Balanitis is an inflammation of the glans penis, and the skin of the foreskin (thin elastic skin located at the end of the penis and covering its head) is fasting. Due to their proximity, the inflammatory process is almost never isolated, which is why it is called balanoposthitis. It is more common in uncircumcised men.
What is the cause of this inflammation?
The cause of balanoposthitis can be infectious or non-infectious.
- Infectious balanoposthitis – caused by:
viruses – herpes simplex virus type II;
bacteria – staphylococci, streptococci, Escherichia coli, Proteus, Enterococcus;
Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium, etc.
Mushrooms – Candida albicans.
- Non-infectious balanoposthitis – as a result of:
allergic reaction to drugs, soap, condoms, underwear;
trauma – with sexual excesses;
toxic substances – improper use of concentrated antibacterial solutions.
Balanoposthitis can be primary and secondary, occurring with other diseases, such as diabetes, gonorrhea, syphilis, and scabies.
How does the disease develop with balanoposthitis?
The main reason for the development of balanoposthitis is the delay of smegma (a foul-smelling secret secreted by glands located on the inner surface of the foreskin, with an admixture of exfoliated epithelial cells).
This can happen both in the absence of personal hygiene and due to phimosis (the inability to whiten the glans penis). Stagnant smegma causes inflammation by two mechanisms:
- represents a favorable environment for the development of a banal infection;
- after decomposition causes chemical irritation.
What is the clinical picture?
Balanoposthitis is acute and chronic. Clinical complaints – itching, serous-purulent discharge, and pain. On examination, phimosis can be detected with discharge from the narrowed foramen.
The skin is edematous and red. In debilitated patients, the swelling may be significant, even in the presence of blisters. In isolated cases, an increase and inflammation of the inguinal lymph nodes were found.
In chronic balanoposthitis, complaints are insignificant, but the discharge is constant. An adhesion forms between the glans penis and the foreskin, making hygiene and drainage of smegma even more difficult.
Only in the most severe advanced cases can develop phlegmon (diffuse purulent inflammation), caverns (inflammation of the cavernous bodies of the penis), and gangrene of the foreskin. In the initial stages, when trying to self-medicate, paraphimosis can be achieved (narrowing of the foreskin, which is pulled over the glans penis and cannot return to it).
How is it diagnosed?
Diagnosis is easily made by questioning the patient and physical examination. The causative agents of infection can be established microbiologically by inoculation of the secretion taken on certain nutrient media.
How is it treated?
The aim of the treatment is to free the entire glans penis from the foreskin and remove the secretion by rinsing with mild disinfectant solutions. With a pronounced non-expanding phimosis, an operative incision (incision) is made until the glans penis is found.
Local baths with disinfectants control the process. Without fail, the patient must be warned to take a bath with a bare head, and then return the foreskin to prevent paraphimosis.
After the bath, topical antibacterial, antifungal, or corticosteroid ointments can be applied, depending on the pathogen identified during secretion culture.
In chronic adhesions, the latter exfoliates in stages by dilatation (expansion) or surgically, most often circumcision (circumcision) is performed.
How to prevent it?
The main place is occupied by the rules of personal hygiene:
- daily thorough care of the genitals;
- use of intimate soaps and shower gels;
- diligence in maintaining hand hygiene before and after going to the toilet
- adherence to the rules of “safe sex”.