81 may differ. Diagnosis can be made by taking some tissue (biopsy) and examining it under a microscope. ra·phae also rha·phae 1. It would be most prudent for you. Discussion The urethral folds appear at the undifferentiated stage in the development of the external genitalia and they include the cloacal membrane. 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 scrotum is part of the male anatomy. This line starts just anterior to the anus and extends through. It is unknown to many clinicians, which usually leads to misdiagnosis. 3 ). In males, this structure continues through the midline of the scrotum (scrotal raphe) and upward…Perineal injury is an injury to the perineum, the area of the body between the anus and the scrotum. 81 - other international versions of ICD-10 N81. Median raphe cysts are a rare, congenital entity. The perineal plates divide the cloacal fold into a circular anal fold, posteriorly, and an ellipsoidal. 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 perianal soft tissue swelling may be mistaken for a skin tag, or acrochordon. Connect with a U. In males, it contains male external genitalia and the perineal muscles. The red extends slightly into the upper scrotum. The perineal raphe joins the anal verge (opening of the anus), to the posterior end of the urogenital fold. Blunt trauma causes split in skin and muscles that may get infected. 2. Created for people with ongoing healthcare needs but benefits everyone. there was a lil piece of the raphe hanging, as ive read in forums people say that the skin hanging will just fall off. 1. Penile/scrotal raphe is red. Let’s start with the male external genitalia, which includes the membranous - or intermediate - urethra, the. A perianal abscess is an abscess near the opening of your bottom (anus). Perineal injury in. Median raphe cyst is an uncommon, mostly asymptomatic condition in young patients. Meaning of gouch. Sit on a rubber ring (for no more than half an hour at a. Once the correct diagnosis is established, treatment is usually straightforward. Keep the area covered with a clean dry bandage if possible. Incidence of this congenital anomaly is underestimated as it may be unrecognized earlier at birth and/or. 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. If you think your swollen perineum is unusually itchy and swollen, go see your OB MD who did the OB care and d. net dictionary. Educating the child and family prior to this examination is important both for their reassurance and for gaining their trust. The perineal lesion (Figure 1) was recognized by CAP as the congenital malformation failure of midline fusion. Articles concerning this topic were mainly case reports and an obvious female predominance was noticed (2, 3). Penile curvature − 0. Along this tract, which extended across the median raphe of the penis and scrotum, were several cj^stic areas, the largest measuring 2 cm. This condition is one of the uncommon anomalies of urogenital/anogenital region that is unknown to many clinicians. &NA; Median raphe cysts are uncommon congenital lesions most often found on the penis or scrotum. This report describes an anterior perianal lesion in a 62 yr old male and draws attention to this rarely described location and the unusually late presentation. What does a swollen perineal mean - Answered by a verified Health Professional. area between the buttocks and genitals (perineum) area around the anus and rectum. Wear loose cotton underwear and keep the area clean and dry. What is. I would be more concerned with a perianal abscess or fistulo in ano or some other infection or inflammatory process. Perineal pain or perineum pain is often caused by infection of perineal skin, subcutaneous tissue or deeper tissue like anus, vulva and vagina. 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. it is normal? 1 doctor answer • 3 doctors weighed in. Introduction. Apply ice to perineum for first 12 hours. [2–5] About 25-45% of these patients can develop serious complications. They can be found all the way from the distal penis and scrotum toward the perineum in a midline. Perineal raphe develops during fetal development inside mother’s womb. This physical finding is known as infantile perianal pyramidal protrusion (IPPP). If you have concerns, seek examination by Physician or Dentist. Human anatomy 1. An anterior perianal lesion is described in a 62 yr old male and attention is drawn to this rarely described location and the unusually late presentation. Swollen perineal A 19-year-old male asked: I think i have a median raphe cyst. The area may look red and feel painful and be swollen. 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. Its purpose is to help support your reproductive organs and pelvic floor muscles. as two masses on both sides of the median raphe,. Nose length- Saddle nose length also seems to be a factor. This tear seems to come and go every few months or so. It is observed as a noticeable line. They can be found all the way from the distal penis and scrotum toward the perineum in a midline position. Median raphe cysts usually don’t cause problems, but some people may develop symptoms later on in life, including: Swelling in the area. Perineal groove is a rare benign congenital anomaly with lesion that resembles perforation of mid-perineum or perineal raphe area. This uncommon cystic lesion was first described by Mermet in 1985. It is noteworthy that a rudimentary gubernaculum also forms in females. Before the perineum tears, if there is a yeast infection, you will notice swelling and irritations. It appears as a thin longitudinal line that runs front to back over the entire scrotum. Gently pat the area dry. After you’ve given birth, it’s common for the perineum to be sore. The perineum pain between the genitals and anus can be commonly caused by anal fissures. The most observant and observant now know what it is. . Women are particularly vulnerable to perineum pain because of childbirth and urinary tract infections. Minor cuts or scrapes heal quickly. My penile/scrotal raphe has been red for about three weeks. Share. It is observed as a noticeable line. An abscess is a painful, swollen area with pus inside. It is mostly presented in female infants as an isolated anomaly but can be found in males as well []. The perineum is an erogenous zone. 1-3 The diagnosis can be made in early infancy through the preschool and early school years. Functional Morphology. My symptoms started on may 6th, I have frequent urination, pain swollen feeling between my scrotum and rectum, sore lower back, pain in the t. 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. Although the raphe frequntly zigzags a bit, it usually starts and ends at or near the midline. Furuncle of perineum. 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 initially thought to be a liposarcoma. The keywords used were levator ani muscle, rhabdosphincter, urethra, perineal membrane, smooth muscles, elastic fibers, continence, and pelvic floor anatomy. 89 became effective on October 1, 2023. This line starts just anterior to the. 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. Long-term complications are not expected in most vaginal tears, except in severe lacerations, which are associated. 2 Other symptoms include localized pain, chronic seepage, and excessive moisture. Using a throwaway account cause this is personal. In males, the muscle consists of two parts that are fused at the median fibrous raphe of penis. The raphe joins the internal septum with the scrotum. 215 - other international versions of ICD-10 L02. I have a discoloration rash which a doctor has diagnosed as. I accidentally cut my perineal raphe. 225 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Following the definitive diagnosis of failure of midline fusion, urology recommended a CT of the abdomen and pelvis to evaluate for additional. Swollen veins are not common in this area and I have not seen this ever in many years of practice although anything is possible. The cysts can occur at parameatus, glans penis, penile shaft, scrotum, or perineum. Gynecology 40 years experience. Injuries to the perineum can happen suddenly like an accident or as the activity which puts the. I was checked for being intersexed before and they found nothing. 1), although cyst enlargement was present at either extremity. 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. Share. This is the American ICD-10-CM version of N48. Jean E. The perineum is divided into the anterior urogenital triangle and the posterior. Bruises and swelling of the labia are most often from a straddle injury. The most common symptom of mycotic infection of the perianal and perineal regions is pruritus. After pressing skin I can feel hard jelly like mass . 1. It is a type of genital injury. ” Another referred to it as the “vagina-nutsack-anus scar,” adding: “Every dude has one. Pain when you pee or have intercourse. Childbirth, weight loss, trauma and other factors can damage this area and cause the skin around your. 2. Hope this helps. who do i go to&is this easy/safe to treat? Median raphe cysts are a rare, congenital entity. In botany and planktology it is commonly used when describing a seam or ridge on diatoms or seeds . I've had my family doctor give me an RX cream but it is not working? What is. Browse 111 authentic perineum stock photos, high-res images, and pictures, or explore additional perineum sunning or perineum tanning stock images to find the right photo at the right size and resolution for your project. Sometimes the tear comes as a result of continuous itchiness and scratching. Median raphe cysts of the perineum are uncommon congenital lesions of the male genitalia. Cross section of male abdomen with pelvic diaphragm, Prostate, bladder, rectum, pubic bone, urethra, anus, and coccyx. [3] [4] The penoscrotal raphe (penile and scrotal raphe) is homologous to the female labia minora. pl. Abscesses are pus-filled “cysts”. The perineal raphe is a small, vertical, slightly raised ridge of scrotal skin under which is found the scrotal septum. Minor injuries can cause lots of bleeding because of the rich blood supply. 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. 1. Perineal groove is a rare benign congenital anomaly with lesion that resembles perforation of mid-perineum or perineal raphe area. 9). 1). Purpose of Review To discuss perineal and robotic approaches to gender-affirming vaginoplasty. What DOES worry me is that just now I found my perineal raphe to be swollen. 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 knot of skin of varying size. Perineal fistula and other anorectal. vulva, labia and clitoris in women. Most. Same-day virtual video appointments and in-person appointments are available. Answered in 1 minute by: 1/28/2021. On physical examination, there was a firm, nontender, nonpulsatile, irreducible, noncompressible mass in the anterior perineal area, on the left of the median raphe. 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. This lesion extends vertically downward from the posterior portion of the vaginal fourchette to the anterior rim of the anus. 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. 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. 31,291 satisfied customers. Median raphe cysts are cysts that develop on the median line in the male genital region in any area from the anus to the external meatus. The burning sensation lessens as each day passes, usually burns now only when I pee in the morning. Although usually asymptomatic, secondary infection may produce swelling, tenderness and a purulent discharge. An anal fissure is most common when a person has a dry, hard bowel movement. —This is a fibrous point in the middle line of the perineum, between the urethra and anus, and about 1. So, two days ago I noticed a little lump near my anus while showering. Discussion. Abstract. 1. Perineal groove is a rare congenital midline malformation of the perineal raphe. 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. There are many Raphes in the human body. We perform scrotal surgery, penile procedures, varicocele and hydrocele repair, and circumcision. The term "IPPP" was introduced in the medical literature within the past 10 years. Therefore gents, you have a bit of a labia on your scrotum. FormalPara Definition . Perineal Injury. , 38 (September. Both cysts and abscesses can cause. penile raphe. Ectopic. The scrotal raphe is in continuity with the penile raphe superiorly and the perineal raphe inferiorly. Wrap this in a flannel or towel to avoid ice-burn, which can be painful. The pathogenesis of perineal groove is not clear, and there are few cases reported in the current medical literature. The raphe has three anatomical sections: the penile raphe, scrotal raphe, and perineal raphe. Take a warm bath. 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!. Perineal raphe synonyms, Perineal raphe pronunciation, Perineal raphe translation, English dictionary definition of Perineal raphe. 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. Median raphe cyst is usually benign and asymptomatic male genitalia lesions. There’s lots of other ways to phrase this explanation of the perineal raphe. 1-3 The diagnosis can be made in early infancy through the preschool and early school years. NSFW. Abstract. The perineal raphe is where the tissue came together, and this line extends down the the scrotum as well. Perineum swelling is associated with a variety of conditions, including: Cysts and abscesses: Cysts (which are fluid-filled sacs) develop due to infection or irritation in the perineum. hav bv tho. Functional Morphology. Introduction and hypothesis: Descending Perineum Syndrome (DPS) is a coloproctologic disease and the best treatment for it is yet to be defined. This structure continues through the midline of the scrotum (scrotal raphe) and upwards through the posterior midline aspect of the penis (penile raphe). Over the next few months, the area became more swollen and did not regress despite recommended sitz baths and barrier creams. Y. Sore or itchy perineum. 5 month (range, 0. A blockage or breakdown of the lymphatic system leads to leakage of lymph (fluid) into surrounding tissues. central tendinous point and the midline raphe on the bulb of the penis. 6. e. The perineal area needs extra care to heal after childbirth, including cool sitz baths to reduce swelling and speed healing. In a new article, our colleagues from IFLScience have put forward a anatomical feature unknown: the perineal raphe. Perineal groove is a rare congenital malformation characterized by a midline wet erythematous sulcus of the perineal raphe extending from the posterior fourchette to the anterior edge of anus with a normal anatomy of urethra, vagina and anus. The wound may be a freshly created surgical wound or may be as a result of trauma or burns. Dr. Fungal infections may account up to 40% of secondary infectious pruritus ani cases–a majority is caused by Candida . Submitted: 2 years ago. These bumps can occur anywhere on perineal raphe most commonly around anus. We report the case of a 4-year-old child presented to the emergency department for a serpiginous and redness lesion extended from the basis of the penis until the perineum. Allergic contact dermatitis. Median raphe cysts are cysts that develop on the median line in the male genital region in any area from the anus to the external meatus. An anterior perianal lesion is described in a 62 yr old male and attention is drawn to this rarely described location and the unusually late presentation. This report describes an anterior perianal lesion in a 62 yr old male and draws attention to this rarely described location and the unusually late presentation. General causes. Product. A few antibiotics and massages are used to treat perineal pain but are done only once the inflammation subsides. Meaning of gouch. Definition of gouch in the Definitions. perineal raphe. Median raphe cysts can develop at any site along the midline of the ventral side of the male genital area, from the meatus to the scrotum and perineum (Figure 1). Median raphe cysts are a rare, congenital entity. A 10-month-old girl was referred to Pediatric Gynecology after her parents noticed an increasing genital bulge. The pathogenesis of perineal groove is not clear, and there are few cases reported in the current medical literature. Perineal raphe: everything on this line that divides the scrotum in two. After delivery, the doctor or midwife usually closes the perineal tear with stitches. Its exact location is the midline of the perineum at the junction of the anus and urogenital triangle in both females and males. anal pain or itching. Alex Kirkham 2, Asif Muneer 3 Correspondence to Arie Stewart Parnham, [email protected] membrane and corpus cavernosum of the clitoris. Definition: Raphe means a line of fusion 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; and it is divided anatomically to: penile raphe, scrotal and perineal raphae. The canals are l. Difficulty getting an erection. 1 It is divided on the midline by the scrotal raphe, which is continuous with the raphe of the prepuce, penis, and. In mid 2014 i had HIV, herpes, vdrl & tsh test and all tests. It is the result of a fetal developmental phenomenon whereby the scrotum (the developmental equivalent of the labia in females) and. 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. Pressure at one extremity. 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 initially thought to. The female perineum is a diamond-shaped structure inferior to the pelvic diaphragm and between the symphysis pubis and coccyx. Hi, I want a dermatologist to look at my rash on my perineum. We perform scrotal surgery, penile procedures, varicocele and hydrocele repair, and circumcision. Antibiotics can help treat certain types of perineal pain. On histological. It is a sac of skin and muscle that hangs in front of the pelvis, between the legs. That line is called the “penile raphe. Repeat the massage for 5-10 minutes total, taking breaks when you need to. Note bulging perineum, and meconium in perineal raphe and scrotal raphe. 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. This rare condition does not usually require surgical correction except for cosmetic reasons or if the. Created for people with ongoing healthcare needs but benefits everyone. A lump on your perineum, redness and swelling. The tourniquet may need to be re-applied as the swelling is reduced. It is found in the superficial perineal space (pouch), together with the ischiocavernosus and superficial transverse perineal muscles. One person on Reddit succinctly (but not completely accurately) described it as “where our vaginas would be had you been born a girl instead of a guy. 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 knot of skin of varying size. Alternatively, hemorrhoids develop close to the anus. 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 Dr. Perineal nodular swelling in a recreational cyclist: diagnosis and discussion. Six cases are reported: five with canals or cysts of the genito-perineal raphe, one with a periurethral cyst. Perineal raphe synonyms, Perineal raphe pronunciation, Perineal raphe translation, English dictionary definition of Perineal raphe. 1 Only a couple hundred case reports of median raphe cysts have been published in the English. The lesion extended 4 cm and was unilocular (Fig. Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. While hemorrhoids may trigger perineum pain, they don’t cause perineum swelling. 2 Other symptoms include localized pain, chronic seepage, and excessive moisture. It is unknown to many clinicians, which usually leads to misdiagnosis. The perineum is the area between the scrotum and the anus in a man. Perineal grooves in two newborn babies were described in this report, and the literature on. Pressure on the scrotal cysts caused expression of a milky fluid from the upper portion of the tract. In perianal Crohn’s disease, these symptoms are located around the anus and may include: anal bleeding. ReplyA 44-year-old male presented with a painless swelling in the perineum which became more prominent with penile erections. Dr. 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. The genital swelling forms a conspicuous prominence in the genital region of the embryo. perineal raphe. It is a tear to your perineum (say "pair-uh-NEE-um"), which is the area between your vagina and anus. 8. Relevant articles and textbook chapters were reviewed, analyzed, and summarized with the consensus of the authors of this paper. Perianal hematomas are effectively swollen bruises under the surface of the skin near the opening of the anus. A. board-certified. Medicaments including neomycin. 1-3 The diagnosis can be made in early infancy through the preschool and early school years. the caudal end of the left and right urethral folds fuse to form the urethral raphe. The penile raphe is part of a broader line in the male reproductive organs, that runs from the anus through the perineum ( perineal raphe) and continues to the scrotum and penis, collectively referred to as median raphe. Some yeast infection discharges can be very itchy, causing endless discomfort. Same-day virtual video appointments and in-person appointments are available. Scrotum. 会阴 （perineum）是人体 生殖器 到 肛门 间的间隙（space），主要是软组织构成；在 针灸学 是一个 任脉 穴 [1] 。. Recent Findings The Davydov peritoneal vaginoplasty has its origins in neovaginal reconstruction for vaginal agenesis. To externally stimulate it, press the fingers gently on the perineum and massage it lightly. The lesion extended 4 cm and was unilocular (Fig. Having pre-existing HSV1 typically reduces symptoms of HSV2. If swelling is present, the area should be. pl. It arises from the central tendinous point of the perineum and from the median perineal raphe in front. Perineum. Fournier gangrene (necrotizing fasciitis) requires prompt resuscitation and surgical. Board Certified Physician. The purpose of the median septum is to compartmentalize each testis in order to prevent friction or trauma. 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. 1), although cyst enlargement was present at either extremity. Subsequent histopathological examination confirmed a median raphe cyst. It is an extension of the perineal raphe, a line of tissue that extends. 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. Other symptoms of an abscess include: a red, pimple-like bump on. Fragrances and preservatives, especially in wet wipes. We present a case where a baby girl was born with failure of fusion of the perineal raphe. You can see yours has some crooked spots too. Slight hyperpigmentation of the genital raphe is almost invariably present (Fig. Use a back and forth U-shaped movement to gently massage the lower half of your vagina for 2-3 minutes. Sir/ma'am I have a lump (painless) in perineal region, which is not visible from eyes or from surface. Perineal raphe bump is a lump formation on the line of tissues i. There are two. N81. Simple orchidectomy: Known as a subinguinal orchiectomy, this type of procedure allows the surgeon to access the testicle through a cut in the scrotum. May be candida: This is a yeast that often causes problems in warm weather. 225 became effective on October 1, 2023. You can vary the pressure as per your liking. If the area looks red and swollen or there is a painful cyst on the perineum, this may be a sign of infection. The female perineum is a diamond-shaped structure inferior to the pelvic diaphragm and between the symphysis pubis and coccyx. From the raphe, the. In a woman, it's. However, it can also occur due to diarrhea, inflammatory bowel disease, and childbirth. The red extends slightly into the upper scrotum. Press down towards the anus and the sides of your vaginal wall. 16. This is the American ICD-10-CM version of L02. An infected median raphe cyst was. my bottom left testicle feels swollen & my perineal area all the way down to my anus. Richard Greengold: May be candida: This is a yeast that often causes problems in warm wea. 4 to 6 weeks: The post partum period is 4 to 6 weeks. The abscess cavities must be opened and drained, including the testis if it is involved. [5] [6] [7] At New York Urology Specialists, we offer same-day treatment for perineal pain . We present a case and review the literature in respect to a 35-year-old man with a non-visible, painless midline. There are two (males) or three (females) openings that. 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. The septum. Men: To stimulate the perineum from the inside, insert two fingers or a prostate massager into the rectum and look for rope-like nerves. 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. DO. [2–5] About 25-45% of these patients can develop serious complications. 5 mm 2 to 28. Causes include poor anal hygiene, allergies, certain foods and drinks and other health conditions. Put an ice/cool pack on the area for about 10 minutes at a time. It may also be too small. "The line that runs down the underside of the penis and down the middle of the scrotum, the peno-scrotal raphe (where the urogenital folds fused early in the womb), will darken. The perineal raphe is visible and pronounced to varying degrees. It is a normal variant of anogenital anatomy, most often found in young girls. Jean E. Swollen red foreskin My Foreskin is red, puffy, itchy, slightly crusty, and HURTS Dry. This is a less invasive procedure and is more often. Pruritus ani Pruritus ani is a condition that can occur in both genders, but. The raphe has three anatomical sections: the penile raphe, scrotal raphe, and perineal raphe. 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. left testicle also feels/looks lower than usual. My penile/scrotal raphe has been red for about three weeks. S. Swollen red foreskin My Foreskin is red, puffy, itchy, slightly crusty, and HURTS Dry. Its exact location is the midline of the perineum at the junction of the anus and urogenital triangle in both females and males. Perineal Injury. [5] [6] [7]At New York Urology Specialists, we offer same-day treatment for perineal pain . In our patient, a probe tube was inserted into the fistula after incision of the median raphe cysts. A chronic perineal wound could result. Perineal injury can occur and cause swelling and/or a lump between anus and scrotum. The cysts can occur at parameatus, glans penis, penile shaft, scrotum, or perineum. 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. I can hold it well with two fingers when pressed hard . WeMedian raphe cysts present anywhere between the external urethral meatus and the anus.