Balanoposthitis - causes, forms and types of the disease. How balanoposthitis proceeds in men: symptoms and treatment Balanoposthitis immediately occurs after intercourse

16.02.2022 -

Men who have promiscuous sex without barrier contraception or if a condom breaks while having sex with a casual partner are persistently interested in when the first symptoms of infection may appear and what is its incubation period. Balanoposthitis - an inflammatory process of the head of the penis and its foreskin - although it does not apply to sexually transmitted diseases, in most cases it is sexually transmitted and is often caused by viruses and bacteria that infect a partner during intimacy. Therefore, the question of the incubation period of balanoposthitis is no less relevant for the strong half of humanity.

The layman, under the medical term the incubation period of balanoposthitis, should understand the length of time from the moment of infection to the onset of the first symptoms of the disease.

Speaking about the nature of the occurrence of this disease, it must be remembered that the inflammatory process of the scalp can occur not only after infection during intercourse, but also against the background of apparent absolute health. In this case, the disease is most often caused by non-specific microorganisms: staphylococci, streptococci, proteas, E. coli, enterobacteria, Candida fungi, the uncontrolled growth of which was provoked by prolonged antibiotic therapy or corticosteroids. In this case, it is meaningless to talk about the incubation period.

Balanoposthitis does not have a strict time frame for the manifestation of the first signs of the disease after infection. This is because the incubation period of the disease depends on several factors:

What sexually transmitted microorganisms caused the inflammatory process. Doctors focus the attention of men on the fact that bacteria and microbes of ureaplasma, mycoplasma, chlamydia, gardnerella, as well as Candida fungi that cause balanoposthitis, are transmitted during oral and anal sex.
Individual characteristics of the body's immune system.

If the body's resistance is lowered, then with external infection, the incubation period of the catarrhal or erosive form of balanoposthitis (the most common types) appears within three days, fungal (candidiasis) - after a week.

Balanoposthitis(from Greek balanos - "acorn", "head of the penis", posthe - "foreskin", and itis - "inflammatory process") is an inflammation of the glans penis (balanitis) and foreskin (postitis).

Anatomical features of the glans and foreskin of the penis

The human penis consists of a body and a head, between which there is a narrowed part - the neck (coronal sulcus).

The head of the penis has an acorn-like shape, on it is the external opening of the urethra, which serves both for urination and for ejaculation.

The head of the penis is covered with thin pink skin, in which there are many glands that secrete a lubricant - smegma. It performs a protective and bactericidal function.

Normally, the head is completely or partially covered by the foreskin - a fold of skin that covers its body in the upper part of the penis and passes into the skin of the pubis, and in the lower part - into the skin of the scrotum. In the lower part, between the foreskin and the head in the longitudinal direction, another skin fold passes - the frenulum of the penis.

Smegma, which is produced by the skin glands, accumulates between the skin and the head of the penis.

Causes of balanoposthitis

The causes of balanoposthitis are divided into infectious and non-infectious.

Causes of infectious balanoposthitis(mostly sexually transmitted infections):

Gonorrhea- sexually transmitted infection STI) caused by gonococcus.
Trichomoniasis- a sexually transmitted infection that occurs in 10% of the world's population. It ranks first in prevalence among both STIs and diseases of the genitourinary system.
Candidiasis- a fungal disease that develops mainly with a decrease in immunity.
Genital herpes- a viral infection that mainly affects the skin and genitals.
Syphilis - Balanoposthitis may be the first sign of primary syphilis.
Gardnerellosis - in women it occurs as a result of a violation of the normal biocenosis (composition of microflora) of the vagina, and in men it manifests itself in the form of balanoposthitis.
HPV (human papillomavirus) - a common viral disease that affects the skin and mucous membranes, which often manifests itself in men in the form of balanitis, postitis, balanoposthitis.
non-specific pathogens among them, streptococci and staphylococci are the most common.

Non-infectious causes of balanoposthitis:

Irritative balanoposthitis - associated with mechanical or other irritation of the skin of the head and foreskin of the penis.
Diabetes - complicated by balanoposthitis as a result of damage to the small vessels of the penis, a decrease in protective functions.
Psoriasis - dermatological disease, which is mainly of an autoimmune nature.
Lichen planus - non-infectious chronic skin disease.
Rarely occurring diseases: Keyr's erythroplasia, Behcet's disease, xerotic obliterans balanoposthitis, Zoon's plasma cell balanitis.

Factors that contribute to the development of balanoposthitis:

Non-compliance with the rules of personal hygiene: while dirt and smegma, which accumulate between the foreskin and the head of the penis, are an excellent breeding ground for the reproduction of pathogens.
Phimosis: a disease in which the foreskin is so narrowed that it is impossible to expose the glans penis. In this case, the implementation of personal hygiene is difficult.
Allergic diseases and immune disorders.
Chronic infections in the body: pathogens enter the skin of the glans penis with the blood stream.
Promiscuous sexual relations: high risk of contracting sexually transmitted infections.
Infections of the genitourinary system: cystitis, prostatitis, urethritis, etc.

Symptoms of balanoposthitis

Most often, balanoposthitis develops with a banal violation of the rules of personal hygiene and is accompanied by typical symptoms. Dominant signs depend on the stage of the disease.

Symptoms of balanoposthitis at different stages of the disease

Simple balanoposthitis

The mildest form of inflammation of the glans penis and foreskin. Most often, balanoposthitis proceeds in this way, complete recovery occurs after 5 to 7 days.

Symptoms of simple balanoposthitis:

Itching and burning. They are often the first symptoms of the disease. These sensations are aggravated by touching the head of the penis and its foreskin, by rubbing underwear, during urination.
Discomfort when opening the head of the penis.
Redness of the glans penis and foreskin. A characteristic sign of the inflammatory process.
puffiness
Maceration of the skin of the foreskin and glans penis. Maceration is swelling due to the fact that the skin is impregnated with edematous fluid.
Erosion on the skin- superficial defects that are especially painful.
Purulent discharge from the external opening of the urethra.

Erosive balanoposthitis

A characteristic feature of this form of balanoposthitis is the formation of erosions on the skin of the head and foreskin of the penis. First, a white thin film appears on a certain small area, which consists of a superficial dead layer of cells. Then it falls off, and in its place a very painful, itchy red spot forms. After the erosion heals, no trace remains in their place.

Often, erosive balanoposthitis is accompanied by an increase and soreness of the lymph nodes in the groin.

Gangrenous balanoposthitis

The most severe form of the disease.

Signs of gangrenous balanoposthitis:

violation of the general condition of the patient: malaise, fever, weakness;
ulcers: occur on the glans penis and its foreskin, are red in color, blood and pus appear in them, they are very painful;
phimosis(inability to expose the glans penis): occurs as a result of swelling of the glans and foreskin;
scarring: remain in place of healed ulcers and can also lead to the development of phimosis;
perforations (holes) in the foreskin, which are also the result of the formation of ulcers.

Symptoms of balanoposthitis caused by certain sexually transmitted infections

Type of balanoposthitis	signs
Gonorrheal	It is accompanied by classic signs of balanoposthitis, almost always combined with urethritis - a lesion of the urethra.
Chlamydial	Most often occurs in the form of balanitis - inflammation of the glans penis. Lesions in the form of red spots have clear contours.
Trichomonas	Most often occurs as a complication of urethritis, but can develop independently. A large amount of pus accumulates between the glans penis and the foreskin, which has a yellow or white color, a foamy texture, and an unpleasant odor. The head of the penis is either completely swollen and red in color, or it is affected in the form of many spots.
candida	The disease begins with itching and burning of the skin of the penis, then pain occurs. In the future, a white coating appears on the head of the penis, which is easily removed and forms lumps similar to cottage cheese.
herpetic	On the skin of the glans penis and foreskin, a large number of vesicles appear, filled with transparent watery contents. When they open, erosions of a red-pink color remain in their place, in place of which pigment spots then remain. Herpetic balanoposthitis most often occurs in a chronic form.
Syphilitic	With syphilis, balanoposthitis is associated with the formation of a primary chancre on the skin of the glans penis and foreskin.
Balanoposthitis with gardnerellosis	Symptoms resemble simple balanoposthitis, but very poor. If the immune system of a man is normal, then the disease goes away on its own within 2 to 3 days.
Papillomavirus balanoposthitis	It manifests itself, like papillomavirus infection in other areas - in the form of genital warts.

Specific symptoms of some types of balanoposthitis caused by non-infectious causes

Type of balanoposthitis	Symptoms
With diabetes	The severity of symptoms depends on the age of the patient, the duration of the course of diabetes mellitus, concomitant diseases: redness of the head of the penis; increased pain sensitivity of the skin of the head and foreskin, bleeding; cracks and ulcers on the skin; after the cracks and ulcerations pass, scars remain in their place.
Psoriatic	In most cases, balanoposthitis in psoriasis is combined with skin lesions in other places. In this case, small red nodules appear, covered with scales.
With lichen planus	On the skin of the penis, mainly in the area of the transition of the body to the head (in the area of \u200b\u200bthe neck of the penis), flat nodules of irregular shape appear. On their surface are white scales. The skin itself in these places is slightly reddish. Individual nodules may merge with each other. They are found not only on the penis, but also in other places.

Features of balanoposthitis in children

Balanoposthitis is one of the most common reasons for parents of boys to contact pediatricians and pediatric surgeons. Most often it is a simple infectious or irritative balanoposthitis, which lasts for 5 days and then disappears.

Sexually transmitted infections are almost non-existent in childhood.

The most common causes of balanoposthitis in childhood:

the release of a large amount of smegma and its accumulation between the glans penis and the foreskin;
overdeveloped foreskin, which hangs down in front of the head of the penis and moves back with difficulty - hypertrophic phimosis;
phimosis - a condition when the foreskin is narrowed so much that the exposure of the head of the penis becomes impossible;
non-compliance with the rules of personal hygiene, a rare change of underwear.

Diagnosis of balanoposthitis

Diagnostic techniques that are used for balanoposthitis:

General blood analysis- a routine study that is performed in all patients. An increase in the content of leukocytes and an acceleration of ESR (erythrocyte sedimentation rate) indicate the presence of an inflammatory process in the body.
General urine analysis- a routine study that is assigned to all patients. An increase in the number of leukocytes in the urine indicates the presence of an inflammatory process.
Bacteriological examination of urine and determination of the sensitivity of microorganisms to antibiotics. It makes it possible to identify the causative agent of the disease and prescribe the correct antibiotic therapy.
PCR– polymerase chain reaction. A laboratory study that makes it possible to isolate the DNA of a pathogen and clarify its type.
Examination of scrapings from the urethra (urethra) for pale treponema- the causative agent of syphilis. This test should be performed in all adult patients in order to exclude the presence of syphilis.

If balanoposthitis is caused by sexually transmitted infections, then the sexual partner must be examined.

Balanoposthitis treatment

Local procedures for balanoposthitis

Procedure	Efficacy and indications	Method of application and duration of the course
Baths with potassium permanganate (potassium permanganate).	Potassium permanganate is a powerful antiseptic that kills most pathogens. It is sold in pharmacies in the form of a powder, which is intended for dilution in water.	For younger children: Dilute a small amount of potassium permanganate in the bath so that the water is slightly tinted. To carry out the usual bathing in this water, during which to open the head of the penis. For older children and adults: Dilute potassium permanganate powder in a glass so that the solution has a pale pink color. Dip the penis with the open head into the glass for about 5 to 10 minutes. Repeat the procedure 1-3 times a day, as prescribed by the doctor.
Baths with furatsilin.	Furacilin is a medicinal substance with antimicrobial and antiseptic action. Sold either in the form of a ready-made solution in vials, or in the form of tablets.	When used in a vial: Pour the solution from the vial into a glass. When using tablets: Dissolve 2 tablets in a glass of water (250 ml). Dip the penis with the naked head into a glass of solution for 10 minutes. Repeat the procedure 1-3 times a day, depending on the doctor's prescription.
Baths with chamomile, sage, plantain, succession, St. John's wort, oak bark (one of the plants to choose from).	These medicinal plants have anti-inflammatory and antiseptic effects. They are able to relieve inflammation and destroy pathogens that caused balanoposthitis.	Take 2 - 3 tablespoons of the medicinal plant. Dilute in 1 cup (200 ml) boiling water. Cool down. Immerse the penis with a naked head in the infusion for 15 to 20 minutes. Repeat the procedure 4-6 times a day for 3-5 days.

The use of therapeutic ointments for balanoposthitis
Levomekol	Ointment, which includes two active ingredients: Chloramphenicol (levomycetin): a strong broad-spectrum antibiotic that destroys various types of pathogens. Methyluracil - a substance that stimulates the nutrition and regeneration of the skin of the head and foreskin of the penis. Levomekol ointment is prescribed for all forms of balanoposthitis.	Before applying the ointment, you need to conduct a thorough hygiene of the external genital organs. In order to treat balanoposthitis, bandages with levomekol are applied to the penis, which are left overnight. The procedure is repeated for 3-5 days.
Xeroform ointment	Xeroform ointment consists of two active ingredients: Xeroform is a medicinal substance that has an antiseptic, anti-inflammatory and drying effect. Petrolatum.	Before applying xeroform ointment, thorough hygiene of the external genitalia is carried out. In order to treat balanoposthitis, bandages with xeroform ointment are applied to the penis, which are left overnight. The procedure is repeated for 3-5 days. Source: Vidal Handbook, 2008
Ointments based flumatasone pivalata: Locacorten; Lorinden; Localized.	Flumatasone Pivalate is a medicinal substance that has pronounced anti-allergic and anti-inflammatory properties. Refers to drugs of hormones of the adrenal cortex. It is most effective for balanoposthitis caused by autoimmune reactions, with severe pain, itching, inflammation.	Before applying ointments based on Flumatasone Pivalat, thorough hygiene of the penis is carried out. Take a small amount of ointment and rub into the affected skin. The procedure is repeated 2-3 times a day. Source: Vidal Handbook, 2008
Other ointments based on hormones of the adrenal cortex: Prednisolone ointment Locoid Advantan Elidel	Preparations of hormones of the adrenal cortex have a strong anti-inflammatory and anti-allergic effect. Ointments based on them are especially effective for inflammation of an autoimmune nature, when balanoposthitis is accompanied by severe itching and burning, pain, swelling and redness of the glans penis and foreskin.	Ointments should only be applied to cleansed skin before careful personal hygiene. Usually, ointments based on preparations of hormones of the adrenal cortex are applied to the skin of the penis 1 time per day at night (sometimes 2 to 3 times.) You need to take a small amount of ointment and rub it into the affected skin. The course of treatment for balanoposthitis lasts 3 to 7 days. Source: Vidal Handbook, 2008
Ointments with antibiotics with infectious balanoposthitis.	There are a large number of ointments, the active ingredients of which are antibacterial drugs.	The ointment is selected for each patient individually and only by the attending physician. It is necessary to take into account the type of pathogens, their sensitivity to various antibiotics.
Ointments based on antifungal drugs: Clotrimazole; Omoconazole; Candide; Miconazole; Mikogal; Terbinafine.	They have an antifungal effect and are prescribed in cases where it is proved that balanoposthitis is caused by Candida or other fungi.	Usually the ointment is applied to the skin 2 times a day. It is rubbed into the skin. Before this, you need to thoroughly wash the genitals. Treatment in most cases lasts for 2 to 4 weeks, more specific terms are determined by the attending physician.

Antibacterial therapy for balanoposthitis

The appointment of antibiotics for balanoposthitis is carried out only in severe cases, when inflammation is accompanied by a pronounced violation of the general condition of the patient, with an ulcerative and gangrenous form, as well as with all types of balanoposthitis, which are caused by sexually transmitted infections. Antibacterial drugs for balanoposthitis, as with other diseases, must be used in strict accordance with certain rules:

the antibiotic should be prescribed only by the attending physician, taking into account the type of microorganism and its sensitivity to antibacterial drugs;

self-administration of these drugs, especially in mild forms of balanoposthitis, is strictly contraindicated;

antibacterial drugs should be used only in the dosages in which they were prescribed;

antibiotics are always used strictly on time, otherwise they will not bring an effect and can have side effects.

Antibiotics that are prescribed for balanoposthitis:

Preparations	Mechanism of action	Dosage and administration
Broad-spectrum antibiotics for balanoposthitis caused by non-specific pathogens
Cefazolin	An antibacterial drug that destroys many types of pathogens. Available in tablets, as well as in powder for intramuscular injection. The most preferred is the injection form, as it has a more effective effect.	Use in adults: 0.5 - 1.0 g of powder diluted in distilled water or saline intramuscularly, 6 - 8 times a day, depending on the doctor's prescription. Use in children: At the rate of 20 - 50 mg per kilogram of body weight, the total dose is divided into 3 - 4 doses during the day. Contraindications: Cefazolin should not be used in pregnant and breastfeeding women, in people who are allergic to this group of drugs. Source: M. D. Mashkovsky
Ceftriaxone	A broad-spectrum antibiotic that can destroy many types of pathogenic microorganisms. Belongs to the group of antibiotics cephalosporins. Ceftriaxone is available in tablets and as a powder for intramuscular injection. The most preferred injectable form, as it is more effective.	Use in adults and children over 12 years of age: 1 - 2 grams of ceftriaxone powder is dissolved in distilled water or saline and injected once a day. The dosage is selected by the attending physician. Use in children under 12 years of age: The dosage of the powder is selected by the attending physician at the rate of 20 - 100 mg per kilogram of the child's weight. Contraindications: Ceftriaxone should not be used in pregnant and breastfeeding women, in people with bleeding and enterocolitis (inflammation of the small intestine and colon), in people allergic to cephalosporins and in children under 2.5 years of age. Source: M. D. Mashkovsky “Medications. A guide for doctors.” 15th edition, revised and enlarged, Moscow, New Wave, 2005.
Azithromycin (Zimaks, Azitrocin, Azivox, Sumamed, Zitrolid, Sumazid).	An antibiotic from the macrolide group, which acts on a wide range of pathogens. It is prescribed in the form of tablets. Most pharmacies distribute a branded drug called Sumamed.	Take 1 g (2-4 tablets, depending on the dosage) once at the onset of illness before meals. Contraindications: Azithromycin is contraindicated in diseases that are accompanied by severe disorders of the kidneys and liver. With arrhythmias (heart rhythm disturbances), the drug is prescribed with caution. Source: M. D. Mashkovsky “Medications. A guide for doctors.” 15th edition, revised and enlarged, Moscow, New Wave, 2005.
Antibacterial drugs that are used for gonorrheal balanoposthitis
Cefixime	An antibacterial drug that belongs to the group of beta-lactam antibiotics and is effective against gonococci. Available in the form of tablets of 200 or 400 mg.	Use in adults and children over 12 years of age weighing more than 50 kg: Take 1 (400 mg) or 2 (200 mg) tablets per day at regular intervals. Use in children under 12 years of age weighing less than 50 kg: 8 mg or 4 mg per kilogram of the child's body weight every 12 hours. The duration of treatment is determined by the doctor individually, depending on the severity of the disease. Contraindications: allergic reactions to antibiotics from this group.
Ciprofloxacin	An antibacterial drug from the group of fluoroquinolones, which are active against most pathogens of infections of the genitourinary system, including gonococci. Produced in the form of tablets.	With gonorrhea, adults are shown taking ciprofloxacin once at a dose of 500 mg. In the future, treatment continues in accordance with the doctor's prescriptions. Contraindications: Ciprofloxacin is contraindicated in children and adolescents under 15 years of age. In the elderly, the dosage should be reduced. You can enter a solution of ciprofloxacin for intravenous use at a dosage of 100 mg of the active substance. Source: M. D. Mashkovsky “Medications. A guide for doctors.” 15th edition, revised and enlarged, Moscow, New Wave, 2005.
Ofloxacin	An antibiotic from the fluoroquinolone group, which serves as an alternative to ciprofloxacin.	For gonorrhea, take 400 mg of ofloxacin in the form of tablets once. In the future, treatment is continued in accordance with the doctor's prescriptions. Contraindications: Epilepsy, children and adolescents under the age of 15, pregnant and breastfeeding women. Source: M. D. Mashkovsky “Medications. A guide for doctors.” 15th edition, revised and enlarged, Moscow, New Wave, 2005.
Antibacterial drugs that are used for balanoposthitis caused by Trichomonas
Metronidazole (Metrogil, Trichopolum)	An antibacterial drug that is effective against protozoa, including Trichomonas.	Use in adults: 2 grams orally once or for 5 days, 0.5 g 2 times a day. In men, trichomonas are usually not detected during a second examination already after 1 day from the start of treatment. Approximate dosages for children: 1 - 5 years - 250 mg; 6 - 10 years - 375 mg; 11-15 years - 500 mg. These doses are divided into 3 doses. Contraindications: Pregnant and breastfeeding women, diseases of the hematopoietic organs, severe pathologies of the nervous system. Source: M. D. Mashkovsky “Medications. A guide for doctors.” 15th edition, revised and enlarged, Moscow, New Wave, 2005.
Antibacterial drugs that are used for candidiasis
Fluconazole (Diflucan, Flucostat)	An antifungal drug that is effective against fungi of the genus Candida. Available in capsules	In the treatment of candidal balanoposthitis and urethritis, 0.2 - 0.4 g of the drug is prescribed per day. Take 1 time. The duration of treatment depends on the severity of the disease and is determined by the doctor. Contraindications Key words: pregnancy, breastfeeding, child under 1 year of age. Source: M. D. Mashkovsky “Medications. A guide for doctors.” 15th edition, revised and enlarged, Moscow, New Wave, 2005.
Antiviral drugs that are prescribed for balanoposthitis caused by the herpes virus
Aciclovir (Aciclovir-Acri, Acivir, Aciclovir BMS, Cyclovax, Gerperax, Aciclovir Virolex, Lizavir, Herpesin, Zovirax, Lovir, Cevirin, Medovir, Supraviran, Cyclovir, Geksal)	An antiviral drug that is active against herpes viruses.	With balanoposthitis, adults should take acyclovir at a dosage of 0.2 g 5 times a day. There is a break for the night. The duration of treatment is determined by the attending physician. Contraindications: During pregnancy and breastfeeding, the drug can be used, but this should be done only for health reasons. Source: M. D. Mashkovsky “Medications. A guide for doctors.” 15th edition, revised and enlarged, Moscow, New Wave, 2005.

Surgical treatment for balanoposthitis

With an uncomplicated course of balanoposthitis, most often surgical treatment is not required.

Indications for the operation of circumcision (circumcision) with balanoposthitis:

Frequent relapses, chronic course, in which conservative methods do not allow to get rid of balanoposthitis. Before performing surgery, it is necessary to achieve a subsidence of the inflammatory process.

Complication in the form of cicatricial phimosis. As a result of pronounced frequent inflammatory processes, scars form on the foreskin, it narrows strongly, exposing the glans penis becomes difficult or impossible.

Prevention of balanoposthitis:

meticulous personal hygiene;
frequent washing, frequent change of underwear;
exclusion of frequent promiscuity;
partner's health: she must also carry out thorough intimate hygiene of the genital organs, appear in a timely manner for examinations to the gynecologist;
it is advisable to bathe young children in water to which a small amount of potassium permanganate has been added;
if the boy’s penis head does not open well, then he needs to sit in warm water for a while, after which the head will open easily, better hygiene can be performed;
boys need to be brought to the scheduled examinations to the pediatric surgeon in a timely manner.

Why does balanoposthitis develop in boys? How to recognize and how to help?

Balanoposthitis in boys is the main reason for visiting a pediatric urologist. Redness of the foreskin and head is especially often noticed by parents of children under one year old.

Causes of balanoposthitis in children not quite the same as in adults:

Hygiene of the foreskin. In boys, the foreskin is narrowed physiologically. For most of them, it is possible to completely pull it off and expose the head of the penis only by 3-5 years, which is considered the norm. But many parents are too zealous with hygiene, and when washing, they pull and injure the foreskin. Through the resulting microcracks, bacteria penetrate the skin, which can cause inflammation.
Injuries. Urinary irritation causes genital itching. Combing this area, the child injures the skin and introduces an infection. Although at an early age, other injuries cannot be ruled out.
Overheating. Wearing a diaper or warm clothes increases the moisture in the genital area and promotes the growth of bacteria.
Candidiasis. After a course of antibiotic treatment, fungi of the genus begin to multiply intensively. Candida causing candidiasis or thrush. In babies, it often appears in the mouth, and sometimes on the genitals.
Inflammation of the urinary system. In children, inflammation of the urinary tract occurs more often than in adults. This is due to the age-related features of the development of the urinary, immune and nervous systems. Often the bladder does not empty completely, and the remaining urine serves as a reservoir for bacteria to multiply.
Allergic reaction. Redness of the glans and foreskin may be an allergy, which is associated with:
- diapers;
- the use of drugs;
- skin care products - powder, baby oil;
- washing powder, which washed children's things;
- sweets, berries or other foods.

Symptoms of balanoposthitis in children

Redness and swelling at the end of the penis, sometimes throughout the organ.
The foreskin does not retract well(provided that before she moved away well).
White-yellow discharge on the head, linen or diaper.
Baby crying while urinating. Older children refuse to sit on the potty.
Itching. The child is restless, constantly scratching or pulling the penis. She often cries because the touch causes pain.
Frequent painful urination- indicates that the inflammation has spread to the opening of the urethra.
Lack of urination, although the child complains that he wants to go to the toilet - it may be due to irritation and swelling of the urethra and bladder.

The urologist is engaged in the treatment of balanoposthitis in boys. The specialist will prescribe treatment based on the symptoms and test results. But If you have not made an appointment with a doctor, you can alleviate the condition of the child yourself:

Put your baby in a warm bath. Warm (not hot) water reduces discomfort. Wash the outside of the genitals with neutral baby soap, free of additives and fragrances, so as not to aggravate the allergic reaction, if any.
Pull the skin of the penis up without exposing the head. Using a syringe without a needle, inject 10 ml of a warm solution of furacilin or an ectericide into the gap formed. The liquid under pressure washes out the smegma that has accumulated between the head and the foreskin.
You can immerse the penis in a container with a warm solution of furacilin, a slightly pink solution of potassium permanganate or chamomile decoction for 5-10 minutes.
Put a few drops of oil solution A, E, vaseline or olive oil into the slot or on the head. Boiled and chilled sunflower oil will do.

Show your child to a specialist as soon as possible! It is better not to start the disease, as it can cause phimosis (narrowing of the foreskin), which will require surgical treatment.

Prevention of balanoposthitis in children is based on the observance of hygiene rules. Every day, the genitals are washed with warm water with baby soap or neutral shower gel. If there is no redness, and nothing bothers the baby, then it is not recommended to move the foreskin during washing.

What is dangerous balanoposthitis and urethritis?

Balanoposthitis and urethritis often occur together. The fact is that bacteria and fungi from the head quickly spread up the urethra. At the same time, the mucous membrane of its walls becomes inflamed. This usually occurs 3-7 days after the onset of symptoms of balanoposthitis.

Symptoms of balanoposthitis and urethritis

Changes in the appearance of the head and foreskin - redness, white bloom, erosion, spots, fine blisters rash;
Pain and burning when urinating;
Purulent or mucous discharge from the opening of the urethra;
Swelling of the tissues surrounding the opening of the urethra;
The initial portion of urine is cloudy, contains mucus, pus, leukocytes, while the residual portion is transparent;
It is possible to increase the temperature up to 38°C.

The doctor makes the diagnosis based on the symptoms of the disease, the results of a urinalysis and a microscopic examination of a smear from the urethra.

Balanoposthitis and urethritis are treated with antibiotics and nitrofuran drugs (Furagin, Furamag), which penetrate the mucous membrane of the urinary tract and destroy the pathogen.

Additionally carry out local treatment:

baths with potassium permanganate, 2 times a day for 2 weeks;
clotrimazole 1% cream, 2 times a day for 2 weeks on the affected area.

What are the complications of balanoposthitis?

Complications of balanoposthitis develop in weakened patients, as well as in men who do not follow the doctor's instructions and ignore the rules of hygiene.

Why does chronic balanoposthitis develop and how is it treated in men?

Chronic balanoposthitis in men is not uncommon. Its symptoms are not as pronounced as in the acute form of the disease, but rashes on the head and itching bring a lot of anxiety. Often men complain that the symptoms subside only for the duration of treatment. But as soon as they stop using ointments and drinking pills, the signs of the disease return.

Symptoms of chronic balanoposthitis

Itching and burning on the skin of the head, aggravated during an erection or after intercourse.
Unpleasant sensations occur with increased humidity and physical activity.
Periodically, the skin of the head and foreskin turns red or becomes covered with spots with clear edges.
The skin of the head is moist, impregnated with interstitial fluid.
White plaque (sometimes grains), accumulating in the region of the coronal sulcus.
Rashes in the form of small pink papules.
Increased dryness and painful cracks.

Treatment of chronic balanoposthitis was developed by specialists of the Moscow State University of Medicine and Dentistry. It effectively eliminates relapses in 97% of men.

1. Lamisil spray is applied to the washed and dried skin of the genital organs 2 times a day for 2 weeks.
2. Laserophoresis with Lamisil spray. Lamisil spray is applied to the skin of the genital organs. After that, a laser is applied to the affected area through a sterile tube. The duration of the procedure is 5 minutes. Course 7 sessions, every other day.

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

What is balanoposthitis?

Balanoposthitis is a pathology in which the inflammatory process captures the glans penis and the inner layer of the foreskin in men. Anatomically, these two formations are located side by side and their surfaces are in contact. This explains the rapid transmission of the inflammatory process from one area to another. However, in rare cases, balanitis is isolated separately ( inflammation of the glans penis) and post ( inflammation of the foreskin).

Balanoposthitis is a common urological disease. From 5 to 15% of patients of this profile go to the doctor specifically for balanoposthitis. The disease is inflammatory and is usually caused by a mixed infection. It is quite difficult to single out any main reason for its development. Various microorganisms, environmental factors and other conditions play their role.

Thus, a number of inflammatory processes can be called balanoposthitis, which can occur with different intensity and different symptoms. The microorganisms that caused the inflammatory process are also different. They are united only by the general localization of inflammation - the glans penis and the foreskin.

In most cases, the initial diagnosis of the disease is not difficult. However, to confirm the final diagnosis, a series of examinations is required. Only in this case it will be possible to prescribe a qualified treatment and eliminate not only the inflammatory process, but also the predisposing factors that could cause it.

Also, aseptic inflammation may be associated with excessive load. Friction is present during intercourse, regardless of the amount of lubricating fluid. Frequent sex in some men can contribute to the development of moderate inflammation. It can also be provoked by the use of low-quality condoms or detergents. This results in an allergic reaction and with strong detergents and a weak chemical burn). After that, an infection often joins superficial skin lesions.

Balanoposthitis is sometimes a manifestation of other diseases. In very rare cases, moderate inflammation of the skin in this area is possible as one of the manifestations of Reiter's syndrome. This is an autoimmune disease in which the direct cause of the inflammatory process is the body's antibodies that attack some cellular structures.

All of the above reasons can be exacerbated by a number of predisposing factors. These are various conditions and influences, which in themselves cannot cause the inflammatory process, but, one way or another, contribute to its development. In people who are not affected by these factors, the likelihood of balanoposthitis is much lower. For example, opportunistic pathogens will not cause an inflammatory response, but simply colonize healthy skin.

There are the following important factors that contribute to the appearance of balanoposthitis:

Non-observance of personal hygiene. The genitals need regular hygienic care. The absence of such allows uncontrolled development and accumulation of various microbes. Men are recommended to take a warm shower 1-2 times a day, washing the head of the penis with warm water and soap. This procedure ensures the supply of oxygen to the skin and removes excess smegma. You also need to change your underwear regularly. pure cotton briefs).
Frequent change of sexual partners. As noted above, sexually transmitted infections are a very relevant cause of balanoposthitis. The likelihood of contracting herpes, gonorrhea, chlamydia and other pathologies from this group increases dramatically with frequent unprotected sexual contact with various partners. At the same time, the set of microorganisms that colonize the mucous membrane of the genital organs is quite individual. Even conditionally pathogenic microflora for one person can cause disease for another.
Accompanying illnesses. In a number of diseases, conditions are created conducive to the reproduction of bacteria. These include some kidney diseases and diabetes mellitus. In this case, a large amount of nutrient glucose enters the urine ( normally there is little). After the act of urination, the remains of urine on the walls of the urethra become a good nutrient medium. Also, diseases that predispose to balanoposthitis include pathologies that affect the immune system ( HIV / AIDS, etc.). The weakening of the body's defenses leads to the fact that opportunistic microbes become more aggressive.
Age. It is statistically noted that in older men and young children, balanoposthitis is also quite common. This is usually due to poor personal hygiene. In addition, the immune system in children and the elderly is usually weaker.
anatomical predisposition. In some cases, balanoposthitis is a secondary problem due to congenital anatomical abnormalities. A relatively common cause is phimosis. In this disease, the foreskin is too narrow to normally expose the glans penis. As a result, smegma accumulates under the foreskin leaf, and microbes actively multiply. Poor access to oxygen and difficulties in hygienic processing also contribute to this.
High sexual activity. With frequent sexual intercourse, skin irritation may occur. It also increases the risk of microtrauma ( tiny cracks in the skin and mucous membranes). These microscopic defects easily get infected, since only a whole skin is an insurmountable obstacle for most microbes. During oral or anal sex, the risk is even higher, as the chance of injury increases even when using a condom. Unprotected contact can lead to penetration into the cracks of the microflora of the oral cavity or rectum. For example, Escherichia coli ( E. coli) in these cases often causes severe purulent balanoposthitis.
Contact with chemical compounds. A number of chemical compounds can irritate the sensitive skin around the glans penis. Poor quality shower gels, soaps, or condoms often cause eczema, contact dermatitis, or other skin problems. Accession of the same infection after some time leads to the development of balanoposthitis.

Another rare cause of balanoposthitis can be malignant tumors of the penis. They are quite rare. Provoke their development can be poor hygiene, chemicals and other factors listed above. The tumor itself is often not accompanied by inflammation in the first stages. However, over time, the process of tissue destruction begins. Dead cells become food for microbes that actively multiply in this area. Ulcers and pus may appear.

Balanoposthitis in diabetes mellitus

As noted above, diabetes is one of the diseases that significantly increase the risk of developing balanoposthitis. With this pathology, a number of different organs and systems are affected. Complex disorders at different levels create favorable conditions for the reproduction of bacteria.

Diabetes itself is a serious metabolic disease. The main problem in this case is high glucose ( Sahara) in blood. This is usually associated with damage at the level of the pancreas, the cells of which ( islets of Langerhans) produce the hormone insulin. This hormone contributes to the accumulation of glucose in tissues and its normal breakdown. The lack of this hormone, which occurs for one reason or another, leads to the fact that sugar remains in the blood, and is not used by the cells of the body.

The following disorders contribute to the development of balanoposthitis in diabetes mellitus:

Glucose in the urine. Elevated blood glucose and sometimes associated kidney damage ( diabetic nephropathy) lead to the fact that a significant amount of glucose also begins to be excreted in the urine. After the act of urination, part of it remains on the walls of the urethra and near the external opening of the urethra. Glucose is a substance that is easily absorbed by many types of bacteria. Accordingly, the accumulation of glucose in the urethra and on the glans penis contributes to the multiplication of microbes. If at the same time the patient does not pay increased attention to the hygiene of the genital organs, it is highly likely that pathogenic microbes will begin to destroy the cells of the body, causing inflammation.
Circulatory disorders. Elevated blood sugar has a bad effect on the walls of blood vessels. They weaken, become more fragile. The deterioration of blood circulation often manifests itself in the form of trophic ulcers on the legs. Blood circulates worse through small vessels, less oxygen and nutrients enter the tissues. In the area of the penis, trophic ulcers usually do not appear. However, if an infection enters, impaired blood circulation will make itself felt, since the vessels are affected everywhere to one degree or another. Less nutrients will simply flow to the inflamed foreskin, and there will be a threat of tissue death.
Weakened immunity. Elevated sugar levels, causing multiple disorders ( at the level of vessels, nerves, metabolism), depresses the immune system. As a result, the body is less able to recognize various infections and does not cope well with their elimination. In patients with diabetes, not only bacterial balanoposthitis is severe, but also other infectious diseases.
Skin changes. Hyperglycemia ( high blood sugar) and kidney damage often cause changes in blood osmotic pressure. This makes it easier for the body to lose fluid. This, in turn, can affect the health of the skin. In particular, minor injuries heal worse, the likelihood of skin erosions and even ulcers increases. Since the foreskin and the surface of the glans penis are modified skin, pathological changes will also affect this area. As a result, local resistance to bacteria will weaken and the likelihood of tissue infection will increase.

In general, it can be noted that bacterial balanoposthitis occurs in patients with diabetes mellitus much more often than in healthy people. The disease is slower and more difficult to treat, and the likelihood of complications ( e.g. gangrenous or purulent form) higher. There are also features in the treatment of such patients. Some drugs are not recommended for use in diabetes. To start treatment, the patient will need to consult not only a urologist or surgeon, but also an endocrinologist.

To reduce the likelihood of disease and the development of complications, simple preventive measures should be taken. For patients with diabetes, it is primarily to maintain normal blood sugar levels ( if possible), adequate hygiene of the genitals and prevention of sexually transmitted diseases.

Does balanoposthitis happen in women?

Balanoposthitis, as a separate disease, women cannot have. The fact is that the very name of this pathology suggests inflammation of the foreskin and glans penis, which are absent in the female body. Thus, the use of this term is not correct. However, there are a number of diseases that have a similar clinical picture and symptoms, as well as similar mechanisms of development. However, these pathologies have different names, according to the type and location of the inflammatory process.

Nonspecific infectious inflammation caused by several ( usually opportunistic) bacteria or fungi can affect not only the penis in men. Normally, several dozen different microorganisms live in the female vagina, which not only do not harm, but even benefit the body. However, in the case of minor injuries or weakened immunity, these same microorganisms become the cause of the inflammatory process. Thus, the causes and mechanism of the development of inflammation are in many ways reminiscent of balanoposthitis.

Diseases similar to balanoposthitis in women are:

colpitis ( vaginitis) - inflammation of the vaginal mucosa;
vulvitis - inflammation of the external female genital organs;
cervicitis - inflammation of the cervix;
bartholinitis - inflammation of a large gland on the eve of the vagina;
candidiasis ( thrush) - a fungal infection of the above organs, often in the form of vulvovaginal candidiasis.

All these diseases are also often caused by a nonspecific inflammatory process. Moreover, there are other similarities with balanoposthitis. For example, in women with diabetes, these pathologies are more common. Glucose in the urine partially remains on the walls of the vagina, which causes an increased development of microbes.

It should also be noted that balanoposthitis and the above forms of inflammatory processes in women can be "transmitted" through sexual contact. Unprotected sex leads to the fact that a large number of microbes from the inflamed mucous membrane are simply mechanically transferred to the partner's genitals. If he has microtraumas or other prerequisites for the development of the disease, the partner also becomes ill. The dominant pathogen in this case can be allocated a common ( for example, the same species of gonococcus or chlamydia). However, diseases in partners will be called differently, according to the names of the genital organs in medicine.

Thus, patients can sometimes confuse terms and call inflammatory processes in women balanoposthitis. However, from a medical point of view, these diseases have a different name. Moreover, diagnosis and treatment due to anatomical and physiological features will also have some differences.

Forms and types of balanoposthitis

There are a fairly large number of different types and forms of balanoposthitis. Such a complex classification is explained by the fact that doctors put various criteria at its basis. Recognition of the form of the disease takes place during the diagnosis. Classification is necessary to select the correct treatment.

When classifying balanoposthitis, the following criteria can be used as a basis:

pathogen superclasses ( bacteria, fungi, etc.);
type of pathogen chlamydia, gonococcus, etc.);
type of inflammation purulent, gangrenous, etc.);
disease course ( acute or chronic).

An additional classification is also possible based on the causes of the disease. As mentioned above, one of the causes of balanoposthitis may be tumors of the penis or the spread of infection from the upper urinary system ( kidneys, bladder). In these cases, we can talk about secondary balanoposthitis, since inflammation is a consequence of another pathological process. They speak of primary balanoposthitis if the process began precisely on the head or foreskin of the penis. As a rule, it is infectious and occurs due to microscopic damage to the skin.

Candida balanoposthitis

Candidiasis ( fungal) balanoposthitis is one of the variants of this disease, in which the main role of the causative agent of the disease belongs to yeast fungi. Most often it is C. albicans - a fungus that normally lives in the cavity of the female vagina and in small quantities on the skin, in the intestines, in the oral cavity. The fungus actively develops and causes skin lesions with a strong weakening of the immune system.

With candidal balanoposthitis, the disease has the following features:

often the disease begins with a slight plaque on the skin of the penis, itching, moderate redness;
the disease develops slowly, which is why patients in the early stages rarely go to the doctor;
treatment of the disease, as a rule, lasts longer than with bacterial balanoposthitis;
the likelihood of complications in the form of purulent abscesses or ulcers is much lower than with a bacterial infection;
without proper treatment, the fungus creates primary lesions on the skin, where a bacterial infection can enter.

In practice, candidal balanoposthitis without treatment often takes a chronic course. Sometimes, after the normalization of metabolic processes in the body and strengthening of immunity, the disease goes away on its own. During the formation of plaque and the manifestation of other symptoms, it is not recommended to have sex. A large number of fungi, which will fall on the mucous membrane of the partner's genital organs, will create a threat of developing vulvovaginitis or other similar lesions.

Chlamydial balanoposthitis

With chlamydial balanoposthitis, the microorganism Chlamydia trachomatis acts as the causative agent of the disease. The disease is one of the possible forms of urogenital chlamydia in men. This is a sexually transmitted disease. You can get infected from a sick partner during unprotected intercourse.

Balanoposthitis is not the most common and characteristic form of chlamydia. More often, microbes infect cells on the mucous membrane of the urethra. Other organs of the genitourinary system may also be affected. Chlamydia affects both men and women.

In men, along with balanoposthitis, lesions of the following organs can be detected:

urethra ( urethritis);
prostate ( chlamydial prostatitis);
epididymis ( epididymitis);
mucous membrane of the eyes chlamydial conjunctivitis).

In most cases, the primary site of infection is the urethra. From here, after a few days or weeks, the infection spreads to other organs. Balanoposthitis caused by chlamydia is not as aggressive as with many other bacterial infections. Usually there is discharge from the urethra, pain during urination, small lesions on the foreskin and glans penis. Direct tissue destruction in the form of ulcers or erosion is rare. However, it is urgent to seek treatment, as the disease is contagious and can be easily transmitted to a sexual partner. In addition, there is a high risk of spread of infection and the occurrence of chronic foci ( e.g. chronic chlamydial prostatitis), which are difficult to treat.

Another danger in chlamydial infection is the development of Reiter's syndrome. This is one of the manifestations of the body's autoimmune reaction to chlamydia antigens. This syndrome complicates treatment and aggravates the course of the disease. There may be more severe skin lesions ( rash) and joint damage.

Anaerobic balanoposthitis

Anaerobic balanoposthitis is a rather rare type of this disease. In this case, the causative agents of the disease are the so-called anaerobic bacteria. These are microorganisms that do not need oxygen to reproduce and grow. Moreover, some of them die at a high concentration of oxygen. Therefore, certain conditions are required for the occurrence of anaerobic infection.

First of all, it should be noted that skin lesions in these cases rarely develop. More often it is about deeper damage ( ulcers, deep areas of erosion, abscesses). That is, inflammation affects not only the surface of the penis, but also deeper tissues. In most cases, anaerobic infection leads to the formation of abscesses and tissue breakdown.

Several anaerobic microorganisms usually act as the causative agent of the disease, among which may be:

bacteroids;
porphyromonas;
fusobacteria;
peptococci;
peptostreptococci.

Particularly serious pathological processes cause clostridia. The pathogen can only be identified by microbiological analysis. It is important not so much to isolate a specific microorganism as to determine the sensitivity of pathogenic microflora to various antibiotics. This will help to quickly and effectively destroy pathogens. The deep lesions themselves sometimes require surgical treatment.

The development of anaerobic balanoposthitis is predisposed to injuries of the penis, wearing underwear that prevents the access of oxygen, non-compliance with personal hygiene, contamination of wounds with earth. This creates conditions for the entry and reproduction of anaerobic microbes. In comparison with other types of balanoposthitis, this one is more severe. Perhaps a general malaise, fever, severe pain, a serious violation of sexual and urinary functions.

Herpetic balanoposthitis

This type of balanoposthitis is due to the presence of the herpes virus ( usually type 2), which is a sexually transmitted disease. The virus enters the mucous membrane of the genital organs, penetrates the cells and may not manifest itself for a long time. One of the possible manifestations of the disease is herpetic balanitis or balanoposthitis. An exacerbation usually occurs when the immune system is weakened.

The herpetic form of the disease, as a rule, does not cause pronounced skin defects. The main visible symptoms are rash and redness. The rash is usually small, in the form of blisters ( vesicular) filled with light liquid. Herpetic inflammation causes severe pain, which at first can appear only during intercourse, and then at rest.

Rapid diagnosis and treatment of herpetic balanoposthitis is important for the following reasons:

this disease can be easily transmitted to a sexual partner;
the spread of infection to other organs is not excluded;
confirmation of the diagnosis will allow rapid initiation of antiviral treatment ( that is, the treatment is different from other forms of balanoposthitis);
the patient in the future must take into account the presence of a viral infection in his body.

Gangrenous balanoposthitis

The gangrenous form of balanoposthitis is perhaps the most serious and dangerous of all types of this disease. By itself, gangrene is tissue necrosis, which is caused by the ingress of dangerous pathogenic bacteria or a pronounced violation of blood flow. The gangrenous form of balanoposthitis is very rare. Redness and soreness of the glans penis gradually turn into severe swelling. The skin becomes darker, deep purulent ulcers and other defects appear. At the same time, the general condition of the patient is seriously deteriorating. The breakdown of tissues is accompanied by the ingestion of a large amount of toxic substances into the blood, which cause a rise in temperature, worsen the functioning of the heart, kidneys and other organs.

Almost always, the gangrenous form is a neglected form of other balanoposthitis. Tissue necrosis can occur as early as 1 to 2 weeks after the onset of severe symptoms of the disease. It is usually not possible to restore destroyed tissues. They are replaced by connective tissue with the formation of scars and adhesions. Quite often it is necessary to remove a significant amount of affected tissue. In this case, we are talking not only about the skin, but also about the cavernous body, part of the urethra, etc. ( depending on how far the gangrene has spread). Just antibiotic therapy without surgical intervention may not be able to cope with the bacteria, since the blood flow in the area of \u200b\u200binflammation is impaired. In severe cases, we can talk about the amputation of most of the penis.

Erosive balanoposthitis

Erosion in medicine is the complete or partial destruction of the epithelium ( surface layer) skin or mucous membrane. With erosive balanoposthitis, similar lesions appear on the foreskin and glans penis. Outwardly, they look like areas of red or pink color with a fairly clear border and a rough surface. These areas are very painful to touch or move the skin. Pain also occurs when urinating, as urine, which has an acidic pH, irritates damaged skin. The number of erosions can be different, as well as their area.

Erosive balanoposthitis is not necessarily the result of the multiplication of pathogenic bacteria. It can also occur with irritation or mild skin burns ( due to poor quality hygiene products), due to an allergic reaction or due to changes in the structure of the skin in severe autoimmune diseases.

Erosions can appear at the very beginning of the disease or complicate the course of simple balanoposthitis over time. As a rule, at first a pronounced reddened area appears on the surface, and only then does the roughness characteristic of erosion appear. Due to damage to the epithelium, pathogens often multiply on the surface of such defects, which slow down tissue regeneration and can deepen the damage. Perhaps the formation of plaque or pus, necrosis of the skin at the border of erosion. Also, after a while, the inguinal lymph nodes may increase.

As a rule, with erosive balanoposthitis, only the epithelium is damaged without complications, so scars and scars do not form after recovery. However, the recovery itself is delayed. Usually a course of antibiotics is required even for preventive purposes) and active local treatment.

Circinary balanoposthitis

The so-called circinary balanoposthitis is a relatively mild form of the disease. The disease is manifested by the appearance of spots on the skin of the glans penis. Usually they have well-marked borders and are distinguished by a more intense pink or reddish color. Most often there are no other symptoms, but sometimes irritation, burning, rash of various forms in the genital area may occur.

The cause of circinary balanoposthitis is Reiter's syndrome, which occurs as a consequence of chlamydia with the participation of the immune system ( autoimmune disease). This form is quite rare. An immunologist or rheumatologist can be involved for consultation before prescribing treatment.

Purulent balanoposthitis

With this form of the disease, the inflammatory process is complicated by the formation of pus on the surface of the skin or in the urethra. This is due to the ingress of a special, pyogenic microflora onto the damaged skin. These microorganisms are able to actively destroy normal tissues with the formation of pus. In this case, it is a mixture of the microbes themselves, leukocytes ( cells that fight infection) and dead tissue.

The main representatives of pyogenic microflora in purulent balanoposthitis are:

staphylococci;
streptococci;

Most often, the purulent form of the disease does not develop immediately. It is preceded by the usual catarrhal) inflammation associated with an allergic reaction or other provoking factors. Pyogenic microflora gets into the formed defects, and after a few days, the actual formation of pus begins. Another possible cause is the spread of a purulent process from the kidneys or bladder ( pyelonephritis or purulent cystitis). Then the infection of the foreskin occurs in the process of urination.

With a purulent form, there is an active destruction of tissues, which can subsequently lead to serious problems. In place of abscesses, areas of connective tissue may form, which make it difficult to open the glans penis and reduce sensitivity in this area.

In general, the purulent form is considered more dangerous than the usual inflammation. Symptoms with it are more pronounced, possibly an increase in body temperature, poor general well-being. Patients, as a rule, go to the doctor at the first sign of the appearance of pus. Sometimes elementary surgical manipulations may be required for more effective and faster treatment ( opening abscesses and washing them).

Acute balanoposthitis

Acute balanoposthitis is the most common variant of the course of this disease. As a rule, its duration is 1 - 2 weeks until a complete cure. The acute form most often occurs under the influence of specific provoking factors. This may be an infection with a sexually transmitted disease, microtrauma, an allergy to any hygiene products, etc. There is a rapid skin irritation or a pathogenic pathogen.

As a rule, acute balanoposthitis begins with pronounced and noticeable symptoms, among which pain in the area of the glans penis and redness of the skin in this area are in the first place. It is very important to consult a doctor and start treatment at this stage. The rapid onset of the disease may indicate the threat of severe forms of the disease. After a few days, pus or ulcers may form, which will greatly complicate the treatment. Self-treatment of acute forms or prolonged ignoring of symptoms is also fraught with chronic disease.

Acute balanoposthitis may well go away on its own. Catarrhal forms of inflammation are especially prone to this, when there is no serious tissue damage and abundant reproduction of pathogenic microbes. However, for a guarantee, it is still better to consult a doctor and exclude an unfavorable course.

Chronic balanoposthitis

Chronic balanoposthitis can last for months and even years with periodic exacerbations of the disease. Most chronic forms are the result of delayed or improper treatment of acute balanoposthitis. Sometimes they are also associated with the presence of serious predisposing diseases in the patient.

Chronic balanoposthitis often occurs with periodic exacerbations. They can be triggered by a variety of factors, among which the main role is played by mechanical load ( high sexual activity) and immunosuppression. In most cases, chronic balanoposthitis is associated with the presence of a specific infectious agent that is difficult to eliminate. Such an agent may be certain types of fungi, gardnerella or other microorganisms. A small amount of bacteria is constantly on the skin, but weakening of the immune system or microtraumas give impetus to aggravation.

In chronic balanoposthitis, the following manifestations of the disease are more common:

the appearance of plaque on the head of the penis and foreskin;
redness and irritation of the skin in this area;
subjective discomfort;
moderate swelling.

Over time, without adequate treatment, other, more pronounced symptoms may appear - pain, erectile dysfunction, difficulty urinating. It should be understood that the spontaneous subsidence of recurrence ( exacerbations) is not about recovery. The cause of inflammation remains and poses a potential threat to the spread of the pathological process to the urethra, prostate and other organs.

Also, balanoposthitis acquires a chronic course in some autoimmune diseases. Since many of them are genetically determined and the mechanism of their occurrence is not fully known, these pathologies are not completely cured. Regular intake of various drugs can reduce the frequency of exacerbations to a minimum. However, a complete recovery does not occur. During the period of exacerbation, catarrhal balanoposthitis may develop, which after a few days is complicated by an infection. In medical practice, balanoposthitis against the background of chronic autoimmune diseases are rare.

Other types of balanoposthitis

Some experts consider other types of balanoposthitis, highlighting certain signs or symptoms as leading ones. These forms are not recognized by all and not in all countries, although from the point of view of medicine they are sometimes quite justified. These forms are quite rare.

Sometimes you can find the following forms of balanoposthitis:

Traumatic balanoposthitis. The traumatic form is sometimes spoken of in cases where the root cause of inflammation was some kind of injury. It can be obtained in case of intentional damage or tearing of the skin ( e.g. insufficient lubricants). In fact, the inflammatory process is caused by a bacterial infection that has entered the wound. Accordingly, we are talking about purulent, catarrhal or gangrenous balanoposthitis. Patients usually do not delay treatment, as the injury itself causes pain.
Gardnerella balanoposthitis. This form of the disease is named after the bacteria that causes inflammation. Gardnerella in small numbers normally live on the vaginal mucosa. In men, they can cause mild inflammation if the immune system is weakened. In isolation, gardnerella almost never affect the penis. More often they are isolated as part of a mixed infection.
Xerotic balanoposthitis. This type of balanoposthitis is rare and is currently poorly understood. It is characterized by the appearance of one or more pale spots on the glans penis, the surface of which is usually wrinkled and devoid of sensation. The disease can occur at any age, but is more common after 45 - 50 years. It is believed that xerotic balanoposthitis without treatment and regular monitoring by a doctor may eventually ( during the years of illness) to become malignant.
Ulcerative hypertrophic balanoposthitis. This form may occur if the disease lasts for many months with occasional relapses ( exacerbations). It is quite common in serious chronic metabolic diseases. Violations in the body make it difficult and slow down the complete healing of skin defects. Because of this, deep ulcers form on the skin, which then become covered with a crust, then open again. The edges of the ulcers become more convex, and the penis itself increases somewhat in size due to swelling and thickening of the stratum corneum. In this case, erectile function is gradually impaired. Treatment of the disease at this stage is quite difficult, and sometimes doctors fail to achieve a full recovery.
Indurative balanoposthitis. This form occurs in the chronic course of the disease. Long-term inflammation is seen by the body as a potential health threat. Therefore, the tissues in the area of inflammation gradually coarsen. The foreskin and the head of the penis gradually lose their sensitivity, wrinkle, change color somewhat. This may cause erectile dysfunction, difficulty urinating ( due to narrowing of the urethra).
Toxic balanoposthitis. This form is one of the rarest, as it is difficult to diagnose. The form of inflammation in this case may be different ( simple, erosive, etc.), but various toxic substances are the cause. These substances do not necessarily reach the glans penis, but may also be inhaled or ingested through food. In other words, during the examination, the doctor has no reason to associate any poisoning with inflammation of the penis. However, in practice this is possible. We are usually talking about toxins that affect blood vessels. Accordingly, only the vessels of the penis are affected ( and it is very rare) will cause an inflammatory process, the appearance of appropriate symptoms, and then the addition of an infection. It is very difficult to recognize toxic balanoposthitis in the early stages, since there are so many types of different toxins.
Adhesive balanoposthitis. This form is characterized by the formation of a sticky liquid on the surface of the head. This can make it difficult to retract the foreskin. The reason for the formation of such a plaque are some types of bacteria. As a rule, there are no deep skin lesions. However, forcible retraction of the foreskin and exposure of the glans can lead to skin damage. Then the formation of pus or ulcers is possible, since through the defects the bacteria will penetrate deeper into the tissues. It is best to immediately consult a doctor with this form. Just a couple of days of proper treatment usually leads to the complete elimination of sticky plaque.

Thus, there are many types and variants of the course of balanoposthitis. Some of them have a favorable prognosis, while others can seriously threaten the patient's health. It is very important for doctors to identify at the very first stages of the disease what form of the disease they are dealing with. In this case, it is easier to prescribe the correct treatment and help the patient faster.

Before use, you should consult with a specialist.

This is an inflammation of the glans penis and prepuce. Symptoms are pain, swelling, rashes, accumulation of secretions in the preputial sac. The diagnosis is established during a physical examination, to determine the cause, laboratory diagnostics are carried out: microscopy of a smear from the urethra, bacteria culture and antibiotic sensitivity, PCR tests for STIs. A skin biopsy is performed in the absence of positive dynamics during therapy to exclude a neoplastic process. Treatment depends on the pathogenetic factor, can be conservative (antibiotics, antihistamines, corticosteroids), with tumor pathology and in the absence of an effect, surgical.

ICD-10

N48.1

General information

Balanoposthitis more often develops in boys aged 1 to 5 years and in men with high-risk sexual behavior (polygamous relationships, non-traditional orientation, penile-anal contacts). Experts say that 30-50% of men experience inflammation of the head of the penis and prepuce, expressed to one degree or another, at least once, this pathology accounts for 11% of all visits to the urologist. Most cases respond to conservative therapy. Balanoposthitis of candidal etiology is especially difficult in people with decompensated diabetes mellitus, AIDS, severe hypovitaminosis. The recurrent course often provokes cicatricial phimosis, which requires hospitalization in the department of clinical urology and surgery.

Causes of balangoposthitis

A certain role belongs to immunosuppressive disorders of any origin (reception of antibiotics or hormones, chemoradiotherapy, concomitant severe generalized infection). Inadequate hygiene leads to the multiplication of microflora in smegma, which initiates inflammation. In older men, balanoposthitis develops due to sclerotic processes between the head and prepuce skin in the absence of a sexual life. The condition causes many diverse etiological factors:

Specific diseases. Neisser's gonococci, trichomonas, chlamydia are the most frequently detected pathogens in genital infections. In 35-50% there is a combined composition of microflora. Urogenital candidiasis in 90% is complicated by inflammation of the head and prepuce. Also, an inflammatory reaction in this area is diagnosed against the background of herpes, HPV and donovanosis.
Nonspecific diseases. In a child, inflammation of the genitals can develop with childhood infections, SARS, tonsillitis. In adults, the cause of balanoposthitis is chronic diseases of the urogenital area: prostatitis, urethritis, orchiepididymitis. Staphylococcus aureus, group B streptococci are the most commonly isolated bacteria. Recurrent balanoposthitis occurs in all patients with cicatricial changes in the prepuce.
Traumatization. Violation of the integrity of the skin as a result of a bite, infringement of the zipper of trousers, tear of the frenulum during sexual contact or aggressive masturbation are the entrance gates for infection. The microflora can spread from the urethra during catheterization, bougienage. Secondary inflammation joins after urological operations. Sometimes balanoposthitis provokes a smegmolite stone formed in the prepuce due to thickening of the infected smegma.
Dermatological pathology. In men who are forced to use urocondoms or diapers due to incontinence, contact dermatitis and secondary balanoposthitis develop on the head of the phallus and the foreskin due to constant irritation with urine. Psoriasis, lichen planus, lichen sclerosus, etc. are accompanied by inflammatory changes in the genitals. Bowen's disease and Queyre's erythroplasia, both predictors of penile cancer, have similar manifestations.

Pathogenesis

Agents that cause balanoposthitis are divided into infectious (pathogenic, opportunistic microorganisms) and non-infectious (trauma, burns, contact with chemicals, etc.). In the genital area, the circulatory and lymphatic networks are extremely developed, which is manifested by pronounced exudation during inflammation, up to the development of phimosis and paraphimosis. Elevated temperature and humidity in the prepuce, the alkaline reaction of smegma (and glucose in diabetes mellitus) contribute to increased reproduction of aerobic and anaerobic microorganisms and viruses.

Violation of hygiene rules, as well as frequent contact with aggressive environments, lead to the implementation of pathogenic properties in conditional pathogens or to the predominance of pathogenic microflora over conditionally pathogenic. In children, balanoposthitis often develops after rough retraction of the foreskin with phimosis, prolonged stay in diapers, or with the generalization of any infectious disease.

Classification

Balanoposthitis can be primary or accompany any pathological process (DM, tumor). According to the type of pathogen, specific and nonspecific balanoposthitis are distinguished, according to the nature of the course - acute or chronic, complicated or uncomplicated. Specialists use a classification that takes into account the predominance of clinical manifestations, on the basis of which the following forms are distinguished:

Simple catarrhal. The inflammatory process is slightly expressed, there are areas of hyperemia on the head of the penis and foreskin. This form is typical for men with latent STIs, for age-related patients with a burdened premorbid background (DM, metabolic syndrome, cardiovascular insufficiency).
papular. Hyperemia is moderately expressed, but nodular elements are visualized. This type of balanoposthitis is associated with lichen planus, psoriasis, and Queir's erythroplasia.
Scleroatrophic. It occurs in the elderly; on examination, you can see cracks, erosion, areas of sclerosis and atrophy with a slight background hyperemia. Cicatricial phimosis is typical.
Verrucous and vegetative. The appearance of growths and vegetations is preceded by papillomavirus infection, urogenital tuberculosis, etc. Moderate hyperemia.
Granulomatous. It is typical for patients with severe immunosuppression as a result of the progression of opportunistic infections, for example, generalized urogenital candidiasis. Granulomatous growths accompany chronic recurrent balanoposthitis.
Vesicular. Redness of the skin and the appearance of vesicles are preceded by severe itching. A typical example is herpetic eruptions accompanied by reactive balanoposthitis.
Pustular. Hyperemia is variable (from slight redness to severe), multiple pustules are visualized (for example, balanoposthitis against the background of donovanosis).
bullous. The appearance of blisters on the hyperemic skin indicates the toxic-allergic nature of the disease. The size of the blisters varies, without treatment and with continued contact with the provocative agent, erosions form.
Erosive and erosive-ulcerative. It occurs in a number of pathologies: syphilis, Vincent's disease, tuberculosis.
Gangrenous. Associated with chancre, may also precede fulminant Fournier's gangrene. The most severe type of balanoposthitis with probable self-amputation of the penis and the development of lethal complications.

Symptoms of balanoposthitis

Clinical manifestations are variable, depending on the pathogen, the severity of the process, concomitant pathology. The nature of skin rashes is different. For all types, edema, hyperemia (of varying severity), soreness, restriction of the mobility of the foreskin are common, with dermatological pathology - skin itching. The most favorable catarrhal form manifests itself clearly: patients complain of excruciating itching, severe pain in the affected area, burning during urination, swelling of the skin of the prepuce and head.

With fungal balanoposthitis, as the infection progresses, deep cracks appear, due to increasing infiltration, the foreskin does not move. The discharge is whitish, with a kefir smell, films may be present on the surface of the inner leaf of the flesh and the head, after their removal a bleeding wound remains.

Herpetic balanoposthitis is manifested by characteristic transparent vesicles-vesicles, their contents gradually become cloudy, and the element itself resolves with the formation of a yellow-brown crust. The temperature may rise, the general condition suffers: weakness, chills, loss of appetite. Some patients have enlarged regional lymph nodes. The severity of the pain syndrome is due to the involvement in the process of the nervous tissue, where the virus persists.

The more weakened the immune response, the higher the likelihood of the transition of the vesicular form into erosive-ulcerative and gangrenous inflammation. In the gangrenous form, the general condition is severe, which can be explained by intoxication and fever, the genital organ is sharply enlarged in size, pus and ichor flow out of the tissues. Tachycardia and pressure drop may be present, which is a predictor (harbinger) of a possible bacteriotoxic shock.

Chronic balanoposthitis has blurred symptoms: episodic hyperemia, there is no pronounced discharge from the prepuce, discomfort increases after sexual contact, physical activity. The use of acute and alcohol exacerbates adverse symptoms. Chronization of the process often leads to atrophy, while the skin of the genitals is dry, wrinkled, thin, easily injured and periodically bleeds.

Complications

Complications are represented by phimosis (if balanoposthitis is primary), frequent recurrences of infectious and inflammatory processes of the urinary tract, impaired sexual function. The likelihood of developing penile cancer is higher in patients with phimosis and balanoposthitis. Cases of the formation of smegmolites (stones from smegma) in the prepuce are described. In children, the infection often spreads to the upper urinary tract (pyelonephritis, hydronephrosis). With the gangrenous type, self-amputation of the penis can occur. Against the background of a weakened immune system, fungal septicemia develops, bacteriotoxic shock.

Diagnostics

The etiological factor of inflammation of the head and skin of the preputial sac needs to be clarified. A morphological study is justified if balanoposthitis does not go away against the background of persistent treatment. Instrumental diagnostics is not required, except for a neoplasm of the penis with reactive inflammation. Laboratory diagnostics is aimed at a comprehensive examination, including the identification of diseases that support balanoposthitis (DM, AIDS, atherosclerotic processes, circulatory disorders). The diagnostic algorithm includes:

History taking and examination. A urologist establishes a connection between inflammation and a causative factor: traumatization, unprotected sexual intercourse, taking antibiotics, using spermicides, etc. It is impossible to establish a provocative factor in 30%. On examination, the nature of the rashes, the state of regional lymph nodes are assessed.
Laboratory tests. Initially, smear microscopy is performed. With an increase in the number of leukocytes, bacteria, further examination is indicated: PCR analysis for STIs, sowing of biomaterial on nutrient media. Testing for HIV, syphilis. If there is information about the patient's trip to endemic areas, it is justified to undergo a diagnosis for donovanosis. If genital tuberculosis is suspected, a consultation with a phthisiourologist and special tests are recommended.

Balanoposthitis treatment

Therapeutic measures depend on the cause, priority is given to the treatment of the underlying disease. The patient is explained the need for personal hygiene. With venereal genesis, both partners receive drugs. Men with allergies should avoid irritants (scented soaps, gels, cosmetic sprays). During intercourse with insufficient moisture, you can use a neutral lubricant. Treatment options for balanoposthitis include:

Systemic drug. Antibacterial drugs are prescribed to suppress the secondary infection that has joined, antihistamines and corticosteroids - for itching and allergic manifestations. For herpes, HPV infection, antiviral drugs and immunomodulators are used. Antifungal drugs are used in combination with hormone therapy for candidiasis against a background of weakened immunity, with generalization of lesions.
Local. Hormonal, antibacterial and antifungal drugs can be applied topically in the form of creams, ointments, sprays. Irrigation with antiseptic solutions contribute to the relief of symptoms in a bacterial infection. Children are prescribed warm baths with decoctions of herbs that have anti-inflammatory effects.
Operational. Complicated balanoposthitis occurring against the background of dermatological diseases, accompanying cancerous and precancerous pathologies, with cicatricial phimosis is an indication for surgical treatment - circumcision (circumcision). If the cause of the inflammation is phimosis with a narrow foreskin ring, preputioplasty may be performed. With a concomitant tumor of the penis, the volume of the operation depends on the type of neoplasm and stage.

Forecast and prevention

The prognosis for primary uncomplicated balanoposthitis is favorable, for the secondary it depends on the concomitant pathology. If conservative measures are ineffective, surgical treatment always relieves unpleasant symptoms. Prevention involves observing the rules of intimate hygiene, avoiding casual sex without a condom, and undergoing regular preventive examinations by a urologist. Careful care is needed for the genitals of boys: diapers should be changed in a timely manner, diaper rash should be prevented, and the head of the penis should not be roughly moved during physiological phimosis.

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Causes of balanoposthitis

Symptoms of balanoposthitis

Symptoms of balanoposthitis at different stages of the disease

Symptoms of balanoposthitis caused by certain sexually transmitted infections

Specific symptoms of some types of balanoposthitis caused by non-infectious causes

Features of balanoposthitis in children

Diagnosis of balanoposthitis

Balanoposthitis treatment

Local procedures for balanoposthitis

Antibacterial therapy for balanoposthitis

Surgical treatment for balanoposthitis

Prevention of balanoposthitis:

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Forms and types of balanoposthitis

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Herpetic balanoposthitis

Gangrenous balanoposthitis

Erosive balanoposthitis

Circinary balanoposthitis

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Chronic balanoposthitis

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ICD-10

General information

Causes of balangoposthitis

Pathogenesis

Classification

Symptoms of balanoposthitis

Complications

Diagnostics

Balanoposthitis treatment

Forecast and prevention

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