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Tuesday, March 25, 2008

Balanitis

Balanitis is inflammation of the glans penis (from Greek: βάλανος balanos "acorn"). When the foreskin (or prepuce) is also affected, it is termed balanoposthitis.
Lack of aeration and irritation because of smegma and discharge surrounding the glans penis causes inflammation and edema.

Causes:
Inflammation has many possible causes, including irritation by environmental substances, physical trauma, and infection by a wide variety of pathogens, including bacteria, virus, or fungus—each of which require a particular treatment.
While any man can develop balanitis, the condition is most likely to occur in men who have a tight foreskin that is difficult to pull back, or who have poor hygiene. Diabetes can make balanitis more likely, especially if the blood sugar is poorly controlled.
Many studies of balanitis do not examine the subjects genital washing habits. However, scientists reported that failure to wash the whole penis, including retraction of the foreskin in uncircumcised men, is more common among balanitis sufferers. Birley et al., however, found that excessive genital washing with soap may be a strong contributing factor to balanitis.

Symptoms:
The incubation period varies from 3 days to 1 week. The first signs of involvement may be small red erosions on the glans or undersurface of the prepuce, with concomitant development of much preputial exudation; the purulent discharge may be accompanied by phimosis. If the disease is unchecked, confluent ulcerations will develop along with considerable edema of the penis.

Diagnosis:

Diagnosis may include careful identification of the cause with the aid of a good patient history, swabs and cultures, and pathologic examination of a biopsy.

Treatment:
Since anaerobic conditions are necessary for growth of the offending organisms, simple exposure to air and local cleansing is most often effective. Formerly, this treatment, used with peroxide powder and arsphenamine and, in severe cases, a dorsal slit, was the extent of therapy. With the advent of penicillin and other systemic and local antibiotics, the treatment is specific and effective; however, even now a dorsal slit procedure is sometimes necessary.

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