Treatment of Perineal Pain, Discomfort and Soreness in NYC: Experienced Urologists

by Alex Shteynshlyuger MD


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5747.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office. 

We offer affordable appointment prices with or without insurance.  Same-day virtual video appointments and in-person appointments are available.


Treatment of Perineal Pain: What You Need to Know

Causes of Perineal Pain and Discomfort

Many men and women may occasionally feel slight discomfort or soreness in the perineum. Usually, the discomfort goes away, spontaneously within a few weeks to a few months.  When this discomfort or soreness becomes persistent, it can severely affect the quality of life. When the perineal discomfort is persistent or if the perineal pain is severe, it requires treatment.

Life pain free from perineal pain.

Life pain-free from perineal pain.

Because of differences in anatomy, the causes of perineal pain and discomfort are different in males and females.

Women most commonly experience perineal pain after childbirth, after sex, or as a result of urinary tract infections.

In men, the causes are different and may be related to prostatitis.

Both men and women can experience perineal or perianal pain as a result of gastrointestinal problems or anal problems.  Perineal discomfort may also be an indication of urinary problems in both men and women.

Burning in the Perineum

Burning sensation in the perineum is often a sign of an underlying urinary problem or neuropathic pain.  A thorough evaluation is typically performed to evaluate urinary function. The treatment plan is created with the goal of addressing the most likely cause of pain in each patient.   Given the complex anatomy and interplay of multiple variables, often a few treatment approaches are tried.

Evaluation Approach:

A physical exam is performed. Relevant laboratory studies are obtained depending on patient history.  Pelvic ultrasound is performed. If necessary, CT or MRI of the pelvis is performed. Back or Spine MRI is sometimes necessary depending on patient history and symptoms.   Cystoscopy and urodynamic studies are performed as needed.  Additional studies may be performed as deemed necessary.

Treatment is initiated individually in each patient, guided by history, physical exam, and test results.  The most likely causes of pain are addressed first.  If there is no adequate improvement, other causes of pain are addressed sequentially.

What is the perineum?

The perineum is the area of the human body that includes the anal opening and the external genital organs. In the male, it includes the penis and the testicles. And In the female, it includes the opening of the vagina and urethra and also the labial folds. The area surrounding these openings is included in the perineum. It is sometimes also called the lowest part of the pelvic region and includes everything that passes through or is present in the pelvic outlet.

Perineal Pain Characteristics

Pain in the perineum is felt as a penetrating ache. It can be felt in the perineum, as well as in the rectum, with associated inguinal discomfort. The pain can be very agonizing; many patients may feel depressed and exasperated by the pain. The pain can be persistent or intermittent. It may recur or may go away on its own.

Common Causes of Perineal Pain:

Prostatitis is an inflammatory condition of the prostate gland (an important gland due to its role in reproduction for providing nutrition to the sperm). It produces the characteristic pain of the prostate that is usually felt in the lower pelvic region but may also be felt in the perineum. Prostatitis can be acute or chronic. Acute prostatitis is usually due to bacterial infection of the prostate gland, whereas chronic prostatitis could be due to infection or maybe non-infectious. Fever usually accompanies infective prostatitis.

An important cause of pain in the perineum is the entrapment of the pudendal nerve. The pudendal nerve is a nerve that supplies many important organs in the lower pelvis and perineum. Entrapment of this nerve results in chronic pain, which is persistent and lasts for a long period of time. The nerve is not damaged but gets compressed. It can be due to pregnancy, any surgery that may leave a scar tissue compressing on the nerve, and it can also occur due to trauma, riding or bicycling, etc. It is not a very common condition but needs expert opinion to reach a definite diagnosis. Typically, the pain of pudendal nerve entrapment is increased when sitting and is reduced while standing or sitting on a toilet seat. It is also reduced while lying down on a bed. It can also result in paresthesias, which are abnormal sensations around the buttock and the perineum. It can also lead to numbness.

Another important cause of perineal pain is the delivery of a baby. It is seen in mothers in the postpartum period, which is the period right after birth. It can occur due to damage to the organs and muscles of the perineum during a difficult labor and also due to damage to any nerve or even the pudendal nerve. The pain usually starts right after delivery and continues for a long period of time. The pain may spread to the inguinal region and becomes a persistent penetrating ache.

An abscess in the perineum is also an important cause of perineal pain. Usually, the abscess develops in the ischiorectal fossa, which is a horse-shoe shaped space in the perineum surrounding the rectum. The infection that usually develops here is secondary to some other cause. For example, the infective organism may reach this space from the rectum. It colonizes this space and forms an abscess, which is very painful and tender. Usually, it is accompanied by high-grade fever and can lead to fistulas, which are unnatural openings that may lead outside.

Other minor causes include perineural cysts, abscesses, and tumors of the anal canal, urethra, or the external genitalia.

Other Causes of Perineal Discomfort and Pain

Pain in the perineum can be confused with a number of other conditions like the discomfort of incomplete bladder emptying or urinary retention, which is also felt in the lower pelvis, but it is associated with urinary symptoms. Prostate carcinoma may also cause similar pain, but often it is associated with urinary symptoms.

Stones in the urethra may also cause pain around the tip of the penis. Scrotal pain should also not be confused with perineal pain as it is usually just localized to the scrotum or the testicles.

Treatment of Pelvic Pain in New York City

Treatment depends on the cause. The pain can be alleviated by taking pain killers. The choice of pain-relieving medicines depends upon the degree of pain. It can range from “over the counter” pills like acetaminophen and ibuprofen to synthetic opioids.

For pudendal nerve entrapment, corticosteroids are prescribed to help relieve pain and injury to the nerve. Corticosteroids are also helpful in reducing inflammation. They are usually recommended in conjunction with pain killers. The pain usually subsides after adequate treatment, but in difficult cases, surgery may be needed to relieve compression on the nerve.

For prostatitis, depending on the cause, antibiotics and anti-inflammatory drugs are used that may relieve the pain and discomfort.   Surgery is also required for tumors developing in the perineal region, and may also need chemotherapy and radiotherapy later on.

Did you know? Dr. Shteynshlyuger has treated thousands of men and women with pelvic pain and bladder pain, perineal pain, penile pain, scrotal pain, testicular pain, kidney pain, prostatitis, and prostate pain.  He performs 150-200 surgeries a year.

Where to Get Treatment for Perineal Pain in NYC?

At New York Urology Specialists, we offer same-day treatment for pain.  Same-day virtual video appointments and in-person appointments are available.

Call/text today: 1-212-204-6300 or make an appointment online.  

We perform scrotal surgery, penile procedures, varicocele and hydrocele repair, and circumcision.  We offer treatment for phimosis, balanitis, missing testis, low testosterone, penile irritation, and redness. We treat sexual and erection problems and offer comprehensive STD testing for infections. We offer confidential appointments.

Our appointment costs are affordable with or without insurance.  We offer free insurance verification.

We perform a bladder, kidney, and testicular ultrasound in our office.  We offer microscopic spermatic cord denervation, treatment for kidney stones, pelvic pain, and prostatitis in our office.   We treat urinary and erection problems. We offer confidential appointments.

Cost of Pain Treatment without Insurance

At New York Urology Specialists, we offer affordable treatment for pain. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. 

At New York Urology Specialists, we offer flat-fee ‘all-cost-included’ procedures such as scrotal and testicular surgery, trigger-point injections, pelvic floor physical therapy, circumcision, spermatic cord denervation, kidney stone removal, vasectomy reversal, hydrocelectomy, varicocelectomy, clitoral phimosis hoodplasty, vulvodynia, vestibulodynia, lichen sclerosus, and many more.  Many procedures are performed in our office under local anesthesia or sedation. Men and women from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment.  Please contact us for current prices and discounts for patients without insurance or with high insurance deductibles.

Cost of Treatment and Insurance

Inexpensive Urologist Visit CostAt New York Urology Specialists, we offer affordable treatment for men and women. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. 

We accept many health insurance plans.  We would be happy to verify your eligibility and benefits and provide you with detailed information on your health plan’s coverage.  Financing options and credit options are available to help you pay for medical care.

Why Choose New York Urology Specialists for Treatment of Perineal Pain?

  • All treatment is performed by a board-certified urologist experienced in treating men and women with pelvic pain and perineal pain symptoms. We also treat pain in the urinary tract, external genitalia, kidneys, bladder, and prostate.  We treat scrotal and testicular pain, and urinary problems using medical therapy, minimally invasive therapies, lasers, and surgery.  
  • We are one of the few practices in the region to offer a full range of options for the treatment of genital pain and urinary pain in men and women.
  • We offer treatment options for testicular pain, penis pain, painful urination in our office.  Office procedures avoid the risks, costs, and recovery from general anesthesia.  
  • We offer diagnostic testing in our office, which avoids hospital costs.
  • Extensive experience: Thousands of men and have been treated successfully for pain symptoms in the kidneys, bladder, pelvis, perineum, and genital areas.
  • Confidential and Understanding Care. We understand that most of our patients desire privacy.  We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
  • We are conveniently located within a 30-60 minute commute to men and women who are seeking treatment for chronic pelvic pain, bladder pain, and perineal pain.  We treat men with testicular pain, epididymitis, testicular torsion, post-vasectomy pain, and penile pain in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.

What do Pain Problems Look Like?

You can find pictures of painful conditions as well as before and after treatment images in our image gallery.

Scheduling Appointments for Perineal Pain Treatment at New York Urology Specialists


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5747.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office. 

We offer affordable appointment prices with or without insurance.  Same-day virtual video appointments and in-person appointments are available.

Dr. Shteynshlyuger MD is a board-certified urologist in NYC who specializes in treating men and women with pelvic pain, urinary pain, perineal pain, as well as chronic pelvic pain, and interstitial cystitis.   He has performed hundreds of bladder, penile and testicular surgeries for relief of pain and other symptoms.  


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Treatment for Men With Fast Recovery at New York Urology Specialists

Excellence-Urology_Care-banner2At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of men’s health concerns including sexual problems and urinary problems in men.  We understand the challenges that penile problems and testicular problems create for our patients, their relationships, and their self-esteem.  We help you find a treatment for penile problems and testicular problems, including appearance concerns, foreskin problems, premature ejaculation, testicular pain, and erectile dysfunction that fit your needs, lifestyle, and preferences.

Urologists are doctors specializing in the treatment of men with sexual problems that include penis problems, scrotal problems, and erectile dysfunction. By virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for any problem that affects the penis.  We offer medical and surgical treatment for men’s sexual problems.

We Treat Some of the Most Complex Pain Problems Including:

Schedule an Appointment with Dr. Shteynshlyuger:

Call/text today: 1-212-204-6300 or make an appointment online

Dr. Shteynshlyuger is a fellowship-trained, board-certified urologist with expertise in the evaluation and treatment of sexual, urinary, and erection problems in men.  He uses modern, effective, and proven treatment methods.  We offer circumcision, circumcision revision, penile frenuloplasty, penoscrotal web repair, testicular implants, inflatable penile implant, shockwave therapy for ED, and treatment for Peyronie’s disease. We perform procedures such as Botox for OAB, Interstim neuromodulation, Rezum for BPH, prostate enucleation for enlarged prostate, and Urolift procedure.  

He has successfully treated hundreds of men with an enlarged prostate, testicular problems, low testosterone, erection problems with symptoms of frequent urination during the day, and excessive urination at night.

He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5747.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office. 

We offer affordable appointment prices with or without insurance.  Same-day virtual video appointments and in-person appointments are available.