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Perineal injury is an injury to the perineum, the part of the body between the anus and the genitals, or sex organs. In males, the perineum is the area between the anus and the scrotum, the external pouch of skin that holds the testicles. Injuries to the perineum can happen suddenly, as in an accident, or gradually, as the result of an activity that persistently puts pressure on the perineum.
Sudden damage to the perineum is called an acute injury, while gradual damage is called a chronic injury. The perineum is important because it contains blood vessels and nerves that supply the urinary tract and genitals with blood and nerve signals.
The perineum lies just below a sheet of muscles called the pelvic floor muscles. Pelvic floor muscles support the bladder and bowel. Injury to the blood vessels, nerves, and muscles in the perineum can lead to complications such as.
Bladder control problems. The nerves in the perineum carry signals from the bladder to the spinal cord and brain, telling the brain when the bladder is full. Those same nerves carry signals from the brain to the bladder and pelvic floor muscles, directing those muscles to hold or release urine.
Injury to those nerves can block or interfere with the signals, causing the bladder to squeeze at the wrong time or not to squeeze at all. Damage to the pelvic floor muscles can cause bladder and bowel control problems. Sexual problems. The perineal nerves also carry signals between the genitals and the brain. Injury to those nerves can interfere with the sensations of sexual contact. Signals from the brain direct the smooth muscles in the genitals to relax, causing greater blood flow into the penis.
In men, damaged blood vessels can cause erectile dysfunction ED , the inability to achieve or maintain an erection firm enough for sexual intercourse.
An internal portion of the penis runs through the perineum and contains a section of the urethra. As a result, damage to the perineum may also injure the penis and urethra. Acute perineal injury may result from surgical procedures that require an incision in the perineum:.
However, sometimes a perineal incision may achieve the best angle to remove a life-threatening cancer. People should discuss the risks of any planned surgery with their health care provider so they can make an informed decision and understand what to expect after the operation.
These injuries include motorcycle and bike riding accidents, saddle horn injuries during horseback riding, falls on playground equipment such as monkey bars, and gymnastic accidents on an apparatus such as the parallel bars or pommel horse. In rare situations, a blunt injury to the perineum may burst a blood vessel inside the erectile tissue of the penis, causing a persistent partial erection that can last for days to years. This condition is called high-flow priapism.
If not treated, ED may result. Forceful and inappropriate sexual contact can result in perineal injury. When health care providers evaluate injuries in the genital area, they should consider the possibility of sexual abuse, even if the person or family members say the injury is the result of an accident such as a straddle injury.
The law requires that health care providers report cases of sexual abuse that come to their attention. The person and family members should understand the health care provider may ask some uncomfortable questions about the circumstances of the injury. Impalement injuries may involve metal fence posts, rods, or weapons that pierce the perineum. Impalement is rare, although it may occur where moving equipment and pointed tools are in use, such as on farms or construction sites. Impalement can also occur as the result of a fall, such as from a tree or playground equipment, onto something sharp.
Impalement injuries are most common in combat situations. If an impalement injury pierces the skin and muscles, the injured person needs immediate medical attention to minimize blood loss and repair the injury.
Chronic perineal injury most often results from a job-or sport-related practice—such as bike, motorcycle, or horseback riding—or a long-term condition such as chronic constipation. In a regular chair, the flesh and bone of the buttocks partially absorb the pressure of sitting, and the pressure occurs farther toward the back than on a bike seat.
The straddling position on a narrow seat pinches the perineal blood vessels and nerves, possibly causing blood vessel and nerve damage over time. Research shows wider, noseless seats reduce perineal pressure. Occasional bike riding for short periods of time may pose no risk. However, men who ride bikes several hours a week—such as competitive bicyclists, bicycle couriers, and bicycle patrol officers—have a significantly higher risk of developing mild to severe ED.
Other activities that involve riding saddle-style include motorcycle and horseback riding. Researchers have studied bike riding more extensively than these other activities; however, the few studies published regarding motorcycle and horseback riding suggest motorcycle riding increases the risk of ED and urinary symptoms. Constipation is defined as having a bowel movement fewer than three times per week. People with constipation usually have hard, dry stools that are small in size and difficult to pass.
Some people with constipation need to strain to pass stools. This straining creates internal pressure that squeezes the perineum and can damage the perineal blood vessels and nerves. Men who have perineal surgery are most likely to have an acute perineal injury. Straddle injuries are most common among people who ride motorcycles, bikes, or horses and children who use playground equipment. Impalement injuries are most common in military personnel engaged in combat. Impalement injuries can also occur in construction or farm workers.
Chronic perineal injuries are most common in people who ride bikes as part of a job or sport, or in people with constipation. Health care providers evaluate perineal injury based on the circumstances and severity of the injury.
In general, the evaluation process includes a physical examination and one or more imaging tests. During a physical examination, the patient lies face up with legs spread and feet in stirrups. The health care provider looks for cuts, bruises, or bleeding from the anus. The health care provider may insert a gloved, lubricated finger into the rectum to feel for internal injuries. To look for internal injuries, the health care provider may order one or more imaging tests.
Imaging is the general term for any technique used to provide pictures of bones and organs inside the body. An x-ray technician performs these procedures in an outpatient center or a hospital, and a radiologist—a doctor who specializes in medical imaging—interprets the images. The person does not need anesthesia. However, people with a fear of confined spaces may receive light sedation before a magnetic resonance imaging MRI test.
Treatments for perineal injury vary with the severity and type of injury. Tears or incisions may require stitches. Traumatic or piercing injuries may require surgery to repair damaged pelvic floor muscles, blood vessels, and nerves. Treatment for these acute injuries may also include antibiotics to prevent infection. After a health care provider stabilizes an acute injury so blood loss is no longer a concern, a person may still face some long-term effects of the injury, such as bladder control and sexual function problems.
A health care provider can treat high-flow priapism caused by a blunt injury to the perineum with medication, blockage of the burst blood vessel under x-ray guidance, or surgery. In people with a chronic perineal injury, a health care provider will treat the complications of the condition. Preventing perineal injury requires being aware of and taking steps to minimize the dangers of activities such as construction work or bike riding:.
To prevent constipation , a diet with 20 to 35 grams of fiber each day helps the body form soft, bulky stool that is easier to pass. High-fiber foods include beans, whole grains and bran cereals, fresh fruits, and vegetables such as asparagus, brussels sprouts, cabbage, and carrots.
For people prone to constipation, limiting foods that have little or no fiber, such as ice cream, cheese, meat, and processed foods, is also important. A health care provider can give information about how changes in eating, diet, and nutrition could help with constipation. Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease.
Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses.
Find out if clinical trials are right for you. Clinical trials that are currently open and are recruiting can be viewed at www. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public.
In males, the perineum is the area between the anus and the scrotum. Why is the perineum important? What are the complications of perineal injury?
Injury to the blood vessels, nerves, and muscles in the perineum can lead to complications such as bladder control problems sexual problems Bladder control problems. What are the most common causes of acute perineal injury? Common causes of acute perineal injury in males include perineal surgery straddle injuries sexual abuse impalement Perineal Surgery Acute perineal injury may result from surgical procedures that require an incision in the perineum: A prostatectomy is the surgical removal of the prostate to treat prostate cancer and other prostate problems.
The prostate, a walnut-shaped gland in men, surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen. In one approach, called the radical perineal prostatectomy, the surgeon makes an incision between the scrotum and the anus.
In a retropubic prostatectomy, the surgeon makes the incision in the lower abdomen, just above the penis. Both approaches can damage blood vessels and nerves affecting sexual function and bladder control. Perineal urethroplasty is surgery to repair stricture, or narrowing, of the portion of the urethra that runs through the perineum.
Without this procedure, some men would not be able to pass urine. However, the procedure does require an incision in the perineum, which can damage blood vessels or nerves. Colorectal or anal cancer surgery can injure the perineum by cutting through some of the muscle around the anus to remove a tumor.
One approach to anal cancer surgery involves making incisions in the abdomen and the perineum. Sexual Abuse Forceful and inappropriate sexual contact can result in perineal injury. Impalement Impalement injuries may involve metal fence posts, rods, or weapons that pierce the perineum.
What are the most common causes of chronic perineal injury?
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Written by PhalloGauge Medical. Looking to enhance sex by adding some size to your penis with penis exercises enlargement? If you already read Dr. Raz's penis enlargement report on penis exercise effectiveness. Here are the top 10 penis stretching exercises for length and how to do them. Or check out this page if you want the penis exercises for girth.
You should bookmark this page to remember all the penis exercises for enlargement and sexual health. Use a cylindrical object, like your forearm, soda can, or a thick diameter pipe to perform this stretch.
But you can actually stretch the penis without having to spend time on exercises: by using a penis extender. The bundled stretch is great for giving your penile tissues a new health stretch compared to the basic pulling motions of the basic penis exercises health stretch. This penis stretch is using a higher erection level to create a bit of variation in the tension and orientation that is being applied to your penile tissues. While experimenting with different erection levels, always check to see how your body responds, especially if there is pain - remember sharp intense penis pain is bad for male health, so release the stretch that you're doing immediately.
The goal is to perform a very light, quick stretch; this exercise should last approximately two seconds. This is exercise allows you to increase your gains as well as allow you to keep challenging yourself, by learning your personal best.
This penis exercise is great to increase the ligament size on the top part of your shaft because you're stretching downwards. For most guys, this penis ligament is their smallest one, and the one that creates the health bottleneck in their length gains. Just like warming up at the gym, you warm-up your man penile tissues to prepare these tissues for the tension.
If you think penis stretching exercises may be too time consuming, you may want to enhance your penis health in a penis extender. Enlargement devices literally do all the stretching for men, so men don't have to. Men also might want to try jelqing exercises specficially for length enlargement. The goal is to pull hard enough to stretch the tissues in the penis, but not hard enough to inflict pain penis health.
The biggest key to all penis stretching exercises for girth is to make sure that you don't feel pain when doing the penis exercises. Sure, of course, you're going to feel pressure due to the forces that you're applying to your penis. But in no way, should you feel any sharp, accute, constant pain during or after you do these penis exercises.
If men are feeling this sort of sharp pain, men need to tone down the intensity for a bit. Let your penis rest back to health from work. For more mistakes that guys usually make, check out the 6 common health mistakes the guys make when doing penis enlargement.
There are various health theories surrounding the best natural penis exercises to enhance penis health and penis size. Rob Michaels, penis enlargement authority and expert of the book Penis Exercises Enhancement notes:. Either way penis exercises trigger enhance the penile cells to grow through resistance forces. The inner penis elongates by stretching and training these ligaments - all with penis exercise.
This allows more of the inner penis to come forward, outside the pelvis, which results in increased penis length and penis size. Stretches also elongate and enhance the connective penile tissue known as the tunica that surrounds the penis shaft. This penis size growth along with the other health benefits, such as curing erectile dysfunction and premature ejaculation is exactly why men want to do penis stretching.
This is why gentle stretching and elongating of the ligament is preferred, by many men over health surgery. In fact, in one form of penis surgery, doctors actually cut this ligament, and the sex result was not good. Ok, so health kegels are not really penis exercises for penis enlargement or penis size. While some advocate that you start light with these penis exercises, the sheer amount of stretching force is too simply too risky for penis size.
Penis enlargement doesn't have to be dangerous. In fact, the lighter, more moderate exercises and techniques are acatually more effective for penis size than the aggressive ones. As a man, If you are concerned about increasing your penis length enlarge , the best and most enjoyable plan is to stick with these penis exercises and do them everyday. Some may not like them because they are sticky, and it takes a lot of washing to get them out of your penis area.
However, as long as you have a private sex area, lubricants definitely enhance work for your penis exercises. Here are some hard rules all men should follow to see the maximum amount of penis exercise results:. Fact Checked: Although product recommendations are only our opinions, this research-backed page has been fact-checked and reviewed by a certified urologist and health specialist. Penis Health Tweets. There is one thing Dr. Edward Matsumoto has in common with every sexual deviant: he lusts for a high quality sex toy just as much as the next horny guy.
Realizing that there were no reliable websites out there reviewing all the superb synthetic vaginas on the for sale, Dr. Edward Matsumoto succeeded and did something about it. It's painfully obvious that men nowaday, more than ever, need to know more about their sex options. Repeat in other directions down, up, left, and right. If you don't have time to do penis exercises, use an extender device instead. The most convenient way, but one way is to wrap a warm, wet washcloth around your penis for minutes.
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