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Suggest Treatment For Pain In The Perineal Area

Posted on Mon, 11 Jul 2016

Question: I have pain between my testicles and anus only when I start to pee then need to hold it, so when I need to stop peeing, this is only at work I do this. 32 year old male, no Med HX, on testosterone therapy, no other issues urinating or ejaculating.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Could be due to Prostatitis.

Detailed Answer:
Hello
Thanks for query .
The pain in testicles and anus when you start to pass urine could be mostly due to mild Prostatitis.

Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Serum PSA.

You need to take You need to take broad spectrum antibiotic like Cefotaxime along with anti inflammatory drug like Diclofenac twice daily .

Ensure to drink more water .

Do not attempt to hold on urine for a long time as it increases congestion of prostate and gives rise to pain .

Further treatment will depend upon result of these tests and final diagnosis.

Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (2 hours later)

As I pee, it's fine. Where the trouble is if I have to stop midstream. I'm a firefighter. Sometimes, even when we're in the middle of going to the bathroom, we have to stop what we're doing and go to the truck. For me, the pain is only if I have to cut off my pee midstream. But when go again everything is fine. My pain is not constant throughout the day.

Answered by Dr. Dr. P. T. Patil (45 minutes later)

Brief Answer:
It is likely to be due to retrograde flow of urine through Vas Difference

Detailed Answer:
Hello
Thanks for follow up .

Whenever you suddenly stop urine flow while passing urine there is retrograde flow of some quantity of urine from urethra (Due to pressure from bladder ) through ejaculatory duct in to Vas Difference and back in to Testicle and this is the reason for pain in testicles .

Thanks and Regards.
Dr.Patil.

Brief Answer:
It is reffered pain along distribution of Pudendal Nerve .

Detailed Answer:
Hello
Thanks for folow up .

The perineum and Ejaculatory duct have same nerve innervation by Pudendal Nerve .

The pain in perineum is a refereed pain along the distribution of Pudendal Nerve .

Thanks and Regards.
Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (28 minutes later)

My pain is not in the testicles. It's between them and the anus. I think the perineum? When it happens it feels like a sharp pinch. Afterwards, I sometimes feel some lingering discomfort as if it were a bad muscle cramp. This pain is only after I stop my pee and its BETWEEN my testicles and my anus. Thank you for your help.