Balanitis is the medical term used for inflammation of the glans penis (head of the penis) and the prepuce (foreskin).
What causes balanitis?
The most common cause is infection. This can include complications of trichomonas, candidiasis, herpes simplex and syphilis.
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Non-infectious causes include drug eruptions, contact dermatitis, psoriasis, lichen planus, and other skin diseases.
In many cases no cause can be found.
Who gets balanitis and who is at risk?
Unsafe sex (sex with multiple partners without using a condom) increases risk for sexually transmitted diseases and thus also balanitis.
Men with poorly controlled diabetes mellitus are at increased risk for balanitis, particularly that caused by candida (yeast infection).
Symptoms and signs of balanitis
The main symptoms are soreness, irritation and a discharge, often two to three days after sexual intercourse.
The foreskin may be constricted due to inflammation and swelling of the glans and the foreskin itself. Both may have superficial ulceration present as a result of inflammation.
The lymph nodes in the groin area may be tender and enlarged.
How is balanitis diagnosed?
The appearance of the condition is characteristic and so diagnosis is made on examination. However, treatment depends on cause so smears are taken from the discharge to identify common sexually transmitted diseases.
The urine should be tested for glucose in all cases and particularly in the case of candida balanitis in middle-aged men.
Can balanitis be prevented?
Balanitis is often associated with sexually transmitted diseases and as such can be prevented by using a condom during sexual intercourse and avoiding multiple sexual partners.
Candida balanitis in diabetic men can be prevented by strict attention to control of blood glucose through correct diet and medication.
Circumcision is recommended in diabetics who suffer from repeated balanitis.
How is balanitis treated?
Specific antibiotics are used for specific infections; an anti-fungal cream and/or tablet is used to treat candida.
If no cause can be found, then saline washes several times a day can help symptoms and relieve the inflammation.
Circumcision is usually recommended in patients with persistent tightness of the foreskin once the inflammation has resolved.
When to call the doctor
If you suffer from pain and irritation of the head of the penis with a discharge, particularly if you have engaged in risky sexual activity recently, you should see your doctor as soon as possible.
Reviewed by Dr Pieter J le Roux MBChB, FRCS(Eng), FRCSI, FCS(SA)Urol.
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