I never had horrid perennial pain just a numbing that would last longer than I wanted. My guess was that a solution would be easiest if there were nothing touching the perineum area and so I started looking into different saddles. There are several including Brooks that offer saddles with cut outs that eliminate contact in that area. The SMP was a solution I looked into because many of my fellow club riders were buying them. I thought it was a bit out of my range pricewise but once I test rode one I had to have one. I got a little side job someone wanted me to do and they paid me just what I needed to get the SMP Glider. Most comfortable road bike saddle I have ever been on. You still need to get one that fits your sit bones but there is no way you could have perineum pressure with one.
There are other saddles with large cut outs that might work for you including a SMP made with a plastic cover at about half or a third of the price. There are just very few with as much of a space clearing the perineum area as SMP. However no saddle will solve everyone’s problems.