Balanoposthitis is an inflammation of the lining of the glans penis and foreskin. It can be caused by infectious or non-infectious skin conditions, or by tumors. Most cases of balanoposthitis are diagnosed from a physical exam. Good penile hygiene is both a treatment step and a way to prevent balanoposthitis. 

Balanoposthitis is a joint infection of the lining of the glans head and foreskin, and if it lasts less than four weeks, balanoposthitis is called acute. Beyond that, the affection becomes chronic.

Causes

Balanoposthitis can start with a simple infection of the lining of the glans (balanitis) or simple inflammation of the foreskin (posthitis).

The causes of inflammation of the penis can be of origin:

Infectious

• Candidiasis, yeast infection of the genus candida
• Chancroid, a condition caused by Ducrey’s bacillus contracted during sexual acts
• Inflammation of the urethra due to bacterial infection (chlamydia, Neisser’s gonococcus) or parasitic disease (Trichomonas vaginalis)
• Virus infection Herpes simplex
• Molluscum contagiosum, benign skin tumor
• Scabies, a skin condition caused by a mite parasite (Sarcopts scabiei)
• Syphilis
• Secretions left under the foreskin can become infected and lead to posthitis

Non infectious

• Lichens
• Contact dermatitis caused by irritants or allergens (latex from condoms)
• Psoriasis, a chronic skin condition that manifests as redness and shreds of skin that break off
• Seborrheic dermatitis, inflammation of an area of ​​the skin with a high density of sebaceous glands

Tumor

• Bowen’s disease, tumor of the skin
• Queyrat’s erythroplasia, an in situ carcinoma of the penis

Diagnostic

Most cases of balanoposthitis are diagnosed from a physical exam.

The doctor should ask the patient about the possible use of latex condoms.

Patients should be tested for infectious and non-infectious causes. Samples from the surface of the glans are analyzed under a microscope. If the infection recurs, the sample can be sent to the laboratory for incubation to identify resistant microorganisms.

Finally, a blood sugar test should be performed.

The people concerned

Balanoposthitis affects both circumcised men as well as those who are not. But the condition is more problematic in uncircumcised men because the hot and humid region under the foreskin presents favorable conditions for the growth of infectious microorganisms.

Risk factors

Balanoposthitis is favored by:

• Diabetes mellitus, the complications of which include a predisposition to infection.
• Phimosis, an abnormal narrowness of the preputial orifice that prevents the discovery of the glans. Phimosis prevents proper hygiene. Secretions under the foreskin can become infected with anaerobic bacteria, leading to inflammation.

The main symptoms often appear two or three days after intercourse:

I

Balanoposthitis is first manifested by inflammation and swelling of the penis (glans and foreskin)

Superficial ulcerations

The inflammation is often accompanied by superficial lesions, the appearance of which varies depending on the cause: white or red spots, erosions on the surface of the mucosa, erythema, etc. Sometimes the irritation can lead to the appearance of cracks (slight cracks).

pain

Balanoposthitis can cause pain, irritation and itching in the penis.

Subsequently, other symptoms may appear:

• Balanoposthitis can cause abnormal discharge from the foreskin
• If it is not the cause, a phimosis can be consecutive to a balanoposthitis as the paraphimosis (compression of the foreskin in the retracted position)
• Inguinal lymphadenopathy: pathological increase in the size of the lymph nodes located in the groin

As a first step, the improvement of the symptoms requires a good hygiene of the penis (see chapter Prevention)

Then the treatment depends on the cause:

• Bacterial infections are treated with antibiotics
• Yeast infection can be treated with antifungal creams, and possibly cortisone
• Contact dermatitis is treated by avoiding the products that caused the inflammation

If the balanoposthitis does not respond to the prescribed treatment, the patient should consult a specialist (dermatologist, urologist). In some cases, it is necessary to remove the foreskin.

The prevention of balanoposthitis requires good penile hygiene. In the shower, you must carefully retract the foreskin to uncover the glans (in boys under 3, do not retract it completely) and let the foreskin and the tip of the penis be cleaned by the flow of water. It is necessary to favor unscented soaps with a neutral pH. The tip of the penis and the foreskin should be dried without rubbing them.

When urinating, the foreskin must be removed so that the urine does not wet it. Then you have to dry the tip of the penis before replacing the foreskin.

For people prone to developing balanoposthitis after intercourse, the penis should be washed immediately after sex.