Changes

{{Construction Site}}'''Balanitis''' is an inflammation of the [[glans ]] (AKA ''balanus''), but is not necessarily an infection. Balanitis may occur together with [[posthitis ]] (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.

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

|coauthorslast2=Casin |first2=I, . |last3=Janier |first3=M, . |last4=Morel |first4=P.

One can’t properly treat balanoposthitis until one knows what is causing it. Different causes require different treatments. When one knows the cause, then an appropriate treatment can be selected.<ref name="edwards1996" />

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. ==Childhood== The foreskin is protective of the glans penis in childhood.<ref>{{REFjournal |last=Gairdner |first=Douglas |author-link=Douglas Gairdner |title=The fate of the foreskin: a study of circumcision |journal=Brit Med J |date=1949-12-24 |volume=2 |issue= |pages=1433-7 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2051968/pdf/brmedj03656-0009.pdf |quote= |pubmedID=15408299 |pubmedCID=2051968 |DOI=10.1136/bmj.2.4642.1433 |accessdate=2019-10-12}}</ref> 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 |last=Van Howe |first=RS |author-link=Robert Van Howe |title=Variability in penile appearance and penile findings: a prospective study |journal=Brit J Urol |date=1997-11-01 |volume=80 |issue=6 |pages=776-81 |url=https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.1464-410X.1997.00467.x |quote= |pubmedID=9393302 |pubmedCID= |DOI=10.1046/j.1464-410x.1997.00467.x |accessdate=2019-10-01}}</ref> Boys who have been circumcised are likely to experience balanitis caused by exposure to ammoniacal diapers (nappies).<ref>{{REFjournal |last=Simpson |first=E. |author-link= |last2=Baraclough |first2=P. |title=The management of the paediatric foreskin |journal=Australian Family Physician |date=1998-05-01 |volume=27 |issue=5 |pages=381-3 |url=http://www.cirp.org/library/hygiene/simpson1/ |quote= |pubmedID=9613002 |pubmedCID= |DOI= |accessdate=2019-07-10}}</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 intact 2,149 boys,<ref>{{REFjournal |last=Hsieh |first=T.F. |author-link= |last2=Chang |first2=C.H. |last3=Chang |first3=S.S. |title=Foreskin development before adolescence in 2149 schoolboys |journal=Int J Urol |date=2006 |volume=13 |issue=7 |pages=968-70 |url=https://onlinelibrary.wiley.com/doi/full/10.1111/j.1442-2042.2006.01449.x |quote= |pubmedID= 16882064 |pubmedCID= |DOI=10.1111/j.1442-2042.2006.01449.x |accessdate=2019-10-09}}</ref> which suggests a protective effect for the foreskin. ==Excessive washing and non-specific dermatitis== Birley ''et al''. (1993) report excessive washing, especially with the use of soap, will dry the oils out of tissues and cause a balanitis like inflammation. The use of soap (including body wash, shower gel, and shampoo) should be avoided.<ref name="Birley1991" >{{REFjournal |last=Birley |first=H.D.L. |author-link= |last2=Wasker |first2=M.M. |last3=Luzzi |first3=G.A. |etal=yes |title=Clinical Features and management of recurrent balanitis; association with atopy and genital washing |journal=Genitourin Med |date=1993-10-01 |volume=69 |issue=5 |pages=400-3 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195128/pdf/genitmed00029-0074.pdf |quote= |pubmedID=8244363 |pubmedCID=1195128 |DOI=10.1136/sti.69.5.400 |accessdate=2019-10-07}}</ref> Although it is commonly believed that the human [[foreskin]] is the source of infection so must be constantly washed to prevent infection, that is not true. Fleiss, Hodges & Van Howe (1998) reported the foreskin has both protective and immunological functions that help to prevent disease.<ref name="Fleiss1997">{{REFjournal |last=Fleiss |first=Paul M. |author-link=Paul M. Fleiss |last2=Hodges |first2=G.M. |last3=Van Howe |first3=R.S. |title=Immunological functions of the human prepuce |journal=Sex Trans Inf |date=1998-10-01 |volume=74 |issue=5 |pages=364-7 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf |quote= |pubmedID=10195034 |pubmedCID=1758142 |DOI=10.1136/sti.74.5.364 |accessdate=2019-10-07}}</ref> Washing removes the protective substances and leaves the [[penis]] prone to infection, so washing should be limited and soap should not be used. Balanoposthitis is ''not'' usually an indication for circumcision. ==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 |last=Verma |first=Shyam B. |author-link= |last2=Molina |first2=Uwe |author2-link= |etal=no |title=Looking through the cracks of diabetic candidal balanoposthitis! |trans-title= |language=English |journal=Int J Gen Med |location= |date=2011-07-07 |volume=4 |issue= |pages=511-3 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150172/ |archived= |quote= |pubmedID=21845057 |pubmedCID=3150172 |DOI=10.2147/IJGM.S17875 |accessdate=2020-06-23}}</ref> Better control of sugar levels is indicated. Recurrent yeast infections that are not responsive to better management of diabetes may be relieved by [[circumcision]]. {{SEEALSO}} * [[Smegma]]  {{LINKS}} * {{REFweb |url=http://www.cirp.org/library/disease/balanitis/ |title=Balanitis |last= |first= |publisher= |website=Circumcision Information Reference Library |date=2008-02-14 |accessdate=2019-10-07 |format= |quote=}} * {{REFweb |url=https://web.archive.org/web/20041030063437/http://www.bashh.org/guidelines/2002/balanitis_0901b.pdf |title=2001 National Guideline on the Management of Balanitis |last=Clinical Effectiveness Group |first= |publisher= |website=Wayback Machine |date=2001 |accessdate=2019-10-07 |format= |quote=}} * {{REFweb |url=https://www.nhs.uk/conditions/balanitis/ |title=Balanitis |trans-title= |language= |last= |first= |author-link= |publisher=National Health Service |website= |date=2017-05-31 |accessdate=2020-01-10 |format= |quote=}} * {{REFweb |url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/phimosis-balantis/ |title=Phimosis and Balanitis |last= |first= |publisher=Doctors Opposing Circumcision |website=Doctors Opposing Circumcision |date=2019 |accessdate=2019-10-07 |format= |quote=}}

[[Category:Medical Conditionsconditions]][[Category:Penile disorders]]