What are the causes of a perineum lump?
A perineal lump is a collection of fluid or blood in your groin area. A lump may be painful, but it usually goes away within a few days. There are several possible reasons why you might have one:
1) You’ve got an infection (or abscess).
If so, it’s probably not life threatening.
2) Your prostate gland is enlarged.
This can cause a lump if there isn’t enough tissue around it to drain the excess fluid. If you’re older than 50 years old, then your prostate glands will shrink over time due to declining health. If this happens, then you’ll develop a lump at the base of your prostate gland because there’s less tissue surrounding it now.
3) You’ve got an enlarged bladder (cyst).
This is most likely to happen when you have a urinary tract infection (UTI). When bacteria from the UTI get into your bladder, they produce pus. Pus collects in the urethra. Normally, urine flows out of your body through your urethra.
If you don’t empty your bladder properly, though, the urine doesn’t flow out very well either and accumulates in the pelvis or lower abdomen instead. This can lead to swelling and pain in these areas.
4) You’ve got hemorrhoids.
This is most likely to happen if you have a history of hemorrhoids. Often, the tissue around your hemorrhoids thins out until it’s so weak that it fails to hold in stool any longer. The thinned out tissue can also result in tiny holes opening up in your hemorrhoids, allowing blood to leak into the surrounding area.
5) You’ve got an inguinal hernia.
This can happen in men and women. In women, it’s often most apparent during pregnancy when there’s an increase in the size of the uterus along with an increase in other abdominal contents. This can push up on the intestines and force some of them through this opening in your inguinal canal.
6) You’ve got perineal cysts.
These are fluid-filled sacs that occur around the muscles in your perineum. They can form in the perineal body, in the skin that surrounds your scrotum or labia, at the base of your prostate, or at other locations. They are typically non-cancerous (benign) but can become painful and even infected over time.
What are the treatment options for a perineum lump?
1) If you’ve got an infection, you’ll need to take antibiotics for it.
2) If you’ve got a perineal cyst, your doctor is likely to drain the fluid from the cyst.
He or she may also prescribe antibiotics so that the cyst doesn’t become infected.
3) Your doctor might perform a needle biopsy to remove a sample of the lump.
This will allow him or her to determine the exact nature of the lump and whether or not it’s cancerous (malignant).
4) If you’ve got an enlarged prostate gland, then your doctor may perform a transurethral resection of the prostate (TURP).
This is a minor operation done using an instrument called a resectoscope. It involves creating a small incision in the wall of the urethra and then cutting out part of the prostate through this incision.
The above approaches are considered by most physicians to be the best way to treat a perineum lump.
What is a perineum cyst?
A perineum cyst is a fluid-filled sac that forms in the perineum. It’s known medically as a hidradenitis suppurativa or an epidermoid cyst.
It can develop in any of the following locations:
Between the skin and the muscles of the perineum. This is called a skin tag or an epidermal inclusion cyst.
Beneath the prostate. It’s known as a perineal gland epidermoid cyst.
Between the skin and the muscles surrounding the urethra at the neck of the bladder. This is called a Skene’s duct cyst.
Around the rectum. This is called an epidermal inclusion cyst or an epidermal cyst.
At the base of the large intestine or rectum. This is called a rectal gland epidermoid cyst.
Beneath the bladder, at the base of the urethra. This is called a bladder gland epidermoid cyst.
Where do perineum cysts form from?
A perineum cyst typically begins during fetal development when a baby is in the womb. At this time, the baby’s skin thickens to form the epidermis layer. It also forms an area known as a placode. This is a small area of thickened skin that’s destined to become part of a sweat gland.
If some of the cells in the placode fail to mature properly or die before birth, a hole can develop in them. This forms what’s known as a embryologic duct remnant. If these cells are in the baby’s perineum region, they can form a perineal cyst.
A similar process is thought to occur in some adult epidermoid cysts that develop in other locations, such as the neck of the bladder.
How do you cure a perineum cyst?
Perineum cysts don’t need any treatment unless they become infected or start to cause problems. This typically only happens when they get bigger.
Sources & references used in this article:
Secondary perineal hernia following open abdominoperineal excision of the rectum: report of a case and review of the literature by RJE Skipworth, GHM Smith, DN Anderson – Hernia, 2007 – Springer
Congenital perineal lipoma associated with bilateral undescended testes and anorectal malformation by Y Le Linn, LW Chiang, AHM Lai, CCP Ong – Journal of Pediatric Surgery …, 2020 – Elsevier
The syndrome of the descending perineum by AG Parks, NH Porter, JD Hardcastle – 1966 – journals.sagepub.com
Laparoscopic repair of primary perineal hernias: the approach of choice in the 21st century by PG Sorelli, SK Clark, JT Jenkins – Colorectal Disease, 2012 – Wiley Online Library
