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Penis-Scrotum Symptoms-Teen

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Definition

  • Genital (penis or scrotum) symptoms in teen boys (after puberty)
  • Penis symptoms include rash, pain, itching and swelling. Discharge from the end of the penis can also occur.
  • Scrotum symptoms include pain and swelling of the testicle, itching and rash.
  • This care guide covers symptoms not caused by an injury

Symptoms

  • Penis symptoms include rash, pain, itching, and swelling. Discharge from the end of the penis can occur.
  • Scrotum symptoms include pain and swelling of the testicle, itching and rash.
  • Any genital pain that is not due to an injury is a concern.

Causes of Rashes on Penis or Scrotum

  • Most rashes on the penis or scrotum are caused by skin irritants.
  • Hand-to-penis contact is normal when passing urine. Therefore, the rash is most likely from an irritant that was on the hands.
  • Examples are plants (such as weeds) or chemicals (such as bug spray). Fiberglass, pet saliva or even food can also be irritants.
  • Rashes are more common in the summer. Reason: teens are outdoors and have more contact with plants and pollens.

Types of Foreskin Retraction Problems

  • Paraphimosis. Forceful retraction can cause the foreskin to get stuck behind the head of the penis. This can cause severe pain and swelling. It's a medical emergency.
  • Bleeding. If retraction is forceful, it can cause a small cut. This cut may cause a small amount of bleeding and pain.
  • Foreskin Infection. This means an infection under the foreskin. The infection can start in a cut caused by forceful retraction. The main symptom is a red and tender foreskin. Pus may also ooze out to the foreskin opening. Passing urine is painful.
  • Urine Retention (Serious). Can't pass urine or just dribbles urine, despite wanting to go.

Causes of Swollen Scrotum

  • Torsion of the Testis (Serious). The testicle twists and cuts off its blood supply. It is always painful. Needs to be repaired within 6 to 12 hours to save the testicle. This is why seeing all males with a swollen scrotum is an emergency.
  • Epididymitis. This is an infection of the epididymis, a tube that stores the sperm made by the testicle. There is one attached to the back of each testicle. It is always very painful. Caused by bacteria, often a sexually transmitted infection (STI).
  • Orchitis. This is an infection of the testicle. It is always painful. It's mainly caused by viruses, such as mumps. Less common than epididymitis.
  • Inguinal Hernia. A hernia is a loop of intestine that slides into the scrotum. Any new bulge that comes and goes is a hernia. All hernias need surgery to fix. Most of the time, the repair can be scheduled. If the hernia can't slide back into the abdomen, emergency surgery is needed.
  • Varicocele. A clump of swollen veins above the testis, often on the left side. It becomes much smaller after lying down and draining. It is painless. It is also harmless and occurs in 10% of teens.
  • Hematoma (Blood Clot) of Scrotum. Blunt injury can cause a large blood clot to form inside the scrotum. Sometimes, it needs to be drained. This can happen from being hit by a ball during sports.
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When To Call

Go to ER Now

  • Foreskin pulled back and stuck (not circumcised)
  • Can't pass urine or can only pass a few drops

Call Doctor or Seek Care Now

  • Scrotum is painful or swollen
  • Severe penis pain
  • Red rash or red foreskin with fever
  • Erection is painful or lasts more than 1 hour
  • Your teen looks or acts very sick
  • You think your teen needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Pus or bloody discharge from end of penis
  • Pus from end of foreskin (not circumcised)
  • Pain or burning when passing urine
  • Rash is painful
  • Rash has tiny water blisters
  • Looks infected (such as draining sore, spreading redness)
  • Sexually transmitted infection (STI) suspected
  • You think your teen needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • All other male genital symptoms. Exception: mild rash for less than 3 days.
  • Rash or itching lasts 3 or more days, using this care advice
  • You have other questions or concerns

Self Care at Home

  • Mild rash or itching of penis or scrotum present less than 3 days
  • Preventing sexually transmitted infections (STIs)
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Care Advice

Mild Rash or Itching of Penis or Scrotum - Treatment

What You Should Know about Genital Rashes:

  • Rashes can be caused by skin irritants. Hand-to-penis contact is normal when passing urine. Rashes are often from an irritant that was on the hands.
  • Examples are a plant (such as an evergreen) or chemicals (such as bug repellents). Fiberglass, pet saliva or even food can also be irritants.
  • Most small rashes can be treated at home.
  • Here is some care advice that should help.

Clean the Area:

  • Wash the area once with soap to remove any irritants.

Steroid Cream for Itching:

  • For itchy rashes, use 1% hydrocortisone cream (such as Cortaid). No prescription is needed.
  • Do this 2 times per day for a few days.

What to Expect:

  • Small rashes from irritants should go away in 1 to 2 days with treatment.

Prevention of Rashes:

  • Teach your teen to wash his hands before touching his penis.

Call Your Doctor If:

  • Rash spreads or gets worse
  • Rash lasts more than 3 days
  • Fever occurs
  • You think your teen needs to be seen
  • Your teen becomes worse

STI Prevention

How to Prevent Sexually Transmitted Infections (STIs):

  • Most STIs are spread by exchange of body fluids (semen, vaginal fluids or blood). This can occur during oral, anal or vaginal sex.
  • They can also occur from direct contact with any sores during sex.
  • Condoms are the only trusted way to prevent most STIs during sex.

Abstinence and Other "Safe" Sexual Activities:

  • Abstaining from sex is the only 100% effective means of not getting STIs. This means not having sex (vaginal, oral or anal).
  • Actions which are believed safe (and don't often spread STIs) are holding hands and hugging. Touching and kissing (if no sores on lips or in mouth) are also safe.

Use of Condoms:

  • Condoms are the only trusted way to prevent most STIs during sex.
  • Putting on a condom: (1) Hold the condom at the tip to squeeze out the air. (2) Roll the condom all the way down the erect penis. Don't try to put a condom on a soft penis.
  • Taking off a condom: (1) After sex, hold onto the condom while the penis is being pulled out. This will keep the condom from coming off before the penis is out. (2) The penis should be pulled out while still erect, so that sperm (semen) doesn't leak out of the condom.
  • Buy latex rubber or plastic condoms. Never use condoms made from animal skins. They can leak.
  • If you use a lubricant during sex, make sure it is water-based (like K-Y Liquid). Do not use petroleum jelly, vegetable oil or baby oil. These can cause a condom to break.
  • For more facts about condoms, see website Condom Effectiveness.

Actions that Don't Prevent STIs:

  • Douching (rinsing out the vagina with water or other fluids) does not prevent STIs. Neither does taking a shower after sex.
  • Withdrawal (when a man pulls his penis out before he ejaculates or 'comes') is not a way to prevent STIs or pregnancy.
  • Having an STI once does not prevent you from getting it again. You can also get different STIs.
  • Using other forms of birth control won't prevent you from getting an STI. If you are using an IUD, birth control pills, implant or shot, you still need to protect yourself with condoms.

Call Your Doctor If:

  • You have any symptoms that you think might be an STI.
  • You have sex without a condom or the condom breaks during sex. Reason: emergency contraception pills can prevent pregnancy if taken within 72 hours.
  • You have other questions or concerns.

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Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2024. Schmitt Pediatric Guidelines LLC.
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