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Date of last update: 8/13/2017.

Forum Name: Urology Topics

Question: Cramping in Perineum


 KJR246 - Mon Dec 07, 2009 12:14 pm

I've had cramping in the perineum area for years now. I get it mostly after I pee or ejaculate, but not always. It has begun to get more frequent lately though I have noticed. I also get it sometimes when just sitting as well. It is a tight cramping that I have to wait for to go away, just like most muscle cramps. It never worried me before I did a little research though. Another problem I have is lower back discomfort when I sit in a spot for too long. I don't know if possibly they're connected. I was wondering what it could possible be. I plan on getting a physical examination as soon as possible.
 Dr.M.Aroon kamath - Sun Dec 13, 2009 9:07 pm

User avatar Hi,
From your description of your symptoms, this could be
- Coccygodynia or
- the piriformis syndrome.

Coccygodynia which is pain in the region of
the coccyx (tail bone), typically is triggered by
sitting. The pain may aggravate by arising from a seated position.

Coccygodynia is five times more prevalent in women than men.

Diagnosis is best done by dynamic radiography.This may show abnormal mobility of the coccyx or subluxation.Advanced imaging techniques(Bone scans and MRI) may show inflammation and edema, but neither technique is said to be as accurate as dynamic radiography.

Treatment for patients with severe pain generally begins with injection of local anesthetic and corticosteroid into the painful segment (relief of pain is diagnostic as well!). Coccygeal massage and stretching of the levator ani muscle can help. Coccygectomy is considered only when nonsurgical treatment fails. Coccygectomy is said to be successful in carefully selected patients, with the best results in those with abnormal radiography.

Dysfunction of the piriformis muscle can cause a somewhat similar pain but generally produces signs and symptoms of pain in the sciatic nerve distribution.This is also more common in women(M:F, 6.5:1). Electromyography of the pyriformis muscle may clinch the diagnosis.

Bursitis or weaver's bottom (ie, ischiogluteal bursitis) is another cause of pain in the perineum.

In your case, coccygodynia (although very much less common in males),seems most probable.It is advisable for you to consult an orthopedic surgeon and get this sorted out.
Best wishes!

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