Perineal pain: Think beyond gynaecological reasons

Abstract

Introduction: Perineal pain is multifactorial in nature. Gynaecological consultation is the first point of contact in females with perineal pain for diagnosis and treatment. Case description: Three females above 60 years presented with non-radiating perineal pain and bladder disturbance. Magnetic resonance imaging revealed severe L5 S1 dural compression, which was released by posterior laminectomy. Patients felt relief in perineal pain, though bladder symptoms persisted for several months. Conclusion: Sacral roots compression leading to pain along pudendal nerve distribution may present with cauda equina symptoms with pain radiating to legs. Awareness of this condition can prevent the delay and lead to better prognosis after the surgery.