Lumps between anus and scrotum may be concerning and may even be a little embarrassing to talk about. Lumps should always be checked out to make sure they are nothing serious. Most of the time, they may just be a symptom of something going on in the lower pelvic region. However, the determination is best made by a doctor.

It may be a lump or cyst, an injury to the perianal area, or a skin abscess. Things like this are common in people with other health conditions, but can occur in anyone. This article will give some of the more common causes of the condition and what to do about it.

Causes of Lump Between Anus and Scrotum

Lumps between anus and scrotum can be caused by a number of conditions. Some may need treatment or they may be nothing to worry about. Only your doctor can diagnose and let you know when to be concerned.

1. Dermoid Cysts

A dermoid cyst is a rare type of cyst that is most often benign, but can progress to cancer. They are usually found on the testicles, but can grow on the edge of the perineum between the anus and scrotum.

These cysts actually happen during the stage of fetal development. The outer sac of the cyst is the same as skin and they often contain hair, nails, teeth, and nerves. Dermoid cysts often have no symptoms until they grow large enough to cause an issue.

Symptoms

• Lump that can be felt from the outside of testicle or on perineum
• Trouble urinating
• Dull backache in the lower back
• Pain that radiates to the thighs

Treatments

Doctors will biopsy to check if it is benign or cancerous. If the cyst is benign, only the cyst is removed. If the cyst shows suspicious or cancerous cells, the cyst and affected testicle(s) will also be removed.

2. Lipoma 

Lipomas are just fatty tumors and almost always benign. They aren't as common in the perineal area, but can happen anywhere on the skin.

Symptoms

• Noticeable lump, tends to be soft
• No pain or discomfort when they are small
• As they grow, they may cause discomfort with tight clothing or underwear

Treatments

If a lipoma is small, no treatment is necessary. The doctor may do a small biopsy just to check and confirm the diagnosis. Then they are left alone unless they grow too large and cause discomfort. Larger lipomas are easily removed in an outpatient surgery.

3. Anal Duct Cyst 

Anal glands have ducts that secrete pheromones to help mammals identify each other. While humans have these glands, they are less prominent than in the animal world. Still they do have openings that can get blocked by sebaceous fluids, oils, and fecal material. This can form a cyst in the perianal and anal area. The cyst can turn into an abscess and become infected.

Symptoms

• A lump between anus and scrotum or near the anal opening
• Perineal pain
• Drainage
• Pelvic and lower abdominal pain
• Pain with moving bowels
• Fever
• Fatigue
• Swelling

Treatment

If you have symptoms of an anal duct cyst, see your doctor right away. These need to be surgically drained as soon as possible. They may need antibiotics and pain relievers. Until you can get into the doctor, you can try warm compresses to the area to relieve swelling and pain.

4. Sacrococcygeal Teratoma 

This is a tumor that develops during the development of a fetus and shows up as a lump at the very end of the tailbone. This may show up as a lump near the perineal area. They're most often benign, but a small number may become malignant tumors. Teratoma is most common under 5 months of age, but can show up in older children.

Symptoms

• Pain when sitting
• Pressure to the bottom area
• Constipation
• Visible lump in the perineal or tailbone area

Treatment

Surgery through the perineum is required and the muscles attached need to be repaired. If the tumor is large, the surgeon may have to go through both the perineum and the abdomen.

5. Sebaceous Cyst 

Sebaceous cysts are skin cells that do not shed, but get trapped deep inside one of the glands that hair grows from. The oils, skin cells and even hair can get trapped and close up. This results in a swelling to the area. In the perineal area between the anus and scrotum there are many hair follicles, plus rubbing of clothing and underwear that can lead to obstruction of these glands.

Symptoms

• Painless lump under the skin
• Drainage of a thick yellow fluid
• Appearance of black material at the head (blackhead)
• It can become painful, red, and inflamed if infection develops

Treatment

• You can apply warm compresses to try and open the cyst so it drains. Never pick or squeeze these due to risk of infection.
• If the lump persists, see your doctor for evaluation and possible drainage.
• Wear loose cotton underwear and keep the area clean and dry.

6. Perineal Injury 

Perineal injury can occur and cause swelling and/or a lump between anus and scrotum. 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.

Symptoms

• Painful erection
• Bruising in the perineal area
• Pain to the touch
• Bleeding if a tear occurs

Treatment

Top priority in treatment is placing stitches to repair any tears. If you only sustain a lump or bruise, the doctor may recommend ice and rest the first few days. You may need antibiotics if an infection develops and the doctor can give you medication for painful erections.

When to See a Doctor

Any swelling or lump in the area of the scrotum, testicles, and anus should be checked by a doctor as soon as possible so as to rule out any kind of cancerous lesions. Even if a lump has no pain, it could still be suspicious for cancer. If the doctor says the lump is benign and it goes away on its own, there is no reason to worry. However, recurrent lumps or lumps that get bigger instead of smaller should be monitored closely.