Crohn's Disease  @ DiagnosisHealth.com Home   More Digestion Related Articles    Disease Information Center      Support Group       Dr. Minocha's health Blog

CROHN'S DISEASE AND MALE GENITOURINARY SYSTEM

About the author:

Dr. Minocha  is a practicing gastroenterologist and author of "Natural Stomach Care: Treating and Preventing Digestive Disorders with Best of Eastern and Western Therapies"

 

Read Daily Crohn's Disease and  Digestive Health News/Tips Here


Involvement of male genitalia by Crohn's disease is rare. It may occur as a result of extension of a fistula from the diseased bowel or may represent spread (metastatic) of Crohn's disease to distant sites. The penis, scrotum, seminal vesicles and prostate have been recorded to be the sites of involvement. We recently had an unusual case who did not have any overlying skin involvement and the diagnosis was based on the CT scan.

  • Our case: Our patient is a 48 year old white male with history of Crohn's disease involving small intestine and colon. He was seen in ER for abscesses in the rectal region. A soft cystic mass was noted in the scrotum. Clear serous material discharge came out from from the penis. CT scan showed an abscess around rectum which extended into the penis, seminal vesicles and scrotum. A urethrogram revealed a fistulous tract extending into the scrotum. The patient was treated with antibiotics. A surgical repair of the fistula was recommended.
   
  • Some patients develop ulceration of scrotum and/or spontaneous perineal urethral fistulae. Formation of a fistula extending from the anal canal to the root of scrotum and the penis may result in "watering can" appearance of scrotum during micturition, i.e. During urination, the urine comes out through openings in the scrotum.

 

  • Depending on symptoms, the patient may first see their primary physician, a gastroenterologist or dermatologist. There may be gross swelling
 

and ulceration's of the scrotum and penis. Total involvement of the skin of the scrotum and penis may lead to the erroneous conclusion that it represents severe but transient edema caused by neighboring perianal abscesses and fistulae. Thickening of the prepuce may result in narrowing of the foreskin.

  • The diagnosis is generally made by clinical features. Imaging studies including CT scan, gallium scan, ultrasound and magnetic resonance imaging may serve as valuable adjuncts. X-ray of urethra after filling it with a dye is diagnostic for urethral fistula. Differential diagnosis of the genitourinary lesions includes syphilis, herpes simplex, hidradenitis suppurativa, tuberculosis, actinomycosis, lymphogranuloma venereum, leishmaniasis, chancroid, Bechet's syndrome and filariasis.

 

  • Treatment is controversial. Metronidazole and prednisone have been inconsistently shown to be of benefit. Azathioprine and 6-mercaptopurine are frequently used. Other treatments including diuretics, ascorbic acid or zinc supplements have been tried. Scrotal support may alleviate scrotal edema. Relapse may occur when medical treatment is withdrawn.

 

  • Extensive genital cutaneous involvement may require incision and drainage of abscesses in the region as well as excision of the adjacent affected

 

bowel. Regular curettage and extensive excision of the perineal, penile and scrotal skin may be needed. Phimosis may require circumcision. Spontaneous healing of metastatic Crohn's disease ulcers has been reported.

CROHN'S DISEASE AND MALE GENITOURINARY SYSTEM TOP>>

Above information is based on the following article

MINOCHA et al. : Crohn's Disease Complicating Male Genitourinary Tract Without Overlying Cutaneous Involvement. American Journal of Gastroenterology 1996.

Questions about Crohn's Disease and Male Genitourinary System? Click to Join Discussions                   

>>Read About Dr. Minocha

>>Back to Articles on Digestive Health

>>Home Page


This is meant to be an informational exercise and NOT a medical consultation. Every patient is different

Your doctor is the only one who can best assess your situation and offer you medical advice


crohn, crohn's, herpes simplex, genitalia, CT scan, ulcers

A message to all visitors and participants:    Contents of this site are meant for educational and discussion purpose only and should not, in any case, be substituted for a medical consultation.  The information posted or linked to this site should not be used to diagnose or treat a health problem. Your doctor is the only one who can best assess your health situation and give you a medical advice. No responsibility/liability can be accepted for any posted or linked information and  use or misuse thereof. Inclusion on this site in no way implies endorsement for a particular organization, products and/or person/persons and their work. Must read disclaimer ...

Copyright 1999-2003 by diagnosishealth.com. All rights reserved.