Balanitis: Difference between revisions

'''Balanitis''' is an inflammation of the [[glans]] (AKA ''balanus''), but is not necessarily an [[infection]]. Balanitis may occur together with <b>[[posthitis]]</b> (inflammation of the [[foreskin]], AKA ''posthe''), when it is known as '''balanoposthitis'''.<ref name="edwards1996">{{REFjournal

}}</ref> Balanitis xerotica obliterans (BXO) is a separate and distinct condition. For more information on BXO, see [[Balanitis xerotica obliterans]]. Balanitis can occur in both [[circumcised]] and [[intact]] (non-circumcised) males.

It has many causes, including fungal, yeast, virus, or bacterial infection, environmental irritants, excess sugar in [[urine]], and others.

The treatment of balanoposthitis requires accurate diagnosis of the cause of the balanoposthitis because different treatments are required for different causes. Abdennader et al. (1996) observe that such dermatological conditions as psoriasis, lichen planus, lichen sclerosus, fixed drug eruptions, and bullous diseases are ''not'' balanitis.<ref>{{REFjournal

The [[foreskin]] is protective of the [[glans penis]] in childhood.<ref>{{GairdnerDM 1949}}</ref> [[Robert S. Van Howe|Van Howe]] (1997) reported data collected in his pediatric practice on 468 boys up to 18 years of age. Among boys less than three years of age, [[circumcised]] boys were significantly more likely to have a reddened meatus or balanitis.<ref>{{REFjournal

  |author-link=Robert S. Van Howe

}}</ref> Infant boys who have been [[circumcised]] are likely to experience balanitis caused by exposure to ammoniacal diapers (nappies).<ref>{{REFjournal

}}</ref> Hsieh et al. (2006), working in Taiwan, where boys are not [[circumcised]], examined 2,149 elementary pre-adolescent schoolboys. Hsieh et al. found ''only'' one case of balanitis in the 2,149 [[intact]] boys,<ref>{{REFjournal

}}</ref> which suggests a protective effect for the [[foreskin]].

 

Birley et al. (1993) reported excessive washing, especially with the use of soap, will dry the oils out of tissues and cause a balanitis like inflammation. The authors specially recommend NOT using soap and to stop excessive washing. The use of soap (including body wash, shower gel, and shampoo) should be avoided and emollients should be applied.<ref name="Birley1991">{{REFjournal

}}</ref> One [[intact]] man recommends applying a "thin layer of jojoba oil" to one's [[glans]] and inner [[foreskin]] daily.

 

Although it is commonly believed that the human [[foreskin]] is the source of infection so must be constantly washed to prevent [[infection]], <b>that is not false information.</b> [[Paul M. Fleiss|Fleiss]], [[Frederick M. Hodges| Hodges]] & [[Robert S. Van Howe|Van Howe]] (1998) reported the foreskin has both [[Immunological and protective function of the foreskin| protective and immunological functions]] that help to prevent disease. Retraction and washing provides an opportunity for pathogens to enter.<ref name="Fleiss1997">{{FleissP HodgesF VanHoweRS 1998}}</ref>  Washing removes the protective substances and leaves the [[penis]] prone to [[infection]], so washing should be limited to occasional removal of beneficial smegma and soap should not be used.

Balanoposthitis is ''not'' usually an indication for [[adult circumcision]].

==Yeast infections and diabetic males==

Diabetic males who have high sugar in their [[urine]] may have recurrent yeast infections. Verma & Molina (2011) report that balanoposthitis caused by yeast infection is prevalent in [[India]] where [[circumcised]] men are rare and the rate of diabetes is high.<ref name="verma2011">{{REFjournal

}}</ref> Better control of sugar levels is indicated.  Recurrent yeast infections that are not responsive to better management of diabetes may be relieved by [[Adolescent and adult circumcision| circumcision]].

 

Yeast infections may cause adult-onset [[phimosis]]. Yeast infections may usually be successfully treated by application of topical clotrimazole.<ref>{{REFjournal

Balanitis has many possible instigators. Diagnosis requires an accurate history, and such tests as biopsy and a swab with a culture.<ref name="edwards1996" /> In the absence of a diagnosis, any prescription for treatment is a guess and is likely to fail.

  |publisher=[[CIRP]]

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  |publisher=[[Doctors Opposing Circumcision (D.o.C.)]]

[[Category:Medical condition]]

[[Category:Medical term]]

[[Category:Penile disorder]]

[[Category:Penile illness]]