Last update:


Arch Hellen Med, 28(2), March-April 2011, 182-187


Chronic perineal pain

N. Andromanakos
Department of General Surgery, "Polykliniki" General Hospital of Athens, Athens, Greece

Chronic perineal pain is considered to be anorectal and perineal pain in the absence of underlying organic disease, anorectal or endopelvic, which has been excluded by careful physical examination and radiological and endoscopic investigation. A variety of neuromuscular disorders of the pelvic floor may lead to the different pathological conditions, such as anorectal incontinence, urinary incontinence, constipation of obstructed defecation, sexual dysfunction and pain syndromes. The most common functional disorders of the pelvic floor muscles accompanied by perineal pain are the levator ani syndrome, proctalgia fugax, myofascial syndrome and coccygodynia. The diagnosis of these syndromes depends on a thorough history, careful physical examination, selected specialized investigations and the exclusion of organic diseases characterized by proctalgia. Accurate differential diagnosis between the syndromes helps in the choice of appropriate treatment and avoidance of unnecessary and ineffective surgical procedures which may often be carried out in an attempt to alleviate the patient's symptoms.

Key words: Coccygodynia, Levator ani syndrome, Myofascial syndrome, Perineal pain, Proctalgia fugax, Rectal pain.

© Archives of Hellenic Medicine