Unexplained Bumps Between Penis and Scrotum: Seeking Answers

The examination does not indicate cauliflower, but there are still persistent growths?

Last May, I noticed a small bump the size of a grain of rice between my penis and scrotum.
I have a history of folliculitis, so I regularly visit a dermatologist.
During one of my visits, I mentioned the bump, but the doctor didn't specify what it was.
Initially, the doctor said it wasn't serious, but after I mentioned it was itchy, he performed cryotherapy.
From then on, I would receive cryotherapy whenever I visited for folliculitis, as it never seemed to improve.
It wasn't until September that the doctor advised me to buy a topical medication, which was Aldara (Imiquimod).
After applying it, what started as one or two bumps quickly turned into seven or eight.
By October, the doctor suggested I go to a larger hospital for electrosurgery or laser treatment.
At the hospital, I was diagnosed with genital warts and underwent electrosurgery the next day.
However, during a follow-up appointment, the doctor informed me that the test results were not indicative of genital warts.
While I felt relieved, I was also confused about what it could be if it wasn't warts.

By January of this year, a few more small bumps appeared.
When I asked the doctor, he could only say it was suspicious but couldn't confirm anything.
I decided to go to another clinic for cryotherapy since the new bumps were small and not numerous.
In February, I had a similar experience with a few more bumps, which I also had cryotherapy for.
In April, even smaller bumps appeared all over the area, and I had them frozen off as well.

I would like to ask the doctor if what I have is indeed genital warts.
Is there any way to confirm this? The doctors I've seen have all suggested that if I'm worried, I should just have them treated, but this ongoing situation is not a solution.
Could you please provide any recommendations or methods for clarification?

Ahan, 30~39 year old female. Ask Date: 2014/05/07

Dr. Li Yilun reply Urology

For your skin condition, you have already sought treatment at the hospital.
You should carefully ask the physician who is treating you for more information, as a physical examination is necessary for diagnosis.
Therefore, please continue to seek medical care and directly ask your treating physician any questions you may have.

Reply Date: 2014/05/07

More Info

The situation you are describing involves a series of unexplained bumps located between the penis and scrotum, which have been treated intermittently with cryotherapy and other methods. Your concern about whether these bumps are genital warts (commonly known as "condyloma acuminata") is valid, especially given the history of similar lesions and the treatments you've undergone.

Firstly, it’s important to understand that the area between the penis and scrotum is prone to various dermatological conditions, including folliculitis, sebaceous cysts, and viral infections like HPV (human papillomavirus), which causes genital warts. The fact that you have a history of folliculitis suggests that you may have a predisposition to skin infections or irritations in that area.

The bumps you initially described as being the size of a grain of rice and later increasing in number after treatment could indicate a few possibilities. If the lesions were indeed warts, they would typically appear as small, flesh-colored or slightly darker bumps that can cluster together. They may be itchy or asymptomatic. The fact that your doctor performed a biopsy or examination and ruled out warts is reassuring, but it leaves us with the question of what these bumps actually are.

Since the bumps have persisted and even multiplied over time, it may be beneficial to consider the following steps:
1. Seek a Dermatologist's Opinion: If you haven't already, consulting a dermatologist who specializes in sexually transmitted infections or genital dermatology could provide more insight. They may perform a thorough examination and possibly a biopsy to determine the exact nature of the lesions.

2. Consider HPV Testing: If there is still a concern about HPV, you might want to discuss the possibility of HPV testing with your healthcare provider. While there is no routine test for HPV in men, certain types of HPV can be identified through specific tests.

3. Monitor Changes: Keep a close eye on the bumps. Note any changes in size, color, or number. Documenting these changes can provide valuable information to your healthcare provider.

4. Treatment Options: If the bumps are confirmed to be benign but bothersome, various treatment options are available. These include cryotherapy, laser treatment, or topical medications that can help reduce the appearance of the lesions.

5. Maintain Hygiene: Good hygiene practices can help prevent further irritation or infection in the area. Ensure that the area is clean and dry, and consider using non-irritating soaps and moisturizers.

6. Avoid Self-Treatment: While it may be tempting to continue with cryotherapy or other home remedies, it’s best to avoid self-treatment without proper medical guidance, as this could lead to further irritation or complications.

In conclusion, while the initial assessment ruled out genital warts, the persistence and recurrence of the bumps warrant further investigation. A thorough examination by a specialist, possibly combined with diagnostic testing, will be essential in determining the exact nature of these lesions and guiding appropriate treatment. Your health and peace of mind are paramount, so don’t hesitate to seek a second opinion if you feel uncertain about your current care.

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