Small Perineal Wounds: Causes and When to Seek Help - Surgery

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There is a small wound in the male perineal area?


About two weeks ago, I noticed a stinging sensation when water hit my perineum while showering.
There appears to be a small pink wound located about 1 to 2 centimeters from the anus, between the scrotum and the anus, measuring approximately 1 mm in size.
Besides the stinging sensation when water touches it, there are no other symptoms (no itching, no pus, no blood in stool), and the wound seems to have maintained its size.
I would like to know what this condition might be, and which specialty I should consult for further evaluation.

Zhengzong, 30~39 year old female. Ask Date: 2021/11/17

Dr. Zhang Shuhao reply Surgery


This symptom is usually due to inflammation of the sebaceous glands.
Proper cleaning or the application of ointments may allow for natural healing.
If there are recurrent inflammations or purulent blood-like discharge, it indicates the formation of a subcutaneous fistula, and surgical removal may be considered.
You may consult a general surgeon or a colorectal specialist.
Wishing you a speedy recovery.

Reply Date: 2021/11/17

More Info


When it comes to small perineal wounds, especially in sensitive areas like the perineum (the area between the anus and the genitals), it is essential to understand the potential causes and when to seek medical attention. Based on your description, you have a small pink wound approximately 1mm in size, located about 1 to 2 centimeters from the anus, which causes a stinging sensation when exposed to water but does not exhibit other symptoms such as itching, pus, or blood in the stool.


Possible Causes
1. Minor Trauma or Irritation: The most common cause of small wounds in the perineal area is minor trauma or irritation. This could occur from activities such as vigorous washing, friction from clothing, or even from sexual activity. Given that you noticed this after bathing, it is possible that the area was irritated by the water or soap.

2. Infection: While you mentioned that there is no pus or other signs of infection, it is still a possibility. Small wounds can become infected, leading to redness, swelling, and pain. However, the absence of these symptoms is reassuring.

3. Dermatological Conditions: Conditions such as folliculitis (inflammation of hair follicles), dermatitis, or even a small cyst can cause localized irritation and wounds. These conditions may not always present with significant symptoms but can cause discomfort.

4. Fungal or Yeast Infections: The perineal area is warm and moist, making it susceptible to fungal infections. These typically present with itching or a rash, but in some cases, they may cause small wounds.

5. Sexually Transmitted Infections (STIs): Although less likely given the absence of other symptoms, certain STIs can cause lesions or sores in the genital area. If there is any possibility of exposure, this should be considered.


When to Seek Help
Given that the wound has persisted for two weeks without significant changes, it is advisable to seek medical attention. Here are some indicators that warrant a visit to a healthcare provider:
- Persistent Pain or Discomfort: If the stinging sensation worsens or becomes more frequent.

- Change in Appearance: If the wound increases in size, becomes red, swollen, or starts to ooze pus.

- Development of New Symptoms: Such as fever, chills, or any systemic symptoms.

- Concerns About STIs: If there is any possibility of exposure to sexually transmitted infections.


Which Specialist to See
For a perineal wound, the most appropriate specialists to consult would be:
- Primary Care Physician: They can evaluate the wound and provide initial treatment or referrals as necessary.

- Dermatologist: If the wound appears to be related to a skin condition, a dermatologist can provide specialized care.

- Urologist: If there are concerns related to the genital area or urinary symptoms.

- Colorectal Surgeon: If there are any concerns about the anal area or if the wound is suspected to be related to anal conditions.


Conclusion
In summary, while your small perineal wound may not currently exhibit alarming symptoms, it is essential to monitor it closely. If you notice any changes or if the discomfort persists, seeking medical advice is prudent. Early intervention can prevent potential complications and ensure proper healing. Remember to maintain good hygiene in the area, avoid irritants, and consider using mild, unscented soap when bathing.

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