Balanitis

Balanitis is swelling (inflammation) of the head of the penis called glans. When the foreskin and prepuce are involved, the disease is called balanoposthitis.[1]

Epidemiology

Approximately 3-11 % of males in the United States have balanitis making it a common condition. The disease can occur in any age. [1]

Causes

One usual cause of balanitis is poor hygiene particularly in uncircumcised males. [2] Other possible causes are diseases like reactive arthritis, strong soaps, diabetes and infection. [3] Drug allergies, morbid obesity and oedematous conditions like congestive heart failure and cirrhosis may also predispose to balanitis. [1]

Symptoms

Balanitis typically presents with the following symptoms: redness and/or swelling around the glans, thick discharge under the foreskin, rash or ulcers around the glans, foul-smelling discharge, pain during urination and pain or difficulty with retraction of the foreskin. [4]

Patients may also present with impotence, difficulty in controlling urination, itching, fever and nausea. [1]

Diagnosis

Balanitis can be diagnosed by examination alone. [3] If infection is suspected, urinalysis and culture might be needed. Patch testing may also be done for allergy confirmation. [5] If deemed essential, laboratory studies are requested such as syphilis serology test, diabetes screening tests and HIV/HPVtiters. 1]

Treatment

The cause of balanitis determines the type of treatment needed. Infection requires empiric antibiotic or antifungal drug. Steroid creams are prescribed for non-infective skin conditions. [5] In severe cases such as when the foreskin could not be retracted, circumcision is the treatment of choice. [2]

Complications

When there is a long standing infection or inflammation, other medical problems may develop.The opening of the penis could narrow, a condition called meatal stricture. The foreskin may also be hard to retract when trying to expose the tip of penis (phimosis) or the foreskin could not be moved over the glans (paraphimosis). The blood supply as well might be compromised. [3]

Prevention

Maintaining good hygiene is the most effective way of preventing balanitis. Avoid using scented shower gels and harsh soaps. Potential irritants are condoms, lubricants, detergents and chemicals. [4] Control of underlying medical disorders like diabetes and weight reduction for obese patients is also an important measure.

References:

1. http://emedicine.medscape.com/article/777026-overview

2. http://www.nlm.nih.gov/medlineplus/ency/article/000862.htm

3. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001865/

4. http://www.nhs.uk/Conditions/Balanitis/Pages/Symptoms.aspx

5. http://www.netdoctor.co.uk/menshealth/facts/balanitis.htm