Male genital dysesthesia

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What is the male genitalia? dysesthesia?

Male genital dysesthesia is a form of cutaneous dysesthesia and describes a burning sensation, heat, irritation, discomfort or increased sensitivity to touch of the penis, foreskin or scrotum. Some men with genital dysesthesia also find it difficult to wear underpants or sit. Symptoms can be very stressful and interrupt sexual function and / or sleep. The affected areas may appear redder than normal.

Genital dysesthesia generally does not itch (the desire to scratch). If the itch coexists with genital dysesthesia, it may be explained by the development of irritating Contact dermatitis due to various applications in the affected area, including soaps and creams.

Other names for male genital dysesthesia include:

The burning scrotum syndrome
Peno-scroto-dynia (penile and scrotal pain) or scrotodynia, in which there is no redness.
Red scrotum syndrome, in which genital dysesthesia is accompanied by redness.

Both men and women with genital dysesthesia may experience similar symptoms of burning, irritability, or discomfort in their genital region. In women, these symptoms are often called vulvodynia, which describes vulvar pain in the absence of primary eruption.

Which men have genital dysesthesia?

Most men with genital dysesthesia are over 60 years of age, light-skinned and of Caucasian ("European") descent. However, genital dysesthesia sometimes affects younger or darker-skinned men. They are generally healthy.

Genital dysesthesia associated with redness and vascular Hyperresponsiveness of the scrotum may be associated with rosacea, a common disorder in which facial redness causes persistent facial redness.

What are the test results?

In many men with genital dysesthesia, the affected areas appear completely normal on close examination. However, the results sometimes include:

Red skin, particularly of the scrotum, often with sharp edges.
Broken blood vessels (telangiectasia)
Extreme tenderness
Pain sensation when lightly touched, e.g. with cotton swab (hyperesthesia or hyperalgesia)

What is the cause of genital dysesthesia?

The cause or causes of genital dysesthesia are often difficult to identify.

The sensations are due to hyperactivity. nerves on the affected skin
Symptoms due to compression of nerve fibers on their way from the spine cable It may be similar, for example, pudendal nerve entrapment. In this case, other symptoms may appear, such as urinary symptoms or disorders of sexual function.
Redness is caused by vascular hyperreactivity, perhaps due to the release of vascular activating substances from the nerve endings of the skin.
Redness may also arise as a consequence of long-term application of strong corticosteroid creams to genital tissue; On the face, this is called rosacea steroid.
Genital dysesthesia can be a condition similar to erythromelalgia, a condition in which there is burning and redness that affects the feet, or less frequently, the hands.

Chronic Genital dysesthesia is not caused by Cancer. But to make sure this is the case, the affected skin, prostate, and spine must be carefully examined.

Genital dysesthesia is not due to infection. However, blood tests and skin smears can be arranged to exclude sexually transmitted diseases (STDs), for example, genital herpes, which can cause fairly similar symptoms.

Factors that contribute to genital dysesthesia may include:

Genetic trend
Back injury or spinal disease
Excessive use of strong current corticosteroid creams.

Are special tests or investigations needed?

When symptoms and signs are typical, an experienced doctor can make the diagnosis of genital dysesthesia without requiring special tests. However, the following investigations are sometimes organized.

Patch tests to exclude allergic corticosteroid contact dermatitis cream, preservative or other product that may have touched the affected area. The results are usually negative in genital dysesthesia.
Images of the back and pelvis (for example, X-rays, Connecticut scan, Magnetic resonance scan)
Prostate exam (PSA blood test, digital exam)

How is male genital dysesthesia treated?

Many men are relieved to have their symptoms explained to them when diagnosed with male genital dysesthesia.

Many treatments may have already been tried before making the correct diagnosis. Unfortunately, no treatment works all the time, always.

General measures for a hypersensitive genital area may include:

Replace the soap with a soap-free cleaner.
Wear cool, loose-fitting underwear (eg, underpants).
Do not use antiseptic washes, wipes, or deodorants in the genital region (penis, scrotum) or around the anus.
Apply a low-irritation moisturizer after showering to the genital region and all over the body (for example, nonionic cream or sorbolen cream)
Stop all other creams, especially corticosteroid creams; steroid creams are prescribed for dermatitis /eczema, and are generally effective for this in a few days. They are not effective for genital dysesthesia, and when used for prolonged periods can worsen the feeling of redness and burning.
Cold compresses can be temporarily relaxing, such as a facial flannel moistened with cold or cold water and placed on the penis and / or scrotum.

Specific prescription treatments reported as beneficial include:

Menthol to 1% in aqueous cream applied 3 to 4 times a day to cool affected areas. Although sometimes useful, it can also be difficult to tolerate.
Pimecrolimus cream can be used 1 to 2 times per day for genital dermatitis. It has been reported to reduce redness and burning in some men with genital dysesthesia.
Doxycycline 50 mg tablets once or twice daily for 3 to 6 months to reduce redness; This tetracycline antibiotic is particularly effective if symptoms have been triggered by strong corticosteroid creams, but it can also help burn and redden from unknown causes.
Tricyclic medications at tea time or at bedtime, e.g. Amitriptyline or Nortriptyline 5-30mg, is used to counteract irritable nerves that cause burning sensation. Start with a low dose and increase slowly to reduce the risks of drowsiness.
Do not take amitriptyline if you are going to drink alcohol, drive a car, or operate dangerous machinery. If you are sleepy in the morning, reduce or stop your amitriptyline, or try taking amitriptyline earlier in the evening.
Tricyclics can cause dry mouth, dizziness, or constipation. Most men tolerate low-dose amitriptyline extremely well, with an improvement in their genital dysesthesia. If it causes daytime sleepiness, discontinue the medication.
Antiseizure agents such as gabapentin, pregabalin, or sodium valproate are medications that are often used to neuropathic Pain syndromes They can be very effective in male genital dysesthesia.
Low-dose beta-blocker carvedilol has been reported to result in resolution and long-term remission of red scrotum syndrome.

Long-term outlook for men with genital dysesthesia

Male genital dysesthesia is a frustrating disease to live with and can be very persistent. It can cause great anguish, shame and fear. Many treatments have often been recommended and tried with limited or no success. However, sometimes it settles down and completely resolves on time.

Medical science continues to search for better treatments.