What is Balanitis?

Balanitis is the inflammation of the head of the penis and the foreskin (the thin elastic skin covering the head of the penis), also known as postitis. When both the head of the penis and the foreskin are inflamed simultaneously, it’s referred to as balanoposthitis. This condition is more common in uncircumcised men.

Causes of Balanitis

Infectious Balanoposthitis

• Viruses: Herpes simplex virus type II
• Bacteria: Staphylococci, Streptococci, Escherichia coli, Proteus, Enterococcus
• Other Microorganisms: Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium
• Fungi: Candida albicans

Non-infectious Balanoposthitis

• Allergic reactions to medications, soaps, condoms, or underwear
• Trauma due to sexual excesses
• Exposure to toxic agents, such as concentrated antibacterial solutions

Development of Balanitis

The primary cause of balanoposthitis is the retention of smegma, a foul-smelling secretion composed of exfoliated epithelial cells and released by the glands on the inner surface of the foreskin. This can occur due to lack of personal hygiene or as a result of phimosis, the inability to retract the foreskin.

Clinical Presentation

Balanoposthitis can be acute or chronic. Common symptoms include itching, serous-purulent discharge, and pain. Upon examination, swelling and redness of the skin, along with phimosis and secretion from the narrowed opening, may be observed. In chronic cases, adhesions may form between the head of the penis and the foreskin, complicating hygiene and exacerbating smegma buildup.

Diagnosis

Diagnosis is typically made through patient interviews and physical examination. Microbiological testing, such as culturing the secretion, can confirm the presence of infectious agents.

Treatment

Treatment aims to release the head of the penis from the foreskin and remove the secretion through gentle washing with disinfectant solutions. Severe cases of non-dilatable phimosis may require surgical intervention. Local baths with disinfectants help control the inflammation. Depending on the identified causative agents, antibacterial, antifungal, or corticosteroid ointments may be applied. Chronic adhesions may require gradual peeling through dilation or surgical circumcision.

Prevention

Prevention primarily involves maintaining good personal hygiene:

• Daily cleaning of the genitals
• Use of intimate soaps and shower gels
• Diligent hand hygiene before and after using the toilet
• Observance of safe sex practices