The following are some of the symptoms or problems you may be concerned about. There are tests and treatments available for the vast majority of them.
This is often caused by a sexually transmitted infection such as Chlamydia or the non-specific urethritis (NSU) group of bacteria. Some of these include bacteria such as mycoplasma and ureaplasma.
Gonorrhoea is a less common cause of discharge, but an important one, and can be simply tested by a urine test or another painless sample.
If an infection is diagnosed, then a short course of antibiotics, usually tablets, will resolve most discharges.
Again, this may be a symptom or sign of infection and all of the above bacteria can contribute to it.
Epididymitis or orchitis (inflammation of the epididymis or the testicle) may be caused by Chlamydia or the NSU group of bacteria. The epididymis is a curved structure behind the testicle and consists of a long narrow tube. It stores sperms that have been maturing.
An examination and urine test will help to diagnose this condition. Effective treatment will often be in the form of antibiotics, taken by mouth for two weeks or more.
Commonly, men also develop other types of swelling in the scrotum, such as cysts. These lumps are usually separate from the testicle itself and may be in the epididymis. They are often smooth and not painful. A gentle examination may be all that’s needed for the diagnosis, although an ultrasound test can be useful too. As they are harmless, they are often best left alone.
The most common, but important, cause for these is genital warts (caused by HPV, the Human Papillomavirus) which is one of the most frequently diagnosed sexual infections in the UK. They tend not to disappear spontaneously, and may grow in size and number. Although often soft and pink, they may be firm or darkly pigmented in many men.
Treatment of genital or anal warts is often possible by way of a cream or paint, or by the doctor performing carbon dioxide laser.
However, there are many harmless causes of lumps around the genital area, and an examination may allow us to reassure you that no treatment is needed, and that you are not infectious.
We also treat Pearly penile papules using carbon dioxide lasers.
One of the important causes of this is genital herpes, caused by Herpes Simplex Virus Type 1 or 2 (HSV), and it can affect the genitals and the area around your anus (even if your sexual experience has only been with women).
An examination and tests will be needed to confirm the diagnosis. As you may be infectious to your sexual partners during the time the spots are present, and sometimes for longer, you will be given advice about this.
Fortunately there are effective treatments for attacks of herpes, which may last from 5 to 14 days if not treated. You may be prescribed a short course of antiviral tablets, for example, which will resolve the lesions (sores).
However, genital (or peri-anal) herpes may recur in the future, as HSV can lay dormant (inactive) for many years, in the nerves close to the spinal cord. So you will be given comprehensive information regarding how to manage any future episodes, including strategies for reducing their frequency.
On the other hand there are other less worrying causes of painful sores on the penis or scrotum, such as simple infection of the oil glands (follicles). This condition can often be diagnosed with a quick examination. These spots often cure themselves and your doctor can reassure you.
This common condition often results in irritation or burning under the foreskin, or over the end of the penis (sometimes called the helmet, or glans). Your skin may look red, and there may be a discharge like cottage cheese under the foreskin. Men who are circumcised are less likely to be affected by thrush.
Thrush (candidiasis) is caused by excessive growth of the yeast fungus Candida albicans, and is not a sexually transmitted condition. This yeast lives harmlessly on the penile skin and is normally kept under control. However, if conditions change you can develop the signs and symptoms described above.
Thrush can usually be diagnosed by a quick examination by the doctor, or a painless sample can be taken with a small swab stick rolled gently over the affected parts.
The skin of your penis, scrotum, and groins and around your anus is quite sensitive to dryness and friction. So if you use too harsh a shower gel, or are frequently rubbing this area, the skin becomes dry, flaky and even inflamed. The resulting rash is called eczema, and is itchy, red and often sore—it is sometimes known as dermatitis.
Treatment will include a discussion with you about more suitable agents for you to use in the shower or bath, ways to prevent irritation of the area, and possible prescription of a cortisone-based cream to use for up to a month or more.
This rash is not easy for a patient to diagnose for himself, as there are many similar, but important, conditions that it can resemble. For example, the rashes of psoriasis, contact dermatitis and fungal infection have different causes and so need specific management. Consequently a careful examination by your doctor will be needed so that the correct diagnosis can be made, and the best treatment prescribed.
Medical Suite Building,
Arwyp Hospital, 22 Pine Avenue,
Kempton Park, Johannesburg.
Behind La Coline Commercial Centre,
Candos (close to hospital) Quatre Bornes