Balanitis
Balanitis | |
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Inflammation of the glans penis and the preputial mucosa of a circumcised penis (balanitis) | |
Specialty | Urology |
![](https://upload.wikimedia.org/wikipedia/commons/thumb/8/8e/Balanitis_caused_by_smegma.jpg/303px-Balanitis_caused_by_smegma.jpg)
Balanitis is inflammation of the glans penis.[1] When the foreskin is also affected, the proper term is balanoposthitis.[1] Balanitis on boys still in diapers must be distinguished from redness caused by ammoniacal dermatitis.[2] The word balanitis is from the Greek βάλανος balanos, literally meaning 'acorn', used because of the similarity in shape to the glans penis.[3]
Signs and symptoms
- Small red erosions on the glans (first sign)
- Redness of the foreskin
- Redness of the penis
- Other rashes on the head of the penis
- Foul smelling discharge
- Painful foreskin and penis
Complications
Recurrent bouts of balanitis may cause scarring of the preputial orifice; the reduced elasticity may lead to pathologic phimosis.[4] Further complications may include:
- Stricture of urinary meatus
- Phimosis
- Paraphimosis
Cause
Inflammation has many possible causes, including irritation by environmental substances, certain medications, physical trauma, and infection such as bacterial, viral, or fungal.[5][6] Some of these infections are sexually transmitted.
It is less common among people who are circumcised, as in many cases, a dysfunction of the foreskin is a causal or contributing factor.[1] Both not enough cleaning and too much cleaning can cause problems.[1]
Diagnosis
Diagnosis may include careful identification of the cause with the aid of a good patient history, swabs and cultures, and pathological examination of a biopsy.[5]
Types
- Zoon's balanitis, also known as Balanitis Circumscripta Plasmacellularis or plasma cell balanitis (PCB), is an idiopathic, rare, benign penile dermatosis[7] for which circumcision is often the preferred treatment.[7][8][9] Zoon's balanitis has been successfully treated with the carbon dioxide laser; [10] and more recently, Albertini and colleagues report the avoidance of circumcision and successful treatment of Zoon's balanitis with an Er:YAG laser.[11] Another study, by Retamar and colleagues, found that 40 percent of those treated with CO2 laser relapsed.[12]
- Circinate balanitis, also known as balanitis circinata, is a serpiginous annular dermatitis associated with reactive arthritis.
- Pseudoepitheliomatous keratotic and micaceous balanitis
Treatment
Initial treatment in adults often involves simply pulling back the foreskin and cleaning the penis.[1] However, some topical antibiotic and fungal ointments may be used for treatment for mild cases. Depending upon severity, hydrocortisone and other steroidal creams may be used upon consultation.
Epidemiology
Balanitis "is a common condition affecting 11% of adult men seen in urology clinics and 3% of children" in the United States; globally, balanitis "may occur in up to 3% of uncircumcised males".[13]
Other animals
![](https://upload.wikimedia.org/wikipedia/commons/thumb/9/90/Balanoposthitis_canine_prepuce_discharge.jpg/220px-Balanoposthitis_canine_prepuce_discharge.jpg)
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).
For the condition in bulls, caused by a virus see Bovine herpesvirus 1.
Balanoposthitis is believed to have contributed to the decline to near-extinction of Gilbert's potoroo.[14]
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