum, sensation of a foreign object in the rectum, poor health, possibly with difficulty, frequent or painful urination, elevated body temperature, intensified when walking and straining, a tumor or inflammatory disease of the male genital organs (orchitis, epididymitis, prostatitis, prostate abscess, adenoma or prostate cancer) is suspected. In this case, you need to contact a urologist.

If a man has nagging, bursting pain in the perineum after sex, which is also felt in the testicles, combined with discomfort, heaviness and visible veins of the scrotum, intensifies when walking, spontaneously disappears after a few hours, then a varicocele is suspected, and in this case it is necessary to contact surgeon

If a man develops a nagging, aching pain or burning sensation in the perineum, which is present almost constantly, intensifying in a sitting position and during defecation, inflammation of the onion-urethral gland (cooperitis) or the seminal tubercle (colliculitis) is suspected. In this case, you need to contact a urologist or andrologist.

If a woman experiences pain in the perineum, combined with itching, burning, pain and abnormal vaginal discharge, and all symptoms worsen with urination, vaginitis is suspected. In this case, you need to contact a gynecologist.

If a woman experiences throbbing pain in the perineum after sex or spontaneously, combined with swelling of the labia, a palpable and painful seal at the entrance to the vagina, enlarged inguinal lymph nodes, chills, weakness and fever, then bartholinitis is suspected. In this case, you need to contact a gynecologist or surgeon.

What tests and examinations can a doctor prescribe for pain in the perineum?

Pain in the perineum is provoked by various diseases, and therefore, if this symptom is present, the doctor can prescribe various tests and examinations, a specific list of which is determined by the accompanying symptoms, which makes it possible to suspect a pathological process and the organ affected by it. Therefore, it is obvious that the choice of prescriptions is determined by the doctor based on all the clinical symptoms that allow him to make a preliminary diagnosis, and then confirm or refute it with the help of examinations. Let's consider what tests and examinations a doctor can prescribe for pain in the perineum caused by a particular disease.

If the pain in the perineum is associated with a past injury to this area of ​​the body, the doctor will prescribe Ultrasound (sign up) to assess the condition of the tissues and identify possible causes of pain. If ultrasound is not informative enough, it may be prescribed Magnetic resonance imaging (sign up). Further, if no serious diseases of the pelvic organs have been identified, therapy for post-traumatic syndrome is prescribed, aimed at the most complete tissue restoration. But if, during an ultrasound or tomography, diseases of the genital, urinary organs or intestines were identified, then the person is referred to the appropriate specialist, who, in turn, performs the necessary examination and prescribes therapy.

If a man or woman has boils, papillomas or condylomas on the skin of the perineum, which provoke pain, the doctor may prescribe the following tests and examinations:

• General blood test (sign up);
• Bacteriological culture of the discharged boil;
• Testing blood or genital secretions for the presence of human papillomavirus (PCR or ELISA) (sign up).

When a man or woman has a boil in the perineum, the doctor usually prescribes only a general blood test to assess the condition of the body and culture of the discharged abscess to determine the pathogen that provoked the inflammatory process. Next, the boil is removed and an antibiotic is prescribed, to which the microorganism that caused the inflammation is sensitive.

When a man or woman has overgrowths of papillomas or condylomas in the perineum, the doctor prescribes a blood and/or genital discharge test for the presence of the human papillomavirus in order to understand whether the process of their formation is chronic or due to a sudden decrease in immunity. If papillomas/condylomas appear as a result of decreased immunity, they are simply removed surgically and no specific treatment is prescribed. But if the process is chronic, then after removing the growths, antiviral and immunomodulatory therapy is necessarily prescribed, which is necessary to prevent the formation of papillomas and condylomas again.

When a man or woman, after a traumatic impact on the coccyx area (bruise, blow, etc.), sharp pain is felt simultaneously in the perineum and coccyx, intensifies when walking, weakens when standing, the doctor prescribes an x-ray of the coccygeal-sacral region of the spine. X-ray (sign up) allows you to identify fractures of the coccyx and distinguish a bruise from a fracture. If the doctor suspects that a coccyx injury has provoked the formation of an extensive hematoma in the soft tissues, then in addition to X-rays, he may prescribe magnetic resonance imaging.

When a representative of either sex experiences pain in the perineum, strongly felt from the outside and not deep into the tissues, combined with itching and swelling, and possibly also rashes on the skin, the doctor suspects an allergic reaction and prescribes the following tests and examinations:

• General blood analysis;
• Blood test for IgE concentration;
• Skin allergy tests using prick test or scarification (sign up);
• Analysis of hypersensitivity to various allergens by determining the concentration of specific IgE in the blood (for guinea pig, rabbit, hamster, rat, mouse, latex, orange, kiwi, mango, pineapple, banana, apple, peach, ragweed, wormwood, pigweed white, plantain, Russian thistle, fragrant spikelet, perennial rye, timothy, cultivated rye, woolly milkweed, for house dust and house dust mites).

To identify the allergic nature of pain in the perineum, the doctor must prescribe a general blood test and any tests for hypersensitivity to allergens (or skin tests (sign up), or determining the concentration of specific IgE in the blood), as this is necessary to identify the substance that provokes a hypersensitivity reaction in humans. A test for the concentration of IgE in the blood is rarely prescribed, since it only reveals the presence of allergies.

When a representative of either sex feels severe pain and burning in the perineum, which can be constantly present and intensify or appear only when urinating, combined with frequent urge to urinate, urine mixed with blood, turbidity - the doctor suspects urethritis and prescribes the following tests and examinations:

• General blood analysis;
• General urine analysis ;
• Three-glass urine sample;
• Urethral smear (sign up);
• Bacteriological culture of urine and urethral discharge;
• Analysis of blood or urethral discharge for the presence of pathogens of sexually transmitted infections ( for chlamydia (sign up), mycoplasma (sign up), gardnerella, ureaplasma (sign up), Trichomonas, gonococci, Candida fungi) by PCR or ELISA methods;
• Ultrasound of the bladder (sign up).

First of all, general blood and urine tests, a three-glass urine sample, a urethral smear and culture of urethral discharge are prescribed. In the vast majority of cases, these tests allow us to identify the cause of urethritis, complete the examination and begin treatment. But if, with the help of such primary tests, it was not possible to identify the causative agent of the infectious-inflammatory process, then the doctor prescribes a blood test or urethral discharge for the presence of pathogens of sexually transmitted infections (for chlamydia, mycoplasma, gardnerella, ureaplasma, trichomonas, gonococci, Candida fungi) using methods PCR (sign up) or ELISA. Ultrasound of the bladder is prescribed only in cases where the doctor suspects that urethritis is complicated by cystitis.

When a representative of either sex suddenly develops a sharp pain in the perineum, combined with a burning sensation, severe sensitivity and a sensation of a foreign body in the pelvic organs, numbness on the inner thigh, and the symptoms intensify when walking, sitting and lying down, the doctor suspects a pinched pudendal nerve. In this case, the diagnosis is made mainly on examination data and characteristic symptoms. Additionally, to identify the cause of a pinched nerve, the doctor may prescribe magnetic resonance imaging. And in order to determine the speed of signal transmission along the nerve and the response of the muscles to the impulse, electroneurography is used, which makes it possible to understand which surrounding organs or tissues put pressure on the nerve and provoke pain.

If in representatives of either sex, pain in the perineum is combined with pain in the anus or rectum, discomfort during bowel movements, possibly with the release of mucus, blood or pus from the rectum, chills and high body temperature - a disease of the terminal parts of the intestine (hemorrhoids) is suspected , rectal fissures, proctitis, paraproctitis). In this case, the doctor prescribes the following examinations:

• Examination of the anus and perineum;
• Digital rectal examination;
• General blood analysis;
• Scatological analysis of feces (with a reaction to occult blood);
• Feces on worm eggs;
• Analysis of stool for microflora (prescribed only if dysbacteriosis is suspected);
• A swab from the area around the anus (prescribed only if a fungal infection or genital herpes is suspected).

The above studies and tests are necessarily prescribed and performed first, and they provide the doctor with a fairly wide range of information about the condition of the terminal sections of the intestine. Based on the information received, the doctor makes a preliminary diagnosis and, if necessary, prescribes additional examinations. For example, if hemorrhoids are detected, then additionally only anoscopy (sign up). But if proctitis, paraproctitis, rectal fissures are suspected, then anoscopy is prescribed, sigmoidoscopy (sign up)/colonoscopy (make an appointment). If the pathology is severe, there are fistulas, adhesions, etc., the doctor may also prescribe specific and rarely used studies, such as fistulography (sign up), probe examination, etc.

If pain in the perineum bothers a woman after childbirth, the doctor prescribes and performs an ultrasound, as well as gynecological two-manual examination (sign up) in order to identify deformations and strictures of internal soft tissues that can provoke pain.

When pain in the perineum is combined with itching, inflammatory discharge from the genital organs (greenish, white, lumpy, etc.) or rashes in the area of ​​the external genitalia (pubis, labia, penis, etc.), then it is suspected sexual infection (genital herpes, candidiasis). In this case, the doctor prescribes a smear from the urethra and vagina, bacteriological culture of vaginal and urethral discharge, which allows identifying the causative agent of the infection. If the results of these tests do not identify the causative agent of infection, then a blood test, urethral or vaginal discharge is prescribed for the presence of a pathogenic microbe (gonococcus, trichomonas, chlamydia, mycoplasma, ureaplasma, Candida fungi, herpes viruses, etc.) using PCR and ELISA methods .

When pain in the perineum is felt simultaneously with pain in the lower abdomen, does not have a clear localization, occurs periodically, goes away on its own, does not intensify with prolonged existence, is not combined with other symptoms of the genital organs (inflammatory discharge, rashes, itching, bleeding, etc. .) – the doctor suspects chronic pelvic pain syndrome. Since this is a syndrome in which a person only experiences pain, but does not have any pathologies of internal organs, this is a diagnosis of exclusion. In other words, a man or woman undergoes a full examination (general, biochemical blood tests, general urinalysis, blood clotting test, Ultrasound of the pelvic organs (if elevated body temperature increases with walking and straining, then a tumor or inflammatory disease of the male genital organs is suspected (orchitis, epididymitis, prostatitis, prostate abscess, adenoma or prostate cancer), and in this case the doctor prescribes the following tests and examinations:

• General blood analysis;
• General urine analysis;
• Blood test to determine the level of prostate-specific antigen (PSA) (sign up);
• Digital examination of the prostate;
• Study of prostate secretion;
• Bacteriological culture of urine and prostate secretions;
• Urethral swab;
• Ultrasound of the prostate gland (make an appointment) And testicles (sign up);
• Testicular or prostate puncture with sampling biopsy (sign up).

First of all, the doctor prescribes a general blood and urine test, and also performs a digital examination of the prostate gland. Based on the data obtained from these initial simple studies, the doctor makes a preliminary diagnosis and already knows for sure whether a person has a tumor or inflammatory disease of the genital organs.

Next, if a tumor disease is detected, the doctor prescribes a blood test to determine the level of prostate-specific antigen (PSA), ultrasound of the prostate, bladder and intestines (sign up), and prostate biopsy (make an appointment). In some cases, magnetic resonance imaging may additionally be prescribed to detect the presence of metastases or assess the condition of soft tissues. If fistulas are suspected, Urethroscopy (sign up), cystoscopy (make an appointment), anoscopy.

If the results of the initial tests reveal an inflammatory disease, the doctor prescribes a smear from the urethra, examination of prostate secretions, culture of urine and prostate secretions in order to identify the causative agent of the infectious-inflammatory process. Additionally, an ultrasound is performed to assess the condition of the genital organs.

If a man suffers from nagging, bursting pain in the perineum after sex, which radiates or is simultaneously felt in the testicles, is combined with discomfort, heaviness and visible veins of the scrotum, intensifies when walking, disappears spontaneously after a few hours - the doctor suspects a varicocele, and prescribes the following tests and examinations:

• Palpation of the testicle in a horizontal, vertical position and when straining;
• Spermogram (sign up);
• Venography;
• Kidney ultrasound (sign up) and testicles;
• Magnetic resonance imaging of the abdominal cavity (make an appointment);
• Dopplerography (sign up);
• Rheography (sign up).

First of all, the doctor prescribes and conducts palpation of the testicle, spermogram and venography, based on the data of which a diagnosis of varicocele is made. Ultrasound, Dopplerography and rheography of the testicles are considered additional examination methods, which are prescribed at the discretion of the doctor, but do not have high information content. Ultrasound of the kidneys and magnetic resonance imaging of the abdominal cavity are prescribed only to identify the possible cause of varicocele, which is often kidney pathology, vascular thrombosis, etc.

When a man develops a nagging, aching pain or burning sensation in the perineum, which is present almost constantly, intensifying in a sitting position and during defecation, cooperitis or colliculitis is suspected, and the doctor prescribes the following tests and examinations:

• General blood analysis;
• General urine analysis;
• Three-glass urine sample;
• Microscopy of prostate secretion and urethral smear;
• Bacteriological culture of prostate secretions, urethral secretions and urine;
• Urethroscopy;
• X-ray contrast urethrography (sign up).

First of all, the doctor prescribes a general blood test and urine tests, microscopy of prostate secretions and smears from the urethra, as well as bacteriological culture of prostate secretions, urethral secretions and urine. These tests allow us to identify the causative agent of the infectious-inflammatory process. Next, urethroscopy is necessarily prescribed and performed, during which colliculitis can be diagnosed and distinguished from cooperitis. After urethroscopy, if cooperitis is detected, urethrography is performed to confirm it.

When a woman experiences pain in the perineum combined with itching, pain and abnormal vaginal discharge that gets worse with urination, the doctor suspects vaginitis and prescribes the following tests and examinations:

• Bimanual gynecological examination;
• Examination of the genitals in the mirrors;
• Vaginal smear for flora (sign up);
• Bacteriological culture of vaginal discharge;
• Detection of pathogens of sexually transmitted infections (chlamydia, mycoplasma, gardnerella, ureaplasma, trichomonas, gonococci, Candida fungi) in the blood and vaginal discharge using PCR and ELISA methods.

All these examinations are prescribed immediately and simultaneously, since they are necessary to identify the causative agent of the inflammatory process in the vagina.

When a woman suffers from throbbing pain in the perineum, which appears spontaneously or is provoked by sex, combined with swelling of the labia, a palpable and painful seal at the entrance to the vagina, enlarged inguinal lymph nodes, chills, weakness and fever - the doctor suspects bartholinitis and makes a diagnosis of based on examination of the patient. After identifying bartholinitis, treatment is carried out. If the process is ongoing for a long time, prone to chronicity, then a bacteriological culture of the discharge of the Bartholin gland is performed to determine sensitivity to antibiotics. This is necessary in order to prescribe antibiotics that are most effective against the causative agent of the infectious-inflammatory process after opening the gland duct and removing the purulent contents. Such targeted prescription of antibiotics minimizes the risk of recurrent bartholinitis in the future.

Before use, you should consult a specialist.

Pain in the perineum cannot but cause feelings of anxiety. Firstly, because they are associated with reproductive function, and secondly, because they make walking difficult, and therefore, very significantly, human life.

Types of perineal pain in men

With a large number of ailments that can cause pain in the perineum, the types of discomfort can be different. In general, pain here can be divided into:

• sharp;
• piercing;
• pulling.

Before talking about the types of pain in connection with certain diseases, it is necessary to clarify that the concept of the perineum can be broad and narrow. In this case, this word is used to name the location of the external genitalia, as well as the openings of the anus and urethra.

Acute pain signal

Since pain always signals problems in the body, acute pain indicates very serious diseases. The most serious of them in the case of acute pain in the perineum is prostate cancer in men (at an advanced stage). In a situation of such pathology, the patient is prescribed the most serious painkillers, including narcotics.

A serious disease such as an abscess associated with suppuration can also cause acute pain in the perineum in men. In this case, this again refers to dysfunction of the prostate gland, usually with a one-sided nature of the sensations, localized where the abscess develops. The pain may radiate to the rectum and other organs. Suppuration is accompanied by high fever and requires prompt medical intervention.

In men, acute pain is caused by prostatitis - inflammation of the prostate gland. If we talk about this organ in more detail, then, being of a muscular nature, it secretes a special substance - a secret - to maintain the activity of male germ cells, sperm, at the proper level. In addition, this substance helps protect sperm from various negative factors.

Prostatitis is one of the most common male diseases. Having a very diverse nature, both in acute and chronic forms, it brings a lot of worries and problems to those who are sick. Therefore, acute pain in the perineum accompanying prostatitis should seriously alert you.

Representatives of both sexes may have inflammation of the mucous membrane of the urethra - urethritis - as a factor in pain in the perineal area. In this case, the discomfort will be more active when urinating.

Pain in the perineum of this nature is also possible in other cases, for example, in situations of trauma, various hematomas, muscle ruptures, bruises, gunshot wounds, etc. or as a result of pinching of the pudendal nerve.

There are many nerve endings in this area, so the pain here is very intense and unpleasant. In trauma situations, they can even cause the patient to faint. Therefore, such conditions, which, among other things, may be accompanied by bleeding, require immediate intervention by a specialist.

Pain in women

Stitching and drawing pain. If we talk about this type of pain, such as negative sensations in the perineum of a stabbing nature, then they are more common in women. For example, with a disease such as vaginitis. Representing an inflammation of the vaginal mucosa, vaginitis, among other things, is accompanied by unpleasant sensations in the vagina itself, as well as copious discharge from it.

Stitching and aching pain is possible during pregnancy.

Nagging or aching pain in the perineum is often caused by chronic diseases. In this case, they are long-lasting, if not permanent. Of course, the way to get rid of them is to treat chronic ailments.

Nagging pain is caused by quite common chronic cystitis or urethritis, which have already been mentioned. The sensations in question may be postpartum or other in nature.

Sex differences

Many organs of this and adjacent areas are similar in representatives of both sexes. Therefore, specific sensations in the perineum, including those caused by diseases of adjacent systems (for example, the gastrointestinal tract), are also largely similar. However, due to the fundamental biological differences in the reproductive systems of the two categories of people, the causes of pain here can also be fundamentally different. The differences are mainly related to prostate problems.

Focusing on the problems of pregnancy in the aspect of pain in the perineum, this point is associated with the more complex reproductive processes of a woman called upon to bear a child. In addition, it is known that pain in the perineum during pregnancy, childbirth and the postpartum period is often normal, so it can be difficult to separate them from pathology.

Often, at 35 weeks of gestation, a woman may begin to experience unpleasant stabbing pain in the area in question. This is due to the normal process of fetal descent putting pressure on various biological tissues (such as muscles and nerves). Moreover, if such pain appears earlier, it may indicate a miscarriage.

There are cases when the fetus in the womb compresses a nerve (often the sciatic one), which causes sharp pain. The expectant mother has to endure this pain because medical workers can do little to help her in such a situation. You should wait for the baby's position to change.

It is known that before childbirth there is a preliminary natural expansion of the pelvic bones, which also causes pain in some women.

If we talk about the birth process itself, it is important that pain in this area serves as a signal about its beginning. Not to miss this moment means to contribute to the normal course of labor and the absence of pathologies in the child. Therefore, on the eve of the approximate date of birth, everyone is experiencing everything that is completely natural. However, ordinary stretching and swelling are different from rupture of the perineal tissue. If a rupture occurs and doctors stitch you up, the healing process, as well as the pain itself (which in this case increases with urination), will take longer.

Etiology of itching

Itching is a symptom that quite often accompanies pain in the perineum. It may indicate:

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Only a doctor can fully understand the symptoms and eliminate them in case of pain. In case of pain in the perineum, you may most likely need a consultation:

• gynecologist - a doctor who treats women's diseases (especially in the case of pregnancy);
• urologist - a doctor who deals with male problems;
• proctologist - a specialist in pathologies of the colon and anus;
• dermatologist - a doctor specializing in skin diseases;
• and even an oncologist who deals with malignant tumors.

You need to dress warmly and use condoms during sex. Regular preventive examinations are good advice. The doctor can promptly identify a threat that can provoke not only pain in the perineum, but also the progress of the disease itself. And most importantly, do not forget about hygiene.

Pain in the perineum in men most often occurs due to various inflammatory diseases of the genitourinary system, such as vesiculitis, urethritis, various diseases of the prostate gland, etc. Also among the main causes of pain and burning in the perineum in men are hypothermia, sexually transmitted diseases, complications of cystitis and urethritis. Pain in the perineum can be aching, sharp, itchy, twitching, pulling, throbbing, etc.

Sharp pain in the perineum

The appearance of acute and sharp pain in the perineum in men is usually associated with acute prostatitis. This disease is accompanied by extremely unpleasant symptoms. The pain can radiate to the penis, anus, or sacrum. Among the common causes of sharp and severe pain is urethritis. When urinating, the pain in the perineum usually intensifies. Sharp pain and burning are a symptom of suppuration (abscess) of the prostate. They can radiate to the rectum and sacrum. This disease is characterized by a unilateral location, i.e. The pain will be stronger from the localization of the purulent focus. In men, this disease is complemented by disturbances in stool and urination. Body temperature rises significantly, causing general malaise.

Very severe pain in the perineum in men is accompanied by the last stages of prostate cancer. In particularly difficult cases, narcotic drugs may be prescribed for pain relief. The cause of suddenly appearing sharp pain in men can be pinched pudendal nerve. The unpleasant sensations subside slightly if the person stands quietly. In a lying and sitting position, during walking and other activities, the pain intensifies. If a nerve is pinched, there may be a feeling of numbness in some part of the thigh. Sharp, severe pain in the perineum in men occurs with any injury:

Many nerve endings are concentrated in the perineum of men; when injured, the pain can be very severe, often people even lose consciousness.

Aching and nagging pain

In men, pain of this nature appears with chronic urethritis and prostatitis, colliculitis and some other diseases. Patients often describe these sensations as a burning sensation in the perineum. The pain, as a rule, is not very severe, but it is long-lasting and sometimes even permanent. A constant burning sensation in the perineum becomes stronger when a person sits and goes to the toilet. Increased pain in such situations is characteristic of inflammation of the bulbo-urethral gland, i.e. Cooperite. This disease is usually a complication of urethritis. With cooperitis, the burning sensation in the perineum can noticeably intensify if suppuration occurs. You should know that in men, not only diseases of the genitourinary system can be accompanied by pain and burning in the perineum. The following factors can be added to the list of reasons:

• various diseases of the rectum: fissures, tumors, paraproctitis, hemorrhoids;
• neuralgic pathologies, which include various types of injuries to nerve trunks, disorders of the sacrococcygeal spine;
• adhesions in the pelvic area that appeared after surgery or inflammation;
• psychosomatic pain;
• muscle spasms;
• various diseases of the hip joints.

In men, discomfort in the perineal area is in most cases associated with various prostate diseases. Such diseases are accompanied by inflammation and pain. In addition, the cause of unpleasant sensations may be the so-called. pelvic pain syndrome. It appears not only in men, but also in women. This syndrome is accompanied by pain in the lower abdomen. As a rule, they give to the perineum. However, it is not possible to identify signs of any disease in such patients. They are usually given treatment aimed at eliminating symptoms.

Painful sensations accompanied by itching

If pain in men is accompanied by itching, the reason may be the presence of various fungal diseases, most often thrush. Itching and burning also appear with genital herpes. Similar sensations can occur with a variety of allergic reactions, liver cirrhosis, hepatitis, diabetes mellitus, and genitourinary tract diseases.

Even low-quality synthetic underwear can cause burning and itching.

It causes allergies and creates the so-called. Greenhouse effect. In such conditions, pathogens of a wide variety of infections feel very good. Therefore, it is necessary to refuse synthetic underwear.

Pain in the perineum, radiating to the groin area

Unpleasant sensations in the perineal area very often radiate to the groin. There are many reasons why men may experience such unpleasant symptoms. Most often, pain of this nature appears in those men whose profession involves constant physical activity. Pain in the perineum and groin plagues many athletes. Among the most common options for the appearance of such sensations are:

1. Hernia - it can form due to weakening of the abdominal tissues under the influence of strong physical exertion. To diagnose the disease, you do not need to conduct any serious examinations; it is enough just to examine the person in a standing position. If the hernia is hidden, it is usually detected by palpation. Another traditional method for diagnosing a hernia is a common cough. It causes a feeling of heaviness in the lower abdomen.
2. Also a common cause of pain in the perineum and groin are inflammatory processes in the pelvis. Most often they appear due to various types of infections. When affected by pathogenic microorganisms, the lymph nodes enlarge, which is why pain appears.
3. The cause of discomfort in the groin and perineum in men may be kidney stones. Especially if they are located too low or have already penetrated the urinary tract.
4. Pain also appears with osteochondrosis of the lumbar vertebrae. In the presence of such a disease, the vertebral discs can compress the nerve endings. Because of this, severe and acute pain appears in the groin area.

Pain when performing various activities

If burning and pain in the perineum appear during urination, it is necessary to check for urethritis, prostatitis and colliculitis. Such pain can also appear after various injuries, surgery, or as a result of exposure to sexually transmitted diseases. If discomfort appears or intensifies while walking, the cause may be fractures, bruises and other injuries to the tailbone. In men, difficulties while walking, accompanied by pain in the perineal area, appear with inflammation of the testicles and/or their appendages, with hydrocele.

Often, pain in the groin, testicles and perineum appears during or after sexual intercourse. This may be evidence of the presence of varicocele, i.e. varicose veins of the spermatic cord and testicle. Such pains are not too intense. They may intensify at rest and subside when walking. Usually the pain goes away within a few minutes. In some cases, they can cause discomfort for several hours. At some point, the sensations disappear on their own. Prostatitis can also cause discomfort in the perineum during sex.

Remember that any pain, burning sensation and other unpleasant and unnatural sensations are a sign that something is wrong with the body. There is no need to try to ignore these phenomena. It is better to analyze the situation in detail and seek help from a doctor as quickly as possible so that he can prescribe the necessary tests, conduct examinations and develop a suitable treatment program. Men with pain in the perineal area should first consult a proctologist or urologist. In some situations, you have to additionally communicate with a dermatologist and/or oncologist. Listen to your body and respond to its signals in a timely manner, because untimely treatment can lead to the development of very serious complications. Be healthy!