Lump in between Bum Cheeks

This post is a response by a doctor to a question one of our community members asked.

Sammy Asks:

I have a lump in between my bum cheek and it is severely sore. It is quite close to my scrotum and I would say approx 7-9 cm long. It has no head but is red on surface. It is quite hard not soft to the touch. It is sore to touch, sit and to walk. The pain has gradually gone into the groin area now as well

Dr Alejandro’s reply:

Hello Sammy,

You are describing the clinical features of an abscess.

An abscess is a collection of pus (a thick yellowish or greenish opaque liquid produced in infected tissue) that has built up within the tissue of the body, in this case, in your perineal area (the area between the scrotum and the anus). Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed.

They are usually caused by a bacterial infection. Often many different types of bacteria are involved in a single infection, specially when located in areas like the abdomen, the pelvis or the perineal area. Treatment consists of a minor surgery for opening and draining the abscess, and a course of antibiotic treatment, which is curative in almost all cases. Once diagnosed, perirectal abscesses should be drained promptly, because any undrained abscess can continue to expand into adjacent spaces as well as progress to generalized systemic infection. This is more common in patients with underlying diseases such as diabetes and other chronic degenerative diseases, that can make this medical condition harder to treat.

The area of redness often extends beyond the swelling, so it may be smaller than it looks. However, it is alarming that the pain has already irradiated to your groin area. This can be translated to an imminent expansion into adjacent tissues. It is important that you seek urgent medical care, so proper treatment (both surgical drainage and antibiotic therapy) is started, which will ensure the best possible outcome. Treatment may also require a hospital stay for intravenous antibiotics and a closer follow up. After your treatment is finished, I recommend to sit in about 10 centimeters of warm water (what is known as sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases discomfort.

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