Balanoposthitis

Balanoposthitis is an inflammation of the glans penis and the prepuce.

Background

Balenoposthitis is defined as the inflammation of the foreskin and glans in uncircumcised males. Balanoposthitis occurs over a wide age range and may have any of multiple bacterial or fungal origins or be caused by contact dermatitis. In the uncircumcised male, balanitis (inflammation of the glans, the rounded head of the penis) and posthitis (inflammation of the foreskin) usually occur together as balanoposthitis: inflammation of both the glans and foreskin. Complex infections have been well documented, often from a poorly retractile foreskin and poor hygiene that leads to colonization and overgrowth. Treatment focuses on clearing the acute infection and preventing recurrent inflammation/infection through improved hygiene. Although not as necessary as in the past, circumcision may be considered for refractory or recurrent balanoposthitis. Chronic balanoposthitis increases the risk of balanitis xerotica obliterans, phimosis, paraphimosis, and cancer.Balanoposthitis should not be confused with Balanitis, which is inflammation of the glans penis or the clitoris.

Causes

In almost every instance balanitis results from the presence of a foreskin, which may be redundant and Phimotic, thereby predisposing to infections. This preputial cloak harbors beneath it normally desquamating epithelial cells, glandular secretions, and Mycobacterium smegmatis, and provides a warm, moist culture medium for any incidental organisms that may be present. It is obvious, therefore, that personal daily hygiene will prevent most instances of simple balanitis and balanoposthitis.

Symptoms and Signs

• Soreness
• Irritation,
• Subpreputial discharge
• Phimosis,
• Superficial ulcerations,
• Inguinal adenopathy
• Anxiety
• Lower back pain
• Fatigue
• Redness of penis
• Painful penis and foreskin
• Rashes on the penis and foul smell discharge

Treatment of Balanoposthitis

• Topical antibiotics like metronidazole cream and antifungals clotrimazole cream or low-potency steroid creams are suggested beneficial for this disease.
• Proper hygiene and regular washing of prepuce is useful for the prevention of balanoposthitis.
• Circumcision may be promoted in recurrent and recalcitrant cases.

Since anaerobic conditions are necessary for growth of the offending organisms, simple exposure to air and local cleansing is most often effective. Formerly, this treatment, used with peroxide powder and arsphenamine and, in severe cases, a dorsal slit, was the extent of therapy. With the advent of penicillin and other systemic and local antibiotics, the treatment is specific and effective; however, even now a dorsal slit procedure is sometimes necessary.

In other animals

In dogs, balanoposthitis is caused by a disruption in the integumentary system, such as a wound or intrusion of a foreign body. A dog with this condition behaves normally, with the exception of excessive licking at the prepuce, and a yellow green, pus-like discharge is usually present. In sheep (rams/wethers), ulcerative enzootic balanoposthitis is caused by the Corynebacterium renale group (C. renale, C. pilosum & C. cystidis). It is also known as "pizzle rot". For the condition in bulls, caused by a virus see Bovine herpesvirus 1.