ZocdocAnswersI hit my perineum and can't ejaculate. What should I do?

Question

I hit my perineum and can't ejaculate. What should I do?

Had a blunt trauma between my two testicles (fell on top of a fence), it was extremely painful even though I didn't hit my testicles. The area got swollen, my perineum got very hard, and my scrotum filled with blood and turned purple. The first few days I had trouble peeing and still I can't ejaculate. My perineum is still kind of hard (like when you have an erection), and i have noticed a very hard (painless) lump in the lower perineum. It seems to be calcified and attached to the pelvis.

Answer

I think, given the situation you are describing, you need to go be evaluated by a physician in person because you may need special testing to see how severely you injured your pelvis, perineum, and/or urogenital tract. Blunt trauma to the perineum has the potential to injure the bony structure of the pelvis, regional vascular structures, and the urogenital tract. Injuries to the urogenital tract are more common in men because the male urethra is longer and the male genitalia are external. I'm concerned you could have a mild pelvic fracture, given the description of the swelling, hemorrhage, and hard nodule in your perineum. The pelvic bones are very vascular and have closely associated veins, so even a small fracture can lead to a collection of blood called a hematoma and significant swelling and pain. Hematomas associated with pelvic fractures typically cause the pubic region, scrotum, and perineum to be bruised, swollen, and filled with blood. Whether or not you fractured your pelvis, there are two alternatives to explain your uretheral obstruction. The most likely scenario is that the severe swelling in your perineum is compressing the urethra and making it difficult to urinate and ejaculate. Unfortunately the other scenario is that you have an injury to your urethra itself, which can sometimes require a catheter or surgery to fix. It sounds like you may have a fairly severe injury to your perineum, so I strongly urge you to see a urologist as soon as possible to assess the severity of your injury, determine whether your pelvis or urethra have been significantly damaged, and provide you the appropriate treatment.

This answer is for general informational purposes only and is not a substitute for professional medical advice.

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