All you need to know about 'Balanitis or balanoposthitis'

Image source: Unsplash.com

INTRODUCTION

Balanitis is one of the penile disorder(any condition that affects the penis of a person comes under the category of penile disorder). The penis is the male external sexual and urinary organ. Problem with the penis may affect the sexual function and cause fertility problems.        

Balanitis is an inflammation that affects the head of the penis. The similar condition is  knows as Balanoposthitis, refers to the inflammation of the head of penis and the foreskin. This condition is not found in everyone, as it occurs primarily in uncircumcised men. 

As we all know Poor hygiene  leads to many health problems, in this case also poor hygiene is responsible for it. As poor hygiene leads to accumulation of  Smegma (foul smelling substance ) that irritates the penile skin,ultimately causing an inflammation and irritation.

DEFINITION Of BALANITIS

The word 'Balanoposthitis' is more appropriate word for 'Balanitis'. The word Balanoposthitis  comes from 2 words basically,these are -

• 'Balanos'-means head of penis/Glans
• 'posthe'-means foreskin/prepuce+'itis' means inflammation

And we get proper definition that is -Inflammation of glans penis and mucosal surface of foreskin, commonly in uncircumcised males. 

ETIOLOGY 

Etiology is basically the Causes behind particular condition , in this condition etiology is divided into 2 main categories -

1. Infectious etiologies
2. Non infectious etiologies

• Infectious etiologies- As we all know , there are many microorganisms present around us which are responsible for causing health diseases. In this case, infectious causes are 
• Fungal infections especially ' candida albicans '
• beta -hemolytic streptococci
• Neisseria gonorrhea
• Chlamydia species
• Human papilloma virus
• Gardnerella vaginalis
•  Treponema pallidum
• Trichomonas species
• Borrelia vincentii and Borrelia burgdorferi 
• Non Infectious etiologies-  Other than infectious causes we have some non infectious causes which are equally responsible for infection such as-
• Presence of foreskin 
• Poor personal hygiene
• various chemical irritants such as spermicides, perfumed soaps, fabric conditioners and shower gels
• Edematous conditions such as cirrhosis of liver,nephrosis etc .
• various drug allergies like tetracycline , sulfonamide allergies etc.
• Morbid obesity
• condom latex allergic reactions
• Any sort of trauma to genital area
• Neoplastic conditions

VULNERABLE AGE GROUP

The vulnerable age groups means 'those age groups which are at more risk'. In this case, Men over 40 years of age are mostly affected with balanitis whereas 11% adult men and 3% of children are affecting. Hence, maintenance of proper hygiene is must.

CLINICAL MANIFESTATIONS

Clinical manifestations  are the various signs and symptoms appear in individual . In this case clinical manifestations only occur in uncircumcised men , balanitis causes the following signs and symptoms:

• Redness, swelling and tenderness of penile head 
• Inflammation of the foreskin 
• Discharge from penis that is Smegma 
• Impotence 
• Pain 
• Difficulty while passing urine 
• Inability to retract the foreskin
• Enlarged lymph glands in groin region 
• chills and fever
• Burning on urination 
• Tight, shiny skin and sores on glans

COMPLICATIONS of BALANITIS

If this condition is left untreated, this may lead to further complications such as:

• Scarring of the penis
• Phimosis or severe tightening of the foreskin making it hard to bare the head of penis
• Para phimosis  or difficulty in pushing the foreskin on the top of the end of the penis 
• Decreased blood supply to the end of the penis because of the narrowed penile orifice
• Genital yeast infection

DIAGNOSIS 

Diagnosis of any disease is very important. We have various methods to diagnose Balanitis such as:

• Laboratory Investigation includes HIV testing , VDRL , urinalysis and culture and CBC. Swab of discharge is taken for microscopy , gram staining, culture and sensitivity testing.
• Potassium hydroxide test  is done to check the presence of Candida infections. 
• Serological test is also prescribed for candida infections , especially in unclear cases
• Skin Biopsy is also done when recommended anti fungal therapy doesn't produce good results and this is also done to check for the malignancy of the affected area .

HOW TO MANAGE BALANITIS?

Management of balanitis is must, otherwise it lead further complications. Basically  we have two type of management, these are: Non Pharmacological treatment  and Pharmacological treatment.

First of all,we discuss about NON PHARMACOLOGICAL TREATMENT  : As it popularly said that Prevention is better than cure. So, most cases of balanitis is treated with good hygiene along with ointments .

• HYGIENE - Proper maintenance of hygiene is must .
• In order to cure it , clean your penis daily with lukewarm water and gently dry it .
• Donot use soap, bubble bath, shampoo or any potential irritant .
• Dry gently under the foreskin after peeing 
• Try a soap substitute like an Emollient.
• EDUCATE THE MOTHER ABOUT CLEANING CHILD'S PENIS- It is the duty of mother to maintain the hygiene of her child until he himself become capable of it .
• Donot pull back their foreskin to clean under it if it is stil fixed
•  Donot use baby wipes to clean their penis

PHARMACOLOGICAL TREATMENT - It includes seeking medical help. Doctor's consultation is must. Treatment depends on the underlying causes. It includes:

• Medical care consist of applying topical creams  to eradicate different microorganisms and to arrest  inflammation.
• Antimicrobial therapy includes the use of Antibiotics and antifungal drugs based on culture sensitivity.
• Potassium Permanganate solution (1:10000) is beneficial when used to wash the penis but causes temporary purple discolouration.
• Aspirin and Acetaminophen is also used to relieve minor pain and fever. 

IF all these management strategies doesn't work then the last option is SURGICAL TREATMENT.

SURGERY is indicated in the severe cases where the foreskin can no longer be retracted for cleaning like in phimosis and para phimosis, then circumcision is done to prevent recurrence and circumcision is the best choice in treating this condition. 

CONCLUSION 

In this whole article, I provide a detailed information regarding BALANITIS. I discussed about its various causes, signs and symptoms, diagnostic tests, its complication and its treatment. 

For any doubt leave your comments. Feel free to ask and suggest me anything regarding topic. I'll try to improve myself. 

If you like this health article and feel worthy, please share it with your friends and family.

Please let me know if you have any kind of trouble here. 

Thank you for reading this!! 

Happy Reading......Stay Healthy :)