PERINEUM CONTUSION |
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General Information
DEFINITION--A direct blow to the floor of the pelvis and associated structures including the genitals, causing bruising of skin and underlying tissues. Contusions cause bleeding from ruptured small capillaries that allow blood to infiltrate muscles, tendons, nerves or other soft tissue.
BODY PARTS INVOLVED
The perineum.
Vaginal lips, mons pubis (pubic mound), vagina, anus, penis, scrotum, testicles.
Skin, subcutaneous tissue, tendons, ligaments, blood vessels (both large vessels and capillaries), periosteum (the outside lining of bone), muscles and connective tissue.
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SIGNS & SYMPTOMS
Swelling in the perineal area--either superficial or deep.
Pain in the perineum.
Feeling of firmness when pressure is exerted from outside.
Tenderness.
Discoloration under the skin beginning with redness and progressing to the characteristic "black and blue" discoloration.
CAUSES
Direct blow to the perineum, usually by a blunt object or because of a fall.
Damage to tiny blood vessels causing bleeding that infiltrates into muscle and other surrounding tissue.
RISK INCREASES WITH
Ice skating.
Gymnastics.
Cycling.
Horseback riding.
Medical history of any bleeding disorder such as hemophilia.
Poor nutrition.
Inadequate protection of exposed areas during sports.
Obesity.
HOW TO PREVENTUsually cannot be prevented.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's care unless the injury is quite small.
Self-care for minor contusions.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Physical exam and medical history by a doctor for all except minor injuries. The total extent of injury may not be apparent for 48 to 72 hours.
X-rays of the pelvis to assess total injury to perineal soft tissue and to rule out the possibility of underlying fracture.
POSSIBLE COMPLICATIONS
Excessive bleeding leading to disability. Infiltrative type bleeding can (rarely) lead to calcification and impaired function of injured muscle.
Prolonged healing time if usual activities are resumed too soon.
Infection if skin over the injury site was broken.
Scarring and narrowing of the birth canal in women.
PROBABLE OUTCOMEHealing is usually complete in 1 to 4 weeks, depending on the extent of injury.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDUse instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION (if possible). See Appendix 1 for details.
CONTINUING CARE
Use an ice pack 3 or 4 times a day. Wrap ice chips or cubes in a plastic bag, and wrap the bag in a moist towel. Place it over the injured area for 20 minutes at a time.
After 72 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Take whirlpool treatments, if available.
Protect the injured area with pads between treatments.
MEDICATIONS
For minor discomfort, you may use non-prescription medicines such as acetaminophen or ibuprofen (available under many different brand names). Do not use aspirin for injuries involving bleeding.
Your doctor may prescribe stronger medicine for pain, if needed.
ACTIVITY
Begin activities slowly and stop exercise as soon as pain begins. Increase activity as healing progresses.
Delay sexual activity until healing is complete.
DIETEat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATIONNone.
CALL YOUR DOCTOR IF
The injured perineum doesn't improve within a day or two.
Signs of infection (drainage from skin, headache, muscle aches, dizziness, fever or a general ill feeling) occur if skin was broken.
You have discomfort with sexual intercourse after healing.
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