Penile, Urethral Testes, and Scrotum Infections
The penis is part of the external male genitalia and is made up of a head (glans), a cylindrical body (shaft) and a base where it joins the rest of the body. The head is covered by a fold of skin called the foreskin. The scrotum is a pouch of skin located under the base of the penis which contains the testicles. The scrotum houses the testes, a reservoir for sperm.
Penile infections
Penile infections may be caused by bacteria, virus, fungi or organisms such as mites. Contamination can occur through the skin or sexual contact and is often seen in those with excessive sweating, poor hygiene, a non-retractable foreskin and promiscuous sexual activity.
Penile infections commonly affect the skin, sweat glands, hair shafts or follicles at the foreskin, glans and scrotum. They can produce inflammation, itching, areas of colour change, rashes, warts, nodules, blisters, or cysts filled with fluid or pus.
When you present to the clinic with these symptoms, your doctor will examine the lesion thoroughly and perform tests to identify the causative organism. Treatment usually includes topical or oral antibiotics, antivirals and antifungals to treat the infection, steroids to reduce inflammation and drying agents to control sweating. You may be advised to shave and improve hygiene. Circumcision (removal of foreskin) may be recommended for repeated infections. In cases of sexually transmitted disease, evaluation of sexual partners is advised.
Testicular and scrotal infections
Infections of the testicles or testes may be caused by bacterial and viral organisms. Epididymitis refers to the inflammation of the epididymis, the coiled tube behind each testicle. This can be followed by orchitis with symptoms such as inflammation of one or both of the testicles, swelling, fever, pain on urination and with intercourse, a testicular lump or blood in the semen.
Epididymitis and orchitis usually occur as a result of sexually transmitted diseases such as chlamydia, gonorrhoea or syphilis. Your doctor will diagnose epididymitis by reviewing your symptoms and performing a thorough physical examination (palpation and external examination) of your testes and scrotum to identify the source of pain and any suspicious lumps. Urine studies and a urethral fluid sample are obtained to identify the causative organism. An ultrasound imaging study of the testes may also be ordered. Your doctor will treat epididymitis or orchitis with appropriate antibiotics and pain medication. You are advised bed rest and ice applications, and can expect to recover in 3-4 days. In cases of sexually transmitted disease, evaluation of sexual partners is advised.
Urethral infections
The urethra is a tube that runs through the penis carrying urine and sperm outside the body. Urethral infections are commonly caused by sexually transmitted bacteria or bacteria transmitted from stool through the opening of the urethra at the tip of the penis.
Infections of the urethra are mainly characterized by pain with urination. Other symptoms include urgency to urinate, discharge from the urethral opening, bleeding and pain during sex. Your doctor will diagnose a urethral infection by reviewing your symptoms, performing a physical examination and order ingurine tests to identify the infectious agent. Treatment involves the administration of antibiotics specific to the infecting bacteria.
Prevention
Penile, urethral, testes and scrotal infections can be prevented by maintaining good hygiene and practicing safe sexual activities.