Balanitis is an inflammation of the glans, which is the final part of the penis. The glans is the final portion of the corpus spongiosum, which is the smallest of the three columns of erectile tissue found in the penis (the other two are the corpora cavernosa, which are two parallel structures located on top of the penis).
This disease produces in almost all cases redness of the glans and foreskin, and other lesions may appear at that level such as blisters, erosions or whitish or grayish spots, depending on the cause that produces it. When there is inflammation, there is pain in the vast majority of cases, and it may also be associated with itching and burning. The intensity of these symptoms is variable. In addition, it is not uncommon for other alterations to appear, such as the emission of foul-smelling secretions.
It can be caused by multiple causes, the most common being lack of intimate hygiene in uncircumcised patients and the use of soaps, perfumes or condoms that contain chemical substances that irritate the glans. Although there are many other reasons that can cause it, ranging from trivial conditions to more serious premalignant lesions. The most important causes of the appearance of balanitis are: Fungal Infections (Candida albicans), Bacteria of different types (G. Vaginalis, Group A Streptococcus, Staphylococcus aureus, T. vaginalis or syphilis) or Viruses such as the herpes virus, of human papilloma (HPV), Dermatological diseases such as Lichen sclerosus, Balanitis circinata, Psoriasis, Pemphigus, Premalignant lesions, such as erythroplasia of Queyrat or Bowen’s disease.
The anamnesis (interview of the specialist with the patient to know their symptoms and condition) and the clinical history are a very important pillar in the diagnosis of balanitis –inflammation of the glans penis– and balanoposthitis –inflammation of the foreskin–. In some cases, such as balanitis caused by drugs (fixed drug erythema), an anamnesis directed towards the use of drugs in the previous days is essential to achieve the diagnosis. The same occurs in balanitis caused by irritants or in those related to poor hygiene.
Physical examination is also essential, since although the clinical presentation is similar in many cases, there are some peculiarities depending on the cause of balanitis. The appearance of the lesions and their characteristics allow the doctor to make a suspected diagnosis.
Many times the diagnosis of balanitis can be made with the anamnesis and a detailed physical examination, without the need for additional tests, but there are conditions in which other tests such as skin biopsy are necessary to rule out premalignant lesions . If there are doubts about the diagnosis, a biopsy can also be performed. Another frequently used test is the culture of a sample obtained from the glans or foreskin lesions.
General measures to treat balanitis include washing the area with warm water or saline a couple of times a day and avoiding soaps or other substances that may be irritating while there is inflammation of the glans.
And it is that, with an adequate hygiene of the penis, many cases of balanitis can be avoided. To do this, it is necessary to wash it completely, which includes retracting the foreskin to expose the glans, thus being able to clean it comfortably. This prevents the accumulation of dirt in the frenulum and on the glans. Subsequently, the area will be dried as is done with the rest of the body. Excessive washing is not good, as it favors the appearance of irritation.
If the cause of balanitis is a sexually transmitted disease, the basic recommendations indicated by the primary care doctor or the specialist doctor for your specific case must be adopted.
And it is that, with an adequate hygiene of the penis, many cases of balanitis can be avoided. To do this, it is necessary to wash it completely, which includes retracting the foreskin to expose the glans, thus being able to clean it comfortably. This prevents the accumulation of dirt in the frenulum and on the glans. Subsequently, the area will be dried as is done with the rest of the body. Excessive washing is not good, as it favors the appearance of irritation.
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