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Pain Between the Genitals and the Anus Symptoms & Causes

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Last updated January 28, 2021

Perineal pain quiz

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The perineum pain between the genitals and anus can be commonly caused by anal fissures. Pain in the area between the scrotum and the anus can be caused by chronic or acute prostatitis. Read below for more information on causes and treatment options.

8 most common causes

Chronic Prostatitis
Anal Fissure
Spinal Stenosis
Hemorrhoids
Illustration of various health care options.
Piriformis syndrome
Illustration of various health care options.
Painful bladder syndrome (interstitial cystitis)
Illustration of a doctor beside a bedridden patient.
Acute prostatitis
Illustration of a doctor beside a bedridden patient.
Anal cancer

Perineal pain quiz

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5 possible pain between the genitals and the anus causes

The list below shows results from the use of our quiz by Buoy users who experienced pain between the genitals and the anus. This list does not constitute medical advice and may not accurately represent what you have.

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Next steps including visiting a primary care physician. For this condition, a physician might suggest further investigation including imaging of the spine. Treatments may include medications, physical therapy, or braces. For severe cases, surgery is sometimes recommended.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain

Urgency: Primary care doctor

Piriformis syndrome

Piriformis syndrome

The two piriformis muscles, left and right, each run from the base of the pelvis to the top of the thighbone. The two sciatic nerves, left and right, are each attached to the spine and run down between the pelvic bone and the piriformis muscle to the back of each leg.

If the piriformis muscle is damaged through sudden trauma, or through overuse as in sports, the resulting inflammation or spasm of the muscle can trap the sciatic nerve between the pelvic bone and the muscle.

Piriformis syndrome is most often found in women over 30.

Symptoms include pain over one or both sides of the low back, and shooting pain (sciatica) down one or both legs.

Diagnosis is made through physical examination and sometimes imaging such as CT scan or MRI.

Treatment involves rest; over-the-counter, nonsteroidal anti-inflammatory drugs; physical therapy; therapeutic injections; and, rarely, surgery.

The best prevention is a good regimen of stretching before exercise, to help prevent damage to the piriformis.

Rarity: Common

Top Symptoms: pelvis pain, butt pain, pain when passing stools, leg numbness, hip pain

Symptoms that never occur with piriformis syndrome: involuntary defecation, leaking urine

Urgency: Primary care doctor

Painful bladder syndrome (interstitial cystitis)

Painful bladder syndrome, also called interstitial cystitis or IC, is a chronic condition of pain and discomfort in the urinary system.

The cause is unknown. It may be an autoimmune disorder and is often found with fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, or vulvodynia (pain in the outer female organs.) Some researchers feel the condition may be linked to a history of abuse.

Painful bladder syndrome is more common in women than in men, but can happen to anyone.

Symptoms vary and may include pressure and discomfort in the lower abdomen; pain during sexual intercourse; bladder pain; and a frequent urge to urinate.

A medical provider should be seen for these symptoms, because painful bladder syndrome can interfere with quality of life and lead to depression.

Diagnosis is made through patient history; physical examination; blood and urine tests; and sometimes cystoscopy. Women may have a pelvic examination and men may have a digital rectal examination.

There is no cure specifically for painful bladder syndrome, so treatment involves addressing the symptoms and making lifestyle changes.

Perineal pain quiz

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Hemorrhoids

Hemorrhoids, or "piles," are swollen veins in the anus or rectum. They may be located inside the rectum (internal) or outside the body at the anus (external.)

The condition is caused by straining during bowel movements and/or from increased pressure during pregnancy and childbirth.

Hemorrhoids are a common occurrence, especially in older people. Pregnant women are susceptible, as is anyone who has chronic constipation or is obese.

Symptoms include discomfort, pain, pressure, and itching. There may be small amounts of bleeding during bowel movements, though some hemorrhoids cause no symptoms at all.

Severe pain can indicate a thrombosed hemorrhoid, meaning a clot has formed within it. This is not serious but the pain can be debilitating and requires treatment right away. Also, rectal bleeding can also be a sign of more serious diseases such as diverticulitis or cancer and should always be diagnosed by a medical provider.

Diagnosis is made through physical examination and sometimes through colonoscopy.

Treatment begins with good hygiene, cold compresses, and over-the-counter pain relievers. Surgery may be done for some cases.

Chronic prostatitis

Chronic prostatitis is an ongoing inflammation or infection of the prostate gland, the small, walnut-shaped organ just below the bladder in men.

Prostatitis is most often due to common bacteria in the urine causing infection. It may also be caused by surgery or other trauma setting up an inflammation. In some cases, the cause remains unknown.

Men of all ages are susceptible. Risk factors include a past urinary tract infection; using a catheter for urination; or pelvic trauma from bike riding or horseback riding.

Symptoms include pain in the abdomen, low back, groin, and genitals; frequent need to urinate; pain, burning, and difficulty when urinating; urine that is cloudy or bloody; and painful ejaculation.

A medical provider should be seen for these symptoms, since a bacterial infection can spread and lead to scarring, pain, and infertility.

Diagnosis is made through urine tests, blood tests, and ultrasound or CT scan.

Treatment involves antibiotics for bacterial prostatitis, though if all the bacteria are not destroyed the disease can become chronic. Nonsteroidal anti-inflammatory drugs are also helpful.

Anal fissure

An anal fissure is a break, or tear, in the mucous membrane lining of the anus. The anus is the opening at the end of the digestive tract where stool leaves the body.

A fissure is caused primarily by constipation, which leads to straining to pass large hard stools; trauma caused by insertion of objects or by anal sex; and illnesses such as any type of inflammatory bowel disease or sexually transmitted disease.

Symptoms include pain and bleeding during and after a bowel movement; discomfort and difficulty with urination; and a visible tear, resembling a crack, in the anal tissue that may have a foul-smelling discharge.

Diagnosis is made through physical examination.

Treatment primarily involves relieving constipation, and the straining it causes, by adding fiber and more fluids to the diet; and easing anal irritation by soaking in a warm bath and gently cleansing the tissues of the anus. In some cases, medicated creams or suppositories may be prescribed.

Anal cancer

Anal cancer is a neoplasm, or tumor, growing in the tissues of the anus. The tumor may be malignant (cancerous) or benign (non-cancerous.)

Most anal cancers are linked to the human papilloma virus, or HPV. However, many people carry HPV and have no symptoms or illness of any kind.

Most susceptible are men who have sexual contact with men; women who have had cervical cancer; and anyone who has engaged in anal intercourse, had anal warts, or is HIV positive. Smoking and lowered immunity are also factors.

Symptoms include minor anal bleeding and itching, which may be attributed to hemorrhoids; pain or fullness in the anal region; and abnormal anal discharge.

It is important to see a medical provider about these symptoms so that if needed, treatment can begin as soon as possible.

Diagnosis is made through patient history; physical examination; anal swab; and biopsy. CT scan, ultrasound, or endoscopy of the anus may also be done.

Treatment involves some combination of surgery, radiation therapy, and chemotherapy depending on the needs of each individual patient.

Perineal pain quiz

Take a quiz to find out what's causing your pain.

Take perineal pain quiz

Acute prostatitis

Acute prostatitis is a sudden-onset bacterial infection of the prostate gland in men.

Bacteria can spread to the prostate through a urinary tract infection, or through a sexually transmitted disease such as gonorrhea or chlamydia. Infection can also start after a medical procedure such as a urinary catheter insertion.

Most susceptible are younger or middle-aged men with a urinary tract infection or STD (sexually transmitted disease;) a pelvic injury from trauma or from bicycling or other sport; an enlarged prostate; or a recent prostate biopsy.

Symptoms include pain and difficulty when trying to urinate; pain on ejaculation; pelvic and abdominal pain; fever; chills; and nausea and vomiting.

These symptoms should be evaluated by a medical provider, because untreated prostatitis can lead to bacteremia of the blood ("blood poisoning,") prostatic abscess, and infertility.

Diagnosis is made through patient history, urinalysis, blood tests, and a physical examination which usually involves a digital rectal examination. Prostatitis does not cause prostate cancer.

Treatment is done with antibiotics, usually as an outpatient.

Rarity: Rare

Top Symptoms: penis pain, fever, urinary changes, painful urination, chills

Urgency: Hospital emergency room

Questions your doctor may ask about pain between the genitals and the anus

  • Do your symptoms worsen when sitting?
  • Have you had any changes in your weight?
  • Any fever today or during the last week?
  • Are you sexually active?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Pain between the genitals and the anus symptom checker statistics

People who have experienced pain between the genitals and the anus have also experienced:

  • 5% Vaginal Itch Or Burning
  • 4% Rectal Pain
  • 4% Abdominal Pain (Stomach Ache)

People who have experienced pain between the genitals and the anus were most often matched with:

  • 60% Acute Prostatitis
  • 30% Chronic Prostatitis
  • 10% Anal Fissure

People who have experienced pain between the genitals and the anus had symptoms persist for:

  • 31% Over a month
  • 27% Less than a week
  • 22% Less than a day

Source: Aggregated and anonymized results from Buoy Assistant.

Hear what 2 others are saying
Pain in the butt and morePosted March 30, 2021 by L.
I have had pain between the genitals and right butt cheek and anus for five weeks now. Sometimes, spasms in my lower back feel like I have swelling in the right butt cheek. Saw a urologist, thinking it was something there, but everything checks out ok. The urologist thinks it could be an infection, so I am on antibiotics. A few years ago, I had surgery on my L5 and L4 disk, unsure if it's related to that. Still in pain. Not sure where to go from here.
Deep pain between anus and testiclesPosted December 18, 2020 by J.
Was diagnosed as chronic prostatitis..deep pain between anus and testicles. Took antibiotics for years, pain never went away. After an anal fissure appeared and couldn’t heal, doc recommended sphincterotomy. Had it and never had pain since. Check your anus, if it’s too tight or in spasm, the spasms might be giving you what you think is prostate pain but it ain’t. The op will leave you with incontinence, but it’s worth it, just a mild inconvenience compared to the agonizing pelvic pain I suffered most of my life.

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