Genital lesions may be primary, recurrent or initial.
Many sites can be involved which includes the penis, vagina, cervix, anus, vulva, bladder, the sacral nerve routes, the spinal and the meninges. The lesions of genital herpes are particularly prone to secondary bacterial infection eg. S.aureus, Streptococcus, Trichomonas and Candida Albicans.
Dysuria is a common complaint, in severe cases, there may be urinary retention.
Local sensory nerves may be involved leading to the development of a radiculitis. A mild meningitis may be present.
60% of patients with genital herpes will experience recurrences. Recurrent lesions in the perianal area tend to be more numerous and persists longer than their oral HSV-1 counterparts.