{"id":116,"date":"2014-12-27T06:16:22","date_gmt":"2014-12-27T06:16:22","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/pain\/?page_id=116"},"modified":"2020-12-27T06:01:00","modified_gmt":"2020-12-27T06:01:00","slug":"perineal-pain","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/pain\/perineal-pain\/","title":{"rendered":"Perineal Pain, Discomfort and Soreness: Specialized Care and Treatment in New York City"},"content":{"rendered":"

Treatment of Perineal Pain, Discomfort and Soreness in NYC: Experienced Urologists<\/h1>\n

by Alex Shteynshlyuger MD<\/a><\/strong><\/p>\n

\n

If you have any questions, to schedule a consultation<\/a>, please <\/a>contact us<\/a> or call\/text: 1-646-663-5747<\/span><\/a><\/strong>.<\/strong><\/p>\n

We have excellent reviews from patients <\/a><\/strong>and their partners.  Information for out-of-state and international patients<\/a>.  Find out our office hours or directions to our office<\/a>. <\/strong><\/span><\/p>\n

We offer affordable appointment prices<\/a> with or without insurance.  <\/strong><\/span>Same-day virtual video appointments<\/strong> and in-person appointments<\/strong> are available.<\/span><\/p>\n

\n

Treatment of Perineal Pain: What You Need to Know<\/strong><\/h1>\n

Causes of Perineal Pain and Discomfort<\/h2>\n

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.<\/p>\n

\"Life

Life pain-free from perineal pain.<\/p><\/div>\n

Because of differences in anatomy, the causes of perineal pain and discomfort are different in males and females.<\/p>\n

Women most commonly experience perineal pain after childbirth, after sex, or as a result of urinary tract infections<\/a>.<\/p>\n

In men, the causes are different and may be related to prostatitis.<\/p>\n

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.<\/p>\n

Burning in the Perineum<\/h3>\n

Burning sensation<\/strong> 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.<\/p>\n

Evaluation Approach:<\/h2>\n

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.<\/p>\n

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.<\/p>\n

What is the perineum?<\/strong><\/h2>\n

The perineum<\/strong> 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.<\/p>\n

Perineal Pain Characteristics<\/strong><\/h2>\n

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.<\/p>\n

Common Causes of Perineal Pain:<\/strong><\/h2>\n

Prostatitis<\/strong> 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.<\/p>\n

An important cause of pain in the perineum is the entrapment of the pudendal nerve<\/strong>. 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.<\/p>\n

Another important cause of perineal pain is the delivery of a baby<\/strong>. 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.<\/p>\n

An abscess in the perineum<\/strong> 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.<\/p>\n

Other minor causes include perineural cysts, abscesses, and tumors of the anal canal, urethra, or the external genitalia.<\/p>\n

Other Causes of Perineal Discomfort and Pain<\/strong><\/h2>\n

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.<\/p>\n

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.<\/p>\n

Treatment of Pelvic Pain in New York City<\/strong><\/h2>\n

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 \u201cover the counter\u201d pills like acetaminophen and ibuprofen to synthetic opioids.<\/p>\n

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.<\/p>\n

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.<\/p>\n

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

Where to Get Treatment for Perineal Pain in NYC?<\/h2>\n

At New York Urology Specialists, we offer same-day treatment for pain<\/strong>.  Same-day virtual video appointments<\/strong> and in-person<\/strong> appointments are available.<\/p>\n

Call\/text today: 1-212-204-6300<\/span><\/a> <\/span><\/strong>or <\/span>make an appointment<\/span><\/a> online.  <\/span><\/span><\/strong><\/p>\n

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

Our appointment costs<\/a> are affordable with or without insurance<\/strong>.  We offer free insurance verification<\/strong>.<\/p>\n

We perform a bladder, kidney, and testicular ultrasound in our office.  We offer microscopic spermatic cord denervation<\/a>, treatment for kidney stones<\/a>, pelvic pain<\/a>, and prostatitis<\/a> in our office.   We treat urinary<\/a> <\/b>and erection problems<\/a><\/strong>. We offer confidential<\/strong> appointments.<\/p>\n

Cost of Pain Treatment without Insurance<\/h2>\n

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

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<\/a>, kidney stone removal, vasectomy reversal, hydrocelectomy<\/a>, varicocelectomy<\/a>, clitoral phimosis hoodplasty, vulvodynia, vestibulodynia<\/a>, lichen sclerosus, and many more<\/strong>.  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<\/strong>.<\/p>\n

Cost of Treatment and Insurance<\/h2>\n

\"InexpensiveAt New York Urology Specialists, we offer affordable treatment for men and women<\/strong><\/a>. Our prices are low<\/strong> for patients without insurance<\/strong><\/span> and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. <\/p>\n

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

Why Choose New York Urology Specialists for Treatment of Perineal Pain?<\/h2>\n