Genital Symptoms

Genital symptoms occur in the sex organs or pelvic region of men and women, and may or may not be caused by an infection--sexually transmitted or otherwise. The conditions associated with genital symptoms vary and carry a host of other symptoms that range from mild to severe.

Conditions Associated with Genital Symptoms

Testicular torsion: This condition occurs when the testicle rotates, causing the cord from which it suspends to twist and cut off the blood supply to the testicle (ischemia). This condition often requires emergency surgery to save the testicle. If left untreated, the tissue within the testicle may die off, leading to its removal.

The most common symptom is sudden and severe testicular or scrotal pain, followed by:

  • Tenderness of the testis
  • Discoloration and swelling of the testis or scrotum
  • Fever
  • Nausea and vomiting
  • Pain that radiates to the groin and/or flank pain
  • A testicle is either at an unusual angle or is positioned higher than normal

Epididymitis, orchitis, epdidymo-orchitis refer to inflammation of the epididymis (the coiled tube at the back of the testicle that stores and carries sperm), the testicles, or both. These conditions are often caused by a bacterial infection or virus, and may or may not be sexually transmitted. Associated symptoms include:

  • Tenderness and swelling of the epididymis, testicles, scrotum, or groin area
  • Hematospermia (blood in the semen)
  • Discharge from the penis
  • Fever
  • Pain in the groin
  • Pain during intercourse or ejaculation
  • Pain during urination
  • Heavy feeling the testicle
  • Increased pain in the testicle after a bowel movement or straining

Genital Cancer: Genital symptoms also include cancerous growths, which may occur in the testicles or cells that line the surface of the vagina, or on the vulva (the skin that surrounds the urethra and vagina) or penis.

Vulvar cancer typically results in a lump or sore on the skin, followed by itching. Other symptoms include:

  • Pain and tenderness
  • Bleeding (not menstruation)
  • Changes in the color and texture of the skin, such as color changes or thickening
  • Wart-like bumps, a lump, or an ulcer

In the early stages of vaginal cancer, symptoms may not present. But as the disease progresses, the following symptoms may occur:

  • Pelvic pain
  • Discharge that is watery
  • A mass or lump in the vagina
  • Pain during urination
  • Constipation
  • Unusual vaginal bleeding

Testicular cancer occurs in the testicles, the male reproductive organs that produce sex hormones and sperm. Symptoms include:

  • A lump in the groin
  • A feeling of heaviness in the scrotum
  • Dull pain in the abdomen or groin
  • A collection of fluid in the scrotum
  • Pain in a testicle or the scrotum
  • Tenderness or swelling of the breasts
  • Testicular swelling with an associated hydocele (a fluid-filled sac that surrounds a testicle and leads to swelling of the scrotum)
  • A tender testis
  • Redness of the scrotal skin
  • Fever

When cancer starts in the penis, symptoms may include:

  • Changes in the color of the skin
  • Warts, rash, sores, lumps, blisters or ulcers on the penis that don't heal within four weeks (may nor may not be painful)
  • Pain and bleeding from the penis (often occurs when the disease is more advanced)
  • Redness of the penis
  • Foul smelling discharge from the penis
  • Pain in the penis
  • Bleeding from the penis or from under the foreskin
  • Change in color of the penis

Priapism is a persistent erection that lasts more than four hours. It occurs without sexual stimulation; rather, the condition develops when blood becomes trapped in the penis and is unable to drain. This may be due to medication (e.g. erectile dysfunction), an injury to the genital area, illicit drug use, or blood disorder (sickle-cell or leukemia).

This condition requires immediate attention to prevent scarring of the penile tissues and permanent erectile dysfunction. Symptoms other than a prolonged erection include:

  • Either a rigid penile shaft with a soft penis tip or an erect but not rigid penile shaft.
  • A painful or tender penis

Sexually-Transmitted Diseases (STDs)

Sexually-transmitted diseases can be caused by bacteria, viruses or other microorganisms, and are spread through sexual contact (including vaginal, anal and oral sex). While some experience no symptoms at all, others encounter:

  • Swelling, redness or rash on the genitals or in the groin area
  • Itching in the groin or pubic area, including in the penis or vagina
  • Pus or discharge (from the urethra in men and women, or the cervix in women)
  • Difficult, painful or burning urination
  • Increased frequency of urination
  • Genital warts
  • Small, fluid-filled sacs
  • Genital ulcers
  • Pain, tenderness or swelling in the testicles (men)
  • Pain in the abdomen or pelvis (women)
  • Fever or body aches
  • Enlarged lymph node in the groin or pelvis

Diagnosing Genital Symptoms Causes

Because the symptoms that affect the genitals are so similar, diagnosis frequently involves the use of laboratory tests. This enables doctors to identify the likely cause of the symptoms and plan an appropriate course of treatment.

Blood and urine tests to look for signs of an infection and, if necessary, to determine the levels of tumor markers (such as prostate-specific antigens) in the blood and urine.

Physical examination of the genitals to look for unusual lumps and growths, as well as tender areas, inflammation, discharge, skin changes, and swollen lymph nodes.

Biopsy: A small piece of tissue is removed and examined to determine the presence and stage (how advanced) of cancerous cells.

Pap smear: This test is done to diagnose cervical cancer, which is caused by the human papillomavirus. During a pap smear, cells are scraped from the opening of a woman’s cervix and examined for signs of cancer. This can be coupled with a colposcopy exam, which uses a magnifying glass to closely inspect the vulva and vagina.

Imaging tests (like X-ray and ultrasound) use various sources of energy to create visuals of the body's organs and tissues. These exams may be performed to detect genital tumors, injuries and abnormalities. They may also be used to diagnose testicular torsion, epididymitis, orchitis, epididymo-orchitis, and priapism (in this case, blood flow within the penis is measured).

Sexually transmitted infection (STI) screening requires a sample of discharge from the urethra (tube that allows urine to exit the body). The sample is then tested for bacteria or other infectious agents.

References

Sexually Transmitted Disease Surveillance, 2011. (2012). Centers for Disease Control and Prevention.

Sharp DS, Angermeier KW. (2011). Surgery of Penile and Urethral Carcinoma. Campbell-Walsh Urology, 10th. ed.

Workowski KA, Berman S. (2010). Sexually transmitted diseases treatment guidelines, 2010. MMWR, Morbidity and mortality weekly report. Centers for Disease Control and Prevention.

Holmes K, Sparling P, Mardh P, et al. (eds). (1999). Sexually Transmitted Diseases, 3rd Edition. McGraw-Hill

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