A Milan judge on Tuesday ordered Prime Minister Silvio Berlusconi to stand trial in April on charges of paying an under-age girl for sex and abuse of office, dealing the most serious blow to his leadership in the 17 years that he has dominated Italian politics.

In a brief statement, the judge said the trial would start on April 6. Mr. Berlusconi faces charges that he paid for sex with Karima el-Mahroug, then an under-age nightclub dancer nicknamed Ruby Heart-Stealer, and that he abused his office to help release her from police custody when she was detained for theft. The scandal has dominated political debate in Italy for months.

Mr. Berlusconi denies wrongdoing and has said he has no intention of stepping down. But in an increasingly tense climate after large anti-Berlusconi demonstrations on Sunday, analysts said the judge’s ruling made it nearly impossible for the prime minister to govern and all but guaranteed early national elections.

“The situation is more political than judicial now,” said Stefano Folli, a political columnist for the financial daily Il Sole 24 Ore. He predicted that in the short term Mr. Berlusconi would hold on, but that “in the middle term it’s an unsustainable situation.”

“And ‘middle term’ means a few months,” he added.

The leader of the center-left opposition, Pier Luigi Bersani, called for Mr. Berlusconi to resign immediately.

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The prime minister has called the accusations “groundless,” and so far his center-right coalition, which governs with a narrow majority, has stood by him. But on Tuesday there was no immediate response from the Northern League, the most powerful party in his coalition. Analysts speculated that there was wrangling over whether to pull the plug on the government.

After the ruling, Mr. Berlusconi flew back to Rome from Sicily, where he did not appear at a scheduled news conference and where Italy is seeking to stem a flow of illegal immigrants. More than 5,000 have arrived from Tunisia in the past month after the revolution there.

Ever since prosecutors announced last week that they would call for an expedited trial, saying they had enough evidence to waive preliminary hearings, Mr. Berlusconi has fought back in the news media, accusing the judiciary of a “moral coup.”

On Tuesday, Fabrizio Cicchitto, the leader of Mr. Berlusconi’s party, People of Liberties, in the lower house of Parliament, called the ruling “a clear political use of justice.” Justice Minister Angelino Alfano said that the government had “a strong mandate” and that the judge’s ruling infringed on the independence of Parliament.

Prime Minister Silvio Berlusconi is charged with paying an under-age girl for sex and abusing his office. Credit Lionel Bonaventure/Agence France-Presse — Getty Images

But President Giorgio Napolitano, who has the power to dissolve Parliament and call early elections if the governing party agrees, said Tuesday that the showdown between the executive and the judiciary posed “reasons for anxiety,” the news media reported.

On Sunday, thousands took to the streets in Italy and worldwide in coordinated demonstrations that organizers said were aimed at restoring the dignity of Italian women after Mr. Berlusconi for years had routinely appointed television showgirls to political office.

Mr. Berlusconi criticized the rally on Monday — not through an official statement or news conference but by calling in to a television show on a channel he owns — saying the center-left “used any pretext to try to bring down an adversary they cannot beat at the polls.”

Defenders of Mr. Berlusconi have pointed to what they call a “Jacobin” climate in which magistrates have become a de facto opposition instead of Parliament, where the center-left opposition is weak and divided and groupings that have broken from the center-right coalition are not seen as having enough power to form a new government.

The judge’s ruling ordering a trial came weeks after prosecutors said they were investigating the prime minister on charges that he paid Ms. Mahroug for sex before she turned 18 and abused his office in calling the police to intervene when she was detained in May for theft.

Mr. Berlusconi has said he called the police to avoid “an international diplomatic incident” because he had been told that the Moroccan-born Ms. Mahroug was the niece of Hosni Mubarak, then the president of Egypt.

Under Italian law the age of consent is 14, but it is illegal to pay for sexual services with a person under 18.

Both Mr. Berlusconi and Ms. Mahroug say they did not have sex, although Ms. Mahroug said the prime minister gave her 7,000 euros, about $9,450, the first time she visited his villa for a party last spring. In a television interview last month she said she had made up “a parallel life,” telling people she was Egyptian, not Moroccan, although she did not say whether she had ever claimed to be Mr. Mubarak’s niece.

The trial would not be Mr. Berlusconi’s first. Over the years he has emerged largely unscathed from a dizzying list of legal troubles, including charges of corruption, tax evasion and the bribing of judges. In each case he was either acquitted on appeal or the statute of limitations ran out.

In the new trial, Mr. Berlusconi would not have to appear in court but could do so if he chose. His lawyers have 15 days to decide whether they want to face a fast-track closed-door trial, in which a panel of judges would rule based only on the evidence gathered by prosecutors, or whether they would seek a plea bargain.

Piero Longo, a lawyer for Mr. Berlusconi, called the judge’s decision “exactly what we expected.” Noting that Mr. Berlusconi would be tried before a panel of three judges, all of them women, he said: “Great. Women are always appreciated, sometimes even agreeable,” the center-left daily La Repubblica reported.

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