1. The exposed bowel loops were a sequestered. Given the above, it's possible that what you are experiencing is herpes, especially if it's recurring at the same place. With a perineal fistula, the abnormal anal opening is located outside of the sphincter muscle complex, such that the fistula usually has very few voluntary sphincter muscle fibers surrounding it. The perineal raphe is a small, vertical, slightly raised ridge of scrotal skin under which is found the scrotal septum. Pressure at one extremity. tight feeling in anus happens also. The scrotum is a sack of skin divided in two parts by the perineal raphe, which looks like a line down the middle of the scrotum. Starting stages of fetal development looks same but at 7th week of pregnancy, fetal genital tissues change and form male reproductive organs i. However, I would never put my money on anything when. Been using a cream to stop the itchyng and it helps and the line has disapeared a little but it itches again after a while!. This line starts just anterior to the anus and extends. The cysts can occur at parameatus, glans penis, penile shaft, scrotum, or perineum. 2. The perineal raphe is a visible line or ridge of tissue on the body that extends from the anus through the perineum to scrotum (male) or labia majora (female). The perineal body (PB), also referred to as the central tendon of the perineum, is a fibro-muscular structure located in the midline of the perineum. A differential diagnosis must be. Perineal body (sagittal view) Anorectal triangle. NSFW. Gently pat the area dry. If you think your swollen perineum is unusually itchy and swollen, go see your OB MD who did the OB care and d. Jean E. In women, the perineum includes the vaginal opening. It is the result of a fetal developmental phenomenon whereby the scrotum (the developmental equivalent of the labia in females) and. Difficulty getting an erection. Congenital perineal groove is characterized by an exposed erythematous nonepithelized mucous membranes that resembles exposed wet erythematous sulcus, inflammation, or rupture of the midperineum area. Caring for the perineum. The canals are l. It was a long and narrow tumefaction developed strictly on the midline on the median raphe between the scrotum and anus. ”. Perineal injury in. Same-day virtual video appointments and in-person appointments are available. The canals are l. 25 cm. Perineal groove is a rare benign congenital anomaly with lesion that resembles perforation of mid-perineum or perineal raphe area. A4 -year-old boy presented at our institution with an anomaly of the perineal median raphe. It consists of two symmetrical parts, united along the median line by a tendinous perineal raphe. The perineal body, a connective tissue mass found between the anus and genitalia, was identified in all specimens caudal to the midline of the perineal membrane; however, no muscles insert on the perineal body, which occupies an anatomical plane caudal to the perineal muscles. Been using a cream to stop the itchyng and it helps and the line has disapeared a little but it itches again after a while!. the caudal end of the left and right urethral folds fuse to form the urethral raphe. Red testicles can have associated symptoms of pain, itchiness, swelling, or dryness of the skin. Lanolin. Even when I touched it, it wasn't so much pain as it. In women, the perineum is the. Perianal region is an extremely rare location for these lesions. Learn how we can help. who do i go to&is this easy/safe to treat? Median raphe cysts are a rare, congenital entity. Following clinical. The perineum (pl. got pap, clear. At night the irch is unbearable at times. La rainure périnéale congénitale (perineal groove), est une malformation anopérinéale rare, survenant presque toujours chez des filles et correspondant à un rainure érythémateuse suintante, s’étendant de la fourchette vulvaire postérieure au bord antérieur de l’anus [1], [2], [3]. This line starts just anterior to the anus and extends through. L02. Perineal groove is a rare anoperineal congenital malformation disease that usually affects newborn females. 89 - other international versions of ICD-10 N48. Although usually asymptomatic, secondary infection may produce swelling, tenderness and a purulent discharge. Painful urination (pain when you pee). : perineums or perinea) in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. I was actually thinking about some kind of technique that is also used to make scars less visible. deep branch of the perineal nerve (from pudendal nerve) perineal a. An infected median raphe cyst was suspected, and the patient. While hemorrhoids may trigger perineum pain, they don’t cause perineum swelling. Congenital perineal groove (CPG) is a rare malformation characterized by the presence of a moist sulcus with mucous membrane on the perineum since birth (1, 2). Both cysts and abscesses can cause. The perineum is the region of the body between the pubic symphysis (pubic arch) and the coccyx (tail bone), including the perineal body and surrounding structures. As per your description, it indicates Anogenital pruritus that is defined as intense itching, acute or chronic, affecting the anal, perianal, perineal, and genital skin. Blunt trauma causes split in skin and muscles that may get infected. It is found in both males and females, and arises from the fusion of the urogenital folds. 2. Answered Jan 10, 2023. Connect with a U. If it's possible to remove it it would just leave a scar in the same place which may or may not be more pleasing to you. 6. The lateral part of the genital tubercle. 6 7 14 Given that the perineal. They are considered congenital alterations in embryologic development. No. DISCUSSION. Main page; Contents; Current events; Random article; About Wikipedia; Contact us; DonateTypes of Genital Injuries in Females. The perineum is an erogenous zone. Perineal Injury. Discussion. Perineal pyramidal protrusion is typically smooth and pink and measures from 5. Scrotal raphe is a slightly elevated ridge of tissue running from the base of the penis to the midline of the perineum. I was checked for being intersexed before and they found nothing. bulbospongiosus, in male. Perineal pyramidal protrusion is typically smooth and pink and measures from. 3 ). [3] The unhealed perineal wounds can lead to significant morbidity. The tissue has been described as triangular, pyramidal, oval, tongue-shaped or leaf-shaped. For classic saddle sores or ischial tuberosity pain, pad your skin with padded tape or moleskin. Thus far, there is no reported case of this anomaly in monozygotic twins. It is found in both males and females, arises from the fusion of the urogenital folds , and is visible running medial through anteroposterior, to the anus where it resolves in a small. What is the perineum and why is it important? In males, the perineum lies just. After you’ve given birth, it’s common for the perineum to be sore. Diagnosis can be made by taking some tissue (biopsy) and examining it under a microscope. 1). Pressure at one extremity. So, the seam is really the remnants of what were originally your labio-scrotal folds, bits that were meant to become a labia. Right now my perineum is swollen, around my anus towards my vagina and I have a have a tiny tear half way between my vagina and anus. 2 Other symptoms include localized pain, chronic seepage, and excessive moisture. It would be most prudent for you. Warm compresses and. vulva, labia and clitoris in women. 1 Only a couple hundred case reports of median raphe cysts have been published in the English literature. The female perineum is a diamond-shaped structure inferior to the pelvic diaphragm and between the symphysis pubis and coccyx. . The cyst may occur anywhere along the midline from glans to anus. Treatments include creams, ointments, medications and home remedies. It is a normal variant of anogenital anatomy, most often found in young girls. As the patient grows older, the cyst may also progress slowly. Signs and Symptoms Dr Basu. area between the buttocks and genitals (perineum) area around the anus and rectum. The lesion extended 4 cm and was unilocular (Fig. Infection is treated with antibiotics. The female perineum is a diamond-shaped structure inferior to the pelvic diaphragm and between the symphysis pubis and coccyx. [2–5] About 25-45% of these patients can develop serious complications. A perianal abscess is an abscess near the opening of your bottom (anus). However, embryological mechanisms have been proposed as follows: (1) a relic of the open cloacal duct, 13 (2) midline fusion failure of medial genital folds between the perineal raphe and the vestibule, 3 4 and (3) urorectal septum developmental defect during cloacal embryological stages at 5th to 8th week of GA. A careful history and examination are required. They can be found all the way from the distal penis and scrotum toward the perineum in a midline position. The vast majority of the raphes do not bifurcate (123 genera), but the raphes of 7 genera do. The perineum is divided into the anterior urogenital triangle and the posterior. 81 may differ. Physical examination revealed 2 nodular lesions at both sides of the perineal raphe, immediately behind the scrotum, both covered by redundant, but otherwise normal-looking skin, with no external signs of inflammation or infection. Raphe means the line of union of the two halves of various symmetrical body parts, and the term median raphe refers to the perineal raphe, which is also known as the median raphe of the perineum. A perineum cut is back again! Vulvitis is common and can result from an allergic reaction, an infection or an injury. 1-3 The diagnosis can be made in early infancy through the preschool and early school years. We present a case and review the literature in respect to a 35-year-old man with a. Is a swollen perineal raphe a sign of a problem? Afghanistan A 24-year-old male asked: My perineal raphe occasionally becomes very swollen and sore to the. The scrotum is part of the male anatomy. Raphe of scrotum. We present a case and review the literature in respect to a 35-year-old man with a non. M. Median raphe cysts of the perineum are uncommon congenital lesions of the male genitalia. ”. The perineal raphe is a visible line or ridge of tissue on the human body that extends from the anus through the the area between the anus and the scrotum or vulva . DPS is frequently associated with pelvic organ prolapse (POP) and it is reasonable to postulate, that treatment of POP will also have an impact on DPS. Dr. D. Raphe means the line of union of the two halves of various symmetrical body parts, and the term median raphe refers to the perineal raphe, which is also known as the median raphe of the perineum. Overview A perineal abscess is an infection that causes a painful lump in the perineum. The perineal raphe is generally considered to mark the line of fusion between the so-called urethral folds (Glenister 1954; Hamilton and Mossman 1972), or of a combination of urethral folds and scrotal swellings (Szenes 1925; Wartenberg 1993), or between urethral folds for the penile raphe and between scrotal swellings for the scrotal. Raphe means the line of union of the two halves of various symmetrical parts, and the term median raphe refers to the perineal raphe, which is also known as the median raphe of the perineum. Here we present a 50-year-old male patient who presented with a cystic, fluctuant lesion, located at 12 o. The perineum of nonhuman primates differs from humans in both shape and function and shows considerable variation among species. Duct obstruction, entrapment of pudendal nerve, abscess, prostatitis, perineural cyst, ischiorectal abscess, benign prostatic hypertrophy, and prostatitis. Perineal injury happens to the perineum, which is the part of the body between the genitals and anus. Injuries to the perineum can happen suddenly like an accident or as the activity which puts the. Anal Itching (Pruritus Ani) Anal itching (pruritus ani) is a skin condition that affects your perianal area, which may become worse at night or after a bowel movement. A 3-year-old boy presented with whitish cystic lesions running along the midline of the perineum in a linear fashion, and there were linear 1to 2-mm yellowish white papules along a cord-like swelling runningAlong the midlines of the scrotum and the ventral aspect of the penis. DO. 4 to 6 weeks: The post partum period is 4 to 6 weeks. 1. It would be most prudent for you to. This is the American ICD-10-CM version of N81. Introduction. Hold your thumbs in this position for about 1 minute. Median raphe cyst is an uncommon anomaly that can develop at any location over the midline of the external genital region from the anus to the scrotum and perineum. Minor cuts or scrapes heal quickly. Perineal groove is a rare congenital midline malformation of the perineal raphe. 215 - other international versions of ICD-10 L02. You can see yours has some crooked spots too. We present a case and review the literature in respect to a 35-year-old man with a non-visible, painless midline swelling in the anterior perineum. Board Certified Physician. [ 2] Median raphe cysts mostly present at birth and may remain asymptomatic or ignored during childhood. My perineum raphe is inflamed and swollen. Created for people with ongoing healthcare needs but benefits everyone. Here we present a 50-year-old male patient who presented with a cystic, fluctuant lesion, located at 12. Perineoplasty is a surgical procedure to repair the perineum and external organs of your vagina (vulva). The perineum swells between the anus and the sex organs, and if you have damage or an injury to this area, it is likely that the entire floor of the muscle will swell. Differential diagnosis for a cystic lesion in the perineum includes a tail gut cyst (a developmental lesion lined with gastrointestinal epithelium which would be retro-rectal , perineal median raphe cysts or urethral and seminal vesicle cysts which would be connected to the urological system. Slight hyperpigmentation of the genital raphe is almost invariably present (Fig. If you think your swollen perineum is unusually itchy and swollen, go see your OB MD who did the OB care and d. These are usually the result of an infection of your internal anal glands. Median raphe cysts are a rare, congenital entity. Created for people with ongoing healthcare needs but benefits everyone. A diamond shaped area between the legs below the pelvic diaphragm. When I shake it , it sound like liquid but it's hard. From conception until 7 weeks, fetuses have no sex difference—the genitals look fairly female. Muneer, “An unusual swelling in the male. Before the perineum tears, if there is a yeast infection, you will notice swelling and irritations. Gastroenterology/General Surgery - 1 - Managing Perianal Itching (Pruritus Ani) What is pruritus ani? Itching around the anal area (called “anal itch” or pruritus ani) is a common condition characterized by irritation of the skin around the anus leading to anThe perineal raphe is generally considered to mark the line of fusion between the so-called urethral folds (Glenister 1954; Hamilton and Mossman 1972), or of a combination of urethral folds and scrotal swellings (Szenes 1925; Wartenberg 1993), or between urethral folds for the penile raphe and between scrotal swellings for the scrotal. Although usually asymptomatic, secondary infection may produce swelling, tenderness and a purulent discharge. An unusual swelling in the male perineum Arie Stewart Parnham,1 Alex Freeman,2 Alex Kirkham,2 Asif Muneer3 1Department of Urology, The. 89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2. RM 2H47JFP – Plate XLII. Abstract: Median raphe cysts occur as a developmental anomaly along the midline male perineum, A perineal median raphe cyst arising in a 3‐year‐old boy was successfully. CAP recommended no further sexual assault or medical work-up and no treatment. Abstract. Noun [ edit] perineal raphe (plural perineal raphae) ( anatomy) The visible line that extends from the anus, through the mid-line of the scrotum and upwards through the posterior mid-line aspect of the penis. Thomas suggests holding a simple, external vibrator—such as a bullet vibrator or a wand—against your perineum. The tourniquet may need to be re-applied as the swelling is reduced. Ingredients of body washes. Anal Itching (Pruritus Ani) Anal itching (pruritus ani) is a skin condition that affects your perianal area, which may become worse at night or after a bowel movement. 1-3 The diagnosis can be made in early infancy through the preschool and early school years. It is noteworthy that a rudimentary gubernaculum also forms in females. If you have concerns, seek examination by Physician or Dentist. Cremasteric reflex should be tested bilaterally. The perineum is the anatomic area between the urethra, the tube that carries urine from the bladder, and the anus. Call/text today: 1-212-204-6300 or make an appointment online. Many times the left testicle can hang lower and the baggy scrotum can look a little asym. Depending on growth of the bulbospongiosus muscle and corpus spongiosus penis, the midline intermuscular septum obtained a connection to the subcutaneous wavy. Median raphe cysts usually don’t cause problems, but some people may develop symptoms later on in life, including: Swelling in the area. Purpose of Review To discuss perineal and robotic approaches to gender-affirming vaginoplasty. Acute complications can occur in 25-60% cases. The attachments of bulbospongiosus are different among males and females. increased bowel. It was a long and narrow tumefaction developed strictly on the midline on the median raphe between the scrotum and anus. Over the next few months, the area became more swollen and did not regress despite recommended sitz baths and barrier creams. Differential diagnosis for a cystic lesion in the perineum includes a tail gut cyst (a developmental lesion lined with gastrointestinal epithelium which would be retro-rectal , perineal median raphe cysts or urethral and seminal vesicle cysts which would be connected to the urological system. Six cases are reported: five with canals or cysts of the genito-perineal raphe, one with a periurethral cyst. The diagnosis is mostly. central tendinous point and the midline raphe on the bulb of the penis. A 32-year-old male asked: If the area looks red and swollen or there is a painful cyst on the perineum, this may be a sign of infection. Another clue to a possible penile torsion is the rotated appearance of the median raphe. " Answered by Dr. May be candida: This is a yeast that often causes problems in warm weather. A case where a baby girl was born with failure of fusion of the perineal raphe is presented, and the embryological origin of this congenital abnormality is reviewed. The perineal lesion (Figure 1) was recognized by CAP as the congenital malformation failure of midline fusion. penis and scrotum. In botany and planktology it is commonly used when describing a seam or ridge on diatoms or seeds . Swollen perineal A 19-year-old male asked: I think i have a median raphe cyst. net dictionary. The perineum is the area between the scrotum and the anus in a man. Perineal raphe: everything on this line that divides the scrotum in two. The purpose of the median septum is to compartmentalize each testis in order to prevent friction or trauma. Perineum pain with coughing. The term "IPPP" was introduced in the medical literature within the past 10 years. Sir/ma'am I have a lump (painless) in perineal region, which is not visible from eyes or from surface. This is common in bike riders, people with chronic constipation, men who work in construction, and patients with a history of pelvic or perineal surgery. Jean E. &NA; Median raphe cysts are uncommon congenital lesions most often found on the penis or scrotum. This was associated with the occurrence of a webbed penis with deficient ventralThe perineal raphe is conti nuous with and takes a direction same as the penile UR. Developmental abnormalities of the male genitalia can result in epithelial-lined canals or cysts which occur along the ventral median raphe from the glans penis to the anus. To our knowledge, there has been limited reports of this form of congenital abnormality in. That's my perineal raphe and although the line is darker as it should be after a year of estrogen use, the skin has become loose and flappy. Abstract. Median raphe cyst is a very rare, benign congenital lesion occurring mainly on the ventral aspect of the penis, but can develop anywhere in the midline between the external urethral meatus. Help make yourself more comfortable by: Applying cold compresses or postpartum cooling pads, witch hazel pads, or Dermoplast spray to help lessen pain and swelling. The 2024 edition of ICD-10-CM L02. Median raphe cyst is an uncommon, mostly asymptomatic condition in young patients. Median raphe cysts are uncommon benign cysts thought to occur due to improper fusion of the genital tubercle and can occur anywhere along the median raphe, from the glans to the anus, most commonly occurring along the ventral penile shaft. RF 2T1WAMX – Pelvic floor muscles. Acute complications can occur in 25-60% cases. In our study we treated a case with a large congenital scrotal sinus by total surgical excision. Let’s start with the male external genitalia, which includes the membranous - or intermediate - urethra, the. This page explains the raphe in detail: Q&A: What Is The Perineal Raphe? | Kinsey Confidential This post explains why it darkens: Quote Any birthmark or pigmented skin area will appear darker and more prominent if that area of skin becomes less stretched (for example, the dark line on a scrotum that has shrunk due to HRT, or an areola on a. Answered in 1 minute by: 1/28/2021. Simple orchidectomy: Known as a subinguinal orchiectomy, this type of procedure allows the surgeon to access the testicle through a cut in the scrotum. Palpation showed mobile, painless lesions, with a relatively elastic consistency. However, it can also occur due to diarrhea, inflammatory bowel disease, and childbirth. It is a normal variant of anogenital anatomy, most often found in young girls. Wear loose cotton underwear and keep the area clean and dry. Pain when you pee or have intercourse. The keywords used were levator ani muscle, rhabdosphincter, urethra, perineal membrane, smooth muscles, elastic fibers, continence, and pelvic floor anatomy. The penis should be returned to the sheath and kept in place by means of a sling support or purse string suture in the prepuce. "my perineal raphe occasionally becomes very swollen and sore to the touch, is this the sign of a problem? i cannot find or determine a cause" Answered by Dr. Your midwife may also suggest using a maternity pad that has been kept in the fridge or freezer. my bottom left testicle feels swollen & my perineal area all the way down to my anus. Turnquist, Nancy Minugh-Purvis, in Nonhuman Primates in Biomedical Research (Second Edition), Volume 1, 2012 Overview of Perineum. Parents reported first noticing what they believed to be a skin tag in the perineal area at birth. In cases of perineal pain caused by perineum tear or episiotomy, regular sitz baths, numbing spray, and pain reliever drugs may provide temporary relief. Pus is a yellow or green liquid made by infected tissue. It is located in the midline and anterior to the anus in an area called the perineal median raphe. The abscess may form after surgery or after delivery of a baby. 1. This physical finding is known as infantile perianal pyramidal protrusion (IPPP). The median age at the first visit to our clinic was 1. 1), although cyst enlargement was present at either extremity. John Chiu agrees. 89 became effective on October 1, 2023. Call/text today: 1-212-204-6300 or make an appointment online. After pressing skin I can feel hard jelly like mass . In males, the bulbourethral ducts, urethra, deep dorsal neurovasculature of the penis and the nerves and vessels of the scrotum all pass over the perineal membrane. Functional Morphology. Genital lymphedema is a buildup of fluid causing swelling in the soft tissues of the genital (crotch) area. This is the visible line or ridge on the underside of the penis that runs from the scrotum to the tip of the penis. Kegel. Abscesses are pus-filled “cysts”. To externally stimulate it, press the fingers gently on the perineum and massage it lightly. Men: To stimulate the perineum from the inside, insert two fingers or a prostate massager into the rectum and look for rope-like nerves. In mid 2014 i had HIV, herpes, vdrl & tsh test and all tests. Warm compresses and numbing sprays may help with the pain. The raphe has three anatomical sections: the penile raphe, scrotal raphe, and perineal raphe. A median raphe of fibrovascular connective tissue separates both halves. Penile/scrotal raphe is red. Swollen perineal A 19-year-old male asked: I think i have a median raphe cyst. The red extends slightly into the upper scrotum. It is noteworthy that a rudimentary gubernaculum also forms in females. The genital swelling forms a conspicuous prominence in the genital region of the embryo. also rha·phe n. , the Sphincter ani externus, the Bulbocavernosus, the two Transversi perinæi superficiales, and the. Repeat the massage for 5-10 minutes total, taking breaks when you need to. 3 ). 81 - other international versions of ICD-10 N81. It can be treated by taking four to six weeks of anti fungal treatment which includes tablets along with creams. scrotum and penis in men. My penile/scrotal raphe has been red for about three weeks. Sit on a rubber ring (for no more than half an hour at a. These canals and cysts are explained as arising from epithelial rests incident to imperfect ventral fusion in the formation of the external genitalia, or from masses of epithelial cells which have migrated from the primitive epithelium. This rare condition does not usually require surgical correction except for cosmetic reasons or if the. Thank. Anatomy and function of the scrotum. The perineal area needs extra care to heal after childbirth, including cool sitz baths to reduce swelling and speed healing. Perineal groove is a rare congenital malformation that is characterized by an exposed wet sulcus with nonkeratinized mucous membrane that extends from the posterior vaginal fourchette to the anterior ridge of the anal orifice. The scrotum of the horse is a prepubic diverticulum of skin that contains the testes, their associated ducts, and the distal portion of the spermatic cords. central tendinous point and the midline raphe on the bulb of the penis. This tear seems to come and go every few months or so. The Perineal raphe on my penis from the head to the bottom is red and very itchy non-stop, it started from Sunday in the afternoon. 89 may differ. The genital area in girls is protected. What is. 225 may differ. Once the correct diagnosis is established, treatment is usually straightforward. Cancel anytime. A 35-year-old man presented with a 12-month history of a non-visible, albeit palpable midline painless swelling from the bottom of his scrotum and extending down into the perineum ( figure 1 ). This condition is noticeably very different from swollen perineum, and you will know right away if you are experiencing. In our patient, a probe tube was inserted into the fistula after incision of the median raphe cysts. Specializes in Obstetrics and Gynecology. The clinical picture did not fit that of an abscess. Cysts of the genito-perineal raphe: a study of 160. Human anatomy 1. 8. Then work up to whatever intensity that feels. Pain in the area between the scrotum and the anus can be caused by chronic or acute prostatitis. Alternatively, hemorrhoids develop close to the anus. compared with his twin's perineal raphe and, whereas the raphe in the affected twin was of the calibre of the lead in a pencil, thatof the unaffected was of the calibre of a hog's bristle. central tendinous point and the midline raphe on the bulb of the penis. Damage, or injury, to either the testes or the epididymis can cause swelling and pain in the scrotum. my cut has healed but the piece of raphe that was hanging curled up and looks like a pimple?. Long-term complications are not expected in most vaginal tears, except in severe lacerations, which are associated. Median raphe cysts of the perineum are uncommon congenital lesions of the male genitalia. Do not use soap over that area. Median raphe cysts are a rare, congenital entity. It is the result of a fetal developmental phenomenon whereby the scrotum. Unfortunately, these very short nose lengths had the downside of reducing the riders’ stability, especially. Cut. The perineum is divided into the anterior urogenital triangle and the posterior anal triangle; the vulva represents the external genitalia. Along this tract, which extended across the median raphe of the penis and scrotum, were several cj^stic areas, the largest measuring 2 cm. Turnquist, Nancy Minugh-Purvis, in Nonhuman Primates in Biomedical Research (Second Edition), Volume 1, 2012 Overview of Perineum. Women are particularly vulnerable to perineum pain because of childbirth and urinary tract infections. Introduction. Functional Morphology. Pruritus ani Pruritus ani is a condition that can occur in both genders, but. In a new article, our colleagues from IFLScience have put forward a anatomical feature unknown: the perineal raphe. 31,291 satisfied customers. Introduction. Right now my perineum is swollen, around my anus towards my vagina and I have a have a tiny tear half way between my vagina and anus.