Introduction Demographics Causes Clinical features Variation in skin types Complications Diagnosis Differential diagnoses Treatment Prevention Outcome
Male genital dysaesthesia is a form of cutaneous dysaesthesia characterised by a burning, hot, irritating discomfort of the penis, foreskin, and/or scrotum. It is often accompanied by increased sensitivity to touch.
Male genital dysaesthesia is also known as dysaesthetic penoscrotodynia (DPSD) or male genital burning syndrome. If dysaesthesia is accompanied by redness, this may be referred to as red scrotum syndrome. Localised symptoms can be described as scrotodynia or burning scrotum syndrome, penodynia, or glansodynia.
Both men and women with genital dysaesthesia may experience similar symptoms of burning, irritability, or discomfort of their genital region. In women, these symptoms are often called vulvodynia, which describes vulval pain in the absence of primary rash.
Click here for an image of red scrotum syndrome
Male genital dysaesthesia can affect males of all ages and skin colour. It is more common amongst those with Fitzpatrick type 1 or 2 skin, and those over the age of 50. Data on prevalence are limited.
Genital dysaesthesia associated with redness and vascular hyperreactivity of the scrotum may be associated with rosacea.
While the aetiology of male genital dysaesthesia is not well understood, symptoms may be related to:
Alcohol and caffeine may trigger or exacerbate symptoms.
Patients experience symptoms including burning, a warm or hot sensation, hyperaesthesia, or irritation of the glans, foreskin, penile shaft, scrotum, or entire external genitalia.
Other symptoms should be explored to assess for other causes of discomfort, such as:
In many patients, no abnormalities are evident on physical examination. Potential clinical findings may include:
It has been suggested that male genital dysaesthesia could be classified using a similar system to that introduced for vulvodynia by The International Society for the Study of Vulvovaginal Disease:
Erythema may be less apparent in darker skin phototypes.
Patients with genital dysaesthesia may find wearing underwear uncomfortable. Sitting down may exacerbate symptoms. Symptoms may be distressing and affect sleep and/or sexual function.
Male genital dysaesthesia is a clinical diagnosis.
The following investigations may be indicated to rule out other causes of symptomatology:
See also: Genital skin problems.
Treatment of male genital dysaesthesia can be challenging and symptoms can be persistent. The following measures may be helpful.
Topical preparations:
Systemic treatments:
Other potential treatments reported to be effective for idiopathic scrotal dysaesthesia:
As the aetiology of male genital dysesthesia is unknown, preventative strategies are unclear.
Male genital dysaesthesia may spontaneously resolve or can be a chronic condition. The aim of treatment is to reduce symptom severity and improve quality of life.
