1. What is balanitis? Balanitis is the overall inflammation of the superficial skin of the penis. The most common manifestations are redness that occurs due to poor personal hygiene or phimosis – common in the younger generation, in which smegma is retained under the foreskin and causes infection of the skin of the penis. Seborrheic dermatitis is most often noticed under the hoop, to which the foreskin is attached by means of the bridle – the frenulum. A common cause of balanitis is the development of candidiasis – fungi or contact allergic dermatitis. The cause of the allergy may be the underwear or an allergy to the lubricant used to moisten the condoms. Xerotic balanitis obliterans is often also referred to as lichen sclerosis. In this disease, the most anterior part of the head of the penis is affected, which progresses to loss of penile skin or its discoloration. Another disease leading to the clinical picture of acute balanitis is circular balanitis. This is a skin manifestation of Reiter’s syndrome, which is complex with arthritis, urethritis or conjunctivitis in patients. Phimosis is a condition that causes poor personal hygiene and retention of smegma and urine under the skin of the head of the penis – foreskin. Treatment is often effective with antibiotic creams. For the correct diagnosis, it is necessary to exclude infectious diseases of the urogenital tract, which may progress and be accompanied by a clinical picture of acute balanitis. Inflamed penile skin can also be caused by paraphimosis. This is a condition where the foreskin relaxes under the glans penis and gets caught at the base, causing inflammation and swelling of the penis. The condition causes impaired venous drainage in the head, which causes blood to pool in the small-lumen vessels – venules and capillaries. The foreskin can be returned to its normal position in glans base involvement after mild anesthesia with 1% lidocaine solution, but if the desired result is not achieved, patients are advised to undergo surgery. The procedure is called circumcision and is the surgical removal of the foreskin. NEWS_MORE_BOX 2. What tests are used in balanitis? It is mandatory to take a microbiological sample and specify it regarding the presence of fungi or bacteria in the subcutaneous tissue. A sample of sterile urine is also taken, which is submitted to a microbiological and clinical laboratory. The goal is to determine if an infection of the urogenital tract is present. Allergy tests are also applied to determine whether the patient is allergic to the fabrics of his underwear or to recently used lubricant or condoms during intercourse. 3. What is the treatment for balanitis? Treatment is based on the underlying cause. The most common therapeutic agents are antibiotics or fungicidal creams that destroy the bacterial and fungal flora. Doctors advise to apply regular washes with a pale pink solution of potassium permanganate or decoction of sumac.These two substances have a pronounced antibacterial and antiseptic effect, which soothe the skin and create a prerequisite for the treatment of the existing infection. In the therapy of balanitis, some steroid creams are also applied, but in a very short period of time. The goal is to protect the penis from the side effects of the administered steroids. When phimosis or paraphimosis is proven by a urologist, circumcision is performed with the aim of permanent treatment of the problem and better personal hygiene in the man.
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