From the Guidelines
Balanitis should be treated based on its underlying cause, with a focus on improved hygiene, antifungal or antibiotic therapy as needed, and consideration of circumcision in recurrent cases, as these approaches prioritize reduction in morbidity, mortality, and improvement in quality of life. Balanitis is inflammation of the glans penis, commonly presenting with redness, swelling, pain, itching, and sometimes discharge. It's often caused by poor hygiene, fungal infections (particularly Candida), bacterial infections, or skin conditions.
Causes and Treatment
- Poor hygiene can contribute to balanitis, so improved hygiene practices like gentle washing with warm water and avoiding harsh soaps are recommended.
- For fungal infections, antifungal creams like clotrimazole 1% or miconazole applied twice daily for 7-14 days are effective, as noted in various guidelines 1.
- Bacterial infections may require antibiotics such as mupirocin ointment or oral antibiotics if severe.
- If the foreskin is tight or cannot be retracted (phimosis), this can contribute to balanitis by trapping moisture and bacteria, and in recurrent cases, circumcision might be recommended.
Prevention and Special Considerations
- Men with diabetes are particularly susceptible to balanitis due to elevated glucose levels in urine, which can promote fungal growth, so blood sugar control is important for prevention 1.
- Avoiding irritants, wearing loose cotton underwear, and thoroughly drying the area after washing can help prevent recurrence.
- The treatment of sex partners is not usually necessary unless they have symptomatic balanitis or penile dermatitis, as suggested by guidelines from the Centers for Disease Control and Prevention 1.
From the Research
Definition and Causes of Balanitis
- Balanitis refers to a variety of unrelated conditions, resulting from infective, irritative, allergic, traumatic, or inflammatory causes, as well as pre-malignant lesions 2.
- It is defined as inflammation of the glans penis, often also encompassing the prepuce (balanoposthitis) 3, 4.
- The clinical aspect of balanitis is often non-specific, making diagnosis a challenge 4.
Complications and Management of Balanitis
- Balanitis can have numerous complications, including severe pain, urethral stenosis, phimosis, sexual dysfunction, and if untreated, malignancy 3.
- The management of balanoposthitis remains a clinical challenge, with treatment options varying depending on the cause of the condition 4.
- Accurate diagnosis is essential for management, with laboratory tests such as culture studies often necessary to confirm the diagnosis 4.
Prevalence and Risk Factors of Balanitis
- Balanitis is a common condition, affecting 53.9% of male STD clinic patients in one study 4.
- Infectious balanitis was found to be more common in uncircumcised men, with Candida spp. being the most frequently isolated microorganisms 4.
- Pre-malignant lesions of the balanopreputial area, although not frequent, represent a difficult diagnosis and therapeutic challenge, with a lifelong follow-up necessary to prevent the occurrence of squamous cell carcinoma 2.