Men’s genital problems: What to look out for

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

A rash may be the first symptom of a sexually transmitted infection.

Male genital problems and injuries can occur fairly easily since the scrotum and penis are not protected by bones.

Genital problems and injuries most commonly occur during:

  • Sports or recreational activities, such as mountain biking, soccer, or baseball.
  • Work-related tasks, such as exposure to irritating chemicals.
  • Falls.
  • Sexual activity.

A genital injury often causes severe pain that usually goes away quickly without causing permanent damage. Home treatment is usually all that is needed for minor problems or injuries. Pain, swelling, bruising or rashes that are present with other symptoms may be a cause for concern.

Common genital conditions

Testicular cancer: this is the most common cancer in men 15 to 35 years old. Testicular cancer is more common in white men than black men. Many growths in the scrotum or testicles are not cancer (benign). But a painless lump in a testicle may be a sign of cancer.

Erection problem: this may occur when blood vessels that supply the penis are injured. A man may not be able to have an erection (erectile dysfunction), or the erection may not go away naturally (priapism), which is a medical emergency.

Torsion of a testicle: this occurs when a testicle twists on the spermatic cord and cuts off the blood supply to the testicle. This is a medical emergency.

Scrotal problems: these problems may include a painless buildup of fluid around one or both testicles (hydrocele) or an enlarged vein (varicose vein) in the scrotum (varicocele). Usually these are minor problems but may need to be evaluated by your doctor.

Problems with the foreskin of an uncircumcised penis: conditions that make it hard to pull the foreskin back from the head of the penis (phimosis) or that prevent a tightened, retracted foreskin from returning to its normal position over the head of the penis (paraphimosis) need to be evaluated.

Hypospadias: this is a common birth defect where the urethra does not extend to the tip of the penis.

Undescended testicles (cryptorchidism): this occurs when one or both testicles have not moved down into the scrotum.

Inguinal hernia: a hernia occurs when a small portion of the bowel bulges out through the inguinal canal into the groin.

A kidney stone: a stone forms from minerals in urine that crystallise and harden. Kidney stones are usually painless while they remain in the kidney. But they can cause severe pain as they break loose and travel through narrow tubes to exit the body.

A sebaceous cyst: a cyst that is filled with a cheese-like, greasy material may develop beneath the outer layer of the skin in the scrotum.


Infections can occur in any area of the genitals, including:

The testicle (orchitis): orchitis is an inflammation or infection of the testicle, often caused by a virus or bacteria.

Symptoms of orchitis include pain, swelling, or a feeling of heaviness in the scrotum. Orchitis can occur in men who get mumps, influenza, or tuberculosis. Sexually transmitted infections may also cause orchitis. Pain and swelling in the scrotum should be evaluated by a doctor. Treatment of orchitis caused by bacteria includes antibiotics. Orchitis caused by a virus, such as mumps, is treated with rest and pain medicine.

Epididymis (epididymitis): Epididymitis is inflammation and infection of the long, tightly coiled tube (epididymis) that lies behind each testicle and collects sperm. Epididymitis can be caused by a urinary tract infection, a sexually transmitted infection, an enlarged prostate, or a urologic procedure. Epididymitis usually starts suddenly.

The urethra (urethritis): urethritis is inflammation of the tube that carries urine from the bladder to outside of the body (urethra). It can be caused by a bacterial or viral infection (like some sexually transmitted infections), irritation from soap or spermicide, or injury. When urethritis is caused by a bacterial infection, antibiotic medicine is used to treat it.

Symptoms of urethritis can include:

The prostate (prostatitis): prostatitis is swelling or infection of the prostate gland that is usually painful. The prostate is a small organ below a man’s bladder that makes fluid for semen. Prostatitis can cause urinary problems, such as an urge to urinate often, burning pain, and a feeling that you can’t empty your bladder. Symptoms may be sudden and severe or mild and long-lasting.

The bladder (cystitis): bladder infection (cystitis) is the most common infection of the lower urinary tract. Bladder infection is usually caused by bacteria that get into the bladder by travelling up the urethra. Bladder infections are more common in females than in males.


Rashes in the groin area have many causes, such as ringworm or yeast. Most rashes can be treated at home. A rash may be the first symptom of a sexually transmitted infection (STI).

If you may have been exposed to an STI, do not have sexual contact or activity until you have been evaluated by your doctor. This will reduce the risk of spreading a possible infection to your sex partner. Your sex partner may also need to be evaluated and treated. Male genital problems may be related to whether or not the penis is circumcised.

Anything wrapped around the penis or an object in the penis needs immediate evaluation to avoid problems.




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