Exploring genitourinary clinical patterns in monkeypox infection: A systematic review
Agrevina Ane Lukito, Janice Suhartono, Lorettha WijayaAbstract
Objective:
Monkeypox is a zoonotic viral infection caused by the monkeypox virus. The 2022 global outbreak marked a shift toward sexual transmission, predominantly affecting men who have sex with men (MSM), with frequent genital and urogenital involvement. This review summarizes evidence on genitourinary features to support accurate diagnosis, guide appropriate treatment, and enhance clinical awareness.
Materials and Methods:
Following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PROSPERO CRD42024626679), three databases were searched through December 2024 for studies reporting genitourinary symptoms in monkeypox. Data extraction and quality assessment were performed independently using Joanna Briggs Institute tools.
Results:
A total of 40 studies were included. The risk factors for monkeypox infection were predominantly associated with high-risk sexual behaviours. HIV was frequently reported as a comorbid condition. Cutaneous lesions typically appeared within 2–14 days following high-risk contact. Lesion progression followed the classic stages, beginning as papules and evolving into vesicles, pustules with central umbilication, ulceration or erosion, and eventually crust formation, with resolution within 2–4 weeks. Urogenital symptoms such as penile discharge, dysuria, and urinary retention were also reported.
Conclusion:
The 2022–2023 monkeypox outbreak showed a shift to sexual transmission, primarily among MSM, with frequent genital involvement and occasional urinary symptoms. Integrated HIV and monkeypox care, early detection, and sexual health education are critical for high-risk populations.