Subcutaneous Bumps Near the Perineum: When to Seek Help

Subcutaneous mass near the perineum?

Hello, doctor.
On January 29th, I discovered a small lump near the perineum (the area of skin between the anus and the vagina, but not directly on the midline).
It feels like it's located beneath the skin, not on the surface, and it doesn't move much.
Initially, it was painful, and I felt discomfort when wiping after using the bathroom, but I couldn't tell if it was the skin or the lump that hurt.
Now, it has become less painful, with only a slight sensation of swelling (very mild pain) when pressed.
It has been a week since I first noticed it, and there has been no discharge of pus.
It still feels like it's beneath the skin, and I can't really tell if its size has changed.
I'm quite worried that it might be something serious, like cancer metastasis.
Should I see a gynecologist, a colorectal surgeon, or a lymphatic specialist? Thank you.

Zhuang Xiaojie, 20~29 year old female. Ask Date: 2023/02/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it could be inflammation.
I recommend seeing a gynecologist for an examination.
Wishing you good health.

Reply Date: 2023/02/06

More Info

When it comes to subcutaneous bumps near the perineum, it is essential to understand the potential causes and when to seek medical help. Based on your description, the bump you discovered could be a variety of things, including a sebaceous cyst, an epidermoid cyst, or even a localized infection such as an abscess. These types of bumps are generally benign, but it is crucial to monitor them for any changes.

When to Seek Help
1. Persistent Symptoms: If the bump remains painful, continues to grow, or changes in appearance, it is advisable to seek medical attention. While many bumps can resolve on their own, persistent symptoms may indicate an underlying issue that requires further evaluation.

2. Signs of Infection: If you notice any signs of infection, such as increased redness, warmth, swelling, or drainage of pus, you should consult a healthcare provider immediately. Infections can lead to more serious complications if not treated promptly.

3. Difficulty with Bowel or Urinary Function: If you experience any changes in bowel or urinary habits, such as difficulty passing stool or urine, this could indicate that the bump is affecting nearby structures. This warrants immediate medical evaluation.

4. Concerns About Cancer: While it is natural to worry about the possibility of cancer, especially with any new growth, most bumps in the perineal area are benign. However, if you have a family history of cancer or other risk factors, it is wise to discuss these concerns with your doctor.

Which Specialist to See
Given the location of the bump, you have a few options for specialists:
- Gynecologist: If you are a female and the bump is near the vaginal area, a gynecologist may be the most appropriate specialist to evaluate the bump. They can perform a thorough examination and determine if any further testing is needed.

- Colorectal Surgeon: If the bump is closer to the anal area or if you have any bowel-related symptoms, a colorectal surgeon would be well-equipped to assess the situation. They specialize in conditions affecting the rectum and anus.

- Dermatologist: A dermatologist can also be consulted, especially if the bump appears to be a skin-related issue. They can provide treatment options for cysts or other dermatological conditions.

Conclusion
In summary, while many subcutaneous bumps are benign, it is essential to monitor them for any changes and seek medical advice if you have concerns. Given your symptoms and the location of the bump, consulting with a gynecologist or a colorectal surgeon would be appropriate. They can provide a thorough evaluation and determine if any further action is necessary, such as imaging studies or a biopsy. Remember, early intervention is key to addressing any potential issues effectively.

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