Inflammation of the foreskin in men causes. Causes and treatment of inflammation of the foreskin in men. The development of balanoposthitis at an early age

If the cause of the development of balanoposthitis is a microbial infection (for example, gonorrhea, trichomoniasis, mycoplasmosis, etc.), then along with local treatment with ointments, antibiotics are used in tablets. The choice of medication depends on the type of infection and is determined only by the attending physician.

For allergic dermatitis, the doctor may recommend taking antihistamines (antiallergic) drugs. To eliminate inflammation in contact dermatitis, it is very important to identify and eliminate the irritating factor (allergen). Cm. .

Is surgery necessary for balanoposthitis?

As a rule, balanoposthitis can be cured with medication, and surgical treatment is not necessary. But if the cause of balanoposthitis is phimosis (narrowing of the foreskin) in an adult male, or the disease often worsens, then an operation can be performed. Usually, surgical treatment of balanoposthitis is to remove the foreskin (circumcision).

Prevention of balanoposthitis in adults

1. Regular toilet of the genitals is the main way to prevent inflammation of the glans penis and foreskin. Take a shower and change your underwear at least once a day. During washing, the foreskin should be retracted, the area should be cleaned of possible secretions, and then the foreskin should be returned to its normal position. Carefully select products for intimate hygiene, rinse well with soap or shower gel from the skin.
2. Use condoms if you are not sure that your partner does not have a sexually transmitted disease.
3. If redness appears in the area of ​​the glans penis and foreskin, the inability to pull the foreskin and expose the head (phimosis), pain during erection and urination, be sure to consult a urologist.

Prevention of balanoposthitis in children

The main measure for the prevention of balanoposthitis in a child is proper hygiene. The following tips and tricks will help you properly care for your baby and avoid many problems (balanoposthitis, diaper dermatitis, dysbacteriosis, etc.)

Caring for a boy in the first two years of life:

1. Choose diapers that are appropriate for your baby's size. Diapers of the wrong size will chafe the baby's skin when moving.
2. Diapers should be changed at least once every 4-6 hours, or immediately after the child has had a bowel movement.
3. Before putting on a new diaper, be sure to clean the baby's skin in the perineal area. All intimate hygiene products for a child should be hypoallergenic (non-irritating to the skin).
4. After washing (especially if the baby's skin is dry or reddened), it is recommended to apply moisturizers to the skin of the perineum, for example, Topicrem emulsion, D-Panthenol, etc.
5. Air baths are very important. After you have removed the diaper and cleaned the skin in the perineal area, put on a new diaper not immediately, but after 10-15 minutes. During this time, the skin of the genitals, perineum and buttocks will dry out.
6. Wash your baby's genitals just like you would any other part of his body. Rinse any soap off your baby's skin thoroughly.
7. If the foreskin (the skin covering the head of the penis) is narrow and the head is not exposed, then in no case should it be forcibly pushed back. In children under 3-5 years old (and sometimes before puberty), a narrow foreskin is a normal phenomenon that does not require treatment.

Genital care for a boy over 2 years of age:

1. Your child's interest in his own penis is quite normal - this is one of the stages of growing up and getting to know your body. However, it is not advisable for a child to touch the genitals with dirty hands.
2. Once the foreskin is easy to retract and expose the glans penis, teach your child to independently retract the foreskin while washing and clean the area. After washing, be sure to return the foreskin "in place".
3. The child should take a shower or bath, and change underwear every day.
4. If redness appears in the genital area or perineum, the child is anxious during urination, fever and other signs of balanoposthitis, consult a doctor.

Inflammation of the foreskin in men (balanoposthitis) is a common disease of the genital organs. This is caused by infections located in the internal intimate areas. Often these are STDs caused by trichomoniasis, chlamydia, herpes, gonorrhea (gonorrhea).

Pathogens (viruses, fungi, bacteria) give rise to periostitis of the foreskin. Edema, redness can cause not only illness, but also neglect of personal hygiene. How to avoid inflammation, what you need to know about infection, prevention - our article is about this and many other things.

Causes of inflammation

The foreskin and the head of the penis form a preputial sac, where excretions, waste products such as urine residues, sebaceous glands, sweat - smegma are collected during the whole day.

By itself, it does not cause irritation, but becomes the basis for the reproduction of pathogenic bacteria.

The following reasons may contribute to this:

• Improper hygiene behind the intimate part of a man. Daily care of the preputial sac is the key to health. Do not abuse this procedure, you can harm yourself.
• When hygienic manipulations, it is necessary to use means that do not cause irritation, some lead to inflammatory consequences.
• The use of high-quality condoms will prevent negative processes.
• Allergic dermatitis, urticaria.
• STD.
• Viruses, fungi (candidiasis, herpes, papilloma).
• Increased sugar in the urine causes irritation of the foreskin, wounds, ulcers.
• Underdevelopment, defects of the penis.

stages

Primary, unpleasant sensations develop, redness of the head, burning, pain. Small rashes and sores may appear.

Erosive, when ulcers appear on the penis with high edges, dead epithelium, edema appears. With timely treatment, it does not scar.

Gangrenous, when deep necrotic ulcers appear on the head, foreskin, leaving keloid scars, the sensitivity of the organ disappears. May lead to neoplasms.

Treatment

At various stages, differential therapy is prescribed. When the first signs appear, local ointments, antibacterial drugs are used. Tests are given to determine the infection that provoked the inflammation.

At the erosive stage, when ulcers appeared, there is a danger of infringement of the head, stagnation of lymph in the groin area, swelling of the penis. Various therapies are used. Drugs are prescribed to improve blood circulation, antibiotics, medical procedures.

When pus appears, the general condition worsens, intoxication begins. Depending on this, urgent treatment is prescribed. The disease spreads rapidly, affecting other organs. There is a narrowing of the foreskin, possibly surgery.

• High-quality implementation of hygiene procedures.
• Rinse the head of the penis with decoctions of herbs, a solution of manganese, hydrogen peroxide.
• The use of external anti-inflammatory ointments.
• Drink drugs to strengthen the immune system, vitamin complexes.
• Lead a healthy lifestyle, stop drinking alcohol, smoking.
• When infected with a fungal infection, use ointments (clotrimazole).
• Sexual relations are limited during treatment.
• With a strong lesion, antibiotics are prescribed (after finding out the cause of the infection).
• When the temperature rises, paracetamol is used.
• In the purulent stage of the disease, long-term use of antibacterial drugs, compresses on lesions with ointments, and thorough hygiene procedures are needed.
• Mandatory delivery of repeated tests to avoid relapses.

Alternative medicine

Folk remedies are very effective. You can get rid of the disease without antibiotics and drugs.

But before starting treatment, we must remember that many plants have contraindications. To do this, you can use the following recipes:

Aloe leaves are considered wound healing, bactericidal. Apply the cleaned layer on the inflamed area several times a day, changing it until the symptoms disappear completely.

Sage tincture is used for washes, applications (10-15). 2st.l/0.5st. boiling water insist 20 min.

The infusion of St. John's wort 1st.l / 1st hot water helps well. You can do applications, baths, just rinse during the day.

A good effect for healing wounds, sores has oak bark. Due to tannins, it tightens well on the mucous membrane of the genital organs. To do this, boil a spoonful of bark in a glass of water for 20 minutes, insist, rinse or do baths 1 time per day.

Plantain has anti-inflammatory properties. Its leaves can be applied to the affected areas, after washing well in hot water, slightly crushing so that the juice appears.

Apply the bandage for half an hour, change every 4 hours. You can use decoctions of chamomile, calendula. They have an anti-inflammatory effect.

Effects

With untimely treatment, a mild form can turn into a severe one with serious consequences, while the man experiences discomfort. Why you need to see a doctor:

• If left untreated, the infection will spread to the internal organs, causing cystitis, urethritis, prostatitis.
• Unpleasant sensations in the groin, itching, burning during the outflow of urine.
• Cracks, ulcers, swelling can lead to serious infections.
• Inability to lead a full sexual life.
• Nervous breakdowns, depressive states, aggressiveness.
• Severe cases lead to cancer.
• Inflammation of the foreskin of the head of the penis may be the result of diseases of the urogenital area.

At the first sign, you should consult a doctor to determine the cause. Self-medication can lead to complications.

Balanoposthitis is a disease characterized by inflammation of the foreskin. It is also accompanied by irritation of the head and other unpleasant symptoms that interfere with daily life. Let's consider what is inflammation of the foreskin in men, the reasons for its occurrence, as well as the most effective ways treatment.

Background of the disease

There are a number of prerequisites that cause balanoposthitis. Inflammation of the foreskin of the penis may occur as a result of exposure to such irritating factors:

1. Non-compliance with the rules of personal hygiene. Too rare or excessively frequent washing of the male genital organ leads to a violation of the microflora. A man in this way creates favorable conditions for the active life of pathogenic microorganisms.
2. Pathology of the foreskin. They can be both congenital and acquired. The most common diseases that cause inflammation of the head and foreskin in men are: strictures, paraphimosis, phimosis, etc.
3. Prolonged wearing of uncomfortable, tight underwear made from poor-quality material. In such cases, the glans and foreskin are subjected to regular friction, which leads to cracks and other damage to the penis. As a result of this impact, enlargement of the foreskin in men, that is, a strong puffiness.
4. Diseases of the genitourinary system, which are characterized by inflammation.
5. Severe hypothermia.
6. Promiscuous sex without the use of condoms. During unprotected sexual contact, infectious diseases are transmitted to a man, the main symptoms of which are inflammation under the foreskin.
7. A sharp decrease in immunity. In this case, the man is subject to active development diseases of the head and foreskin.
8. Somatic diseases. Balanoposthitis often develops with diabetes, psoriasis, etc.

Inflammatory processes on the foreskin spread rapidly. Therefore, after a while, the man has inflammation of the head and foreskin.

Causes and symptoms of the disease

If there is inflammation of the foreskin in men, the causes of its appearance can be divided into infectious and non-infectious. Let's take a closer look at each of these reasons.

Inflammation of infectious etiology

Diseases of the foreskin in men caused by pathogenic microorganisms. The most common microbes in this case are:

• trichomonas;
• gonococci;
• mycoplasmas;
• chlamydia;
• gardnerella;
• human papilloma virus;
• genital herpes.

Beyond what's going on inflammation of the frenulum of the foreskin infections cause additional symptoms such as:

• head change;
• severe swelling;
• the appearance of plaque under the foreskin, which causes an unpleasant odor;
• itching, burning and other discomfort in the groin.

If a male foreskin pain, then pain is gradually added to this characteristic symptom at the time of urination, as well as during sexual contact.

Inflammation of a non-infectious nature

There are times when inflamed foreskin in a man as a result of somatic diseases. The most common non-infectious pathologies are:

• psoriasis;
• red lichen;
• pemphigus;
• diabetes.

Also, inflammation in men can develop as an allergic reaction to a specific irritant. This can also be the natural lubricant of the partner, released at the time of intimacy.

Common signs of inflammation of the foreskin, regardless of the cause of their appearance:

• severe burning, gradually developing into acute pain;
• when probing the penis, a man experiences severe unbearable pain;
• an increase in body temperature, especially for infectious diseases;
• headache;
• nausea;
• eruptions along the penis.

Also, the process of urination is disturbed in a young man. He experiences too frequent urge to go to the toilet.

Diagnosis of the disease

In order to get rid of inflammatory processes in men as quickly as possible, you need to seek help from a specialist at the first sign of malaise. A urologist can diagnose and treat. After a detailed examination of the patient, the doctor will take a swab from the head of the penis. To establish an accurate diagnosis, that is, to identify the true cause of the disease, a young man is sent for such studies:

• bacteriological culture;
• testing for exclusion of syphilis;
• analysis of secreted fluid from the urethra.

Based on the results of the studies, each man is assigned the appropriate treatment, which is determined on an individual basis.

After determining the exact cause of the appearance of balanoposthitis, it is required to immediately begin its treatment. During the period of therapy, a man must adhere to the following rules:

1. Abstinence from sexual contact. If a inflamed head and foreskin, treatment provides for sexual rest for this period.
2. Compliance with personal hygiene. Washing the penis regularly should be done, but excessive washing with soap should be avoided. This disrupts the local microflora.
3. Treatment at the local level. The use of drugs intended for local treatment is aimed at relieving inflammation and eliminating other unpleasant symptoms that accompany the disease.
4. The use of antibacterial and antiviral drugs. They are appointed strictly on an individual basis, if balanoposthitis was caused by the active development of pathogenic microorganisms.

A regular partner should also undergo treatment if inflammation of the head and foreskin in a man caused by infection.

If observed inflammation of the head and foreskin in men, how to treat, let's look at it in more detail.

Medical therapy

The basis for the medical treatment of inflammatory processes on the foreskin is the use of ointments, creams or solutions for topical application. Usually these are antibacterial and anti-inflammatory drugs. The most common are the means of the glucocorticosteroid group of combined action.

If balanoposthitis was caused by the ingress of pathogenic microorganisms, then the patient is prescribed antiviral and antifungal creams and ointments.

It's important to know! Regardless of the cause of the inflammatory process, a man is also prescribed a course of complex vitamins aimed at strengthening the immune system!

Surgical treatment

Diseases of the head and foreskin in extremely rare cases require surgical intervention. This only happens when the forms are running. A severe stage of balanoposthitis can lead to the development of phimosis, as a result of which blood circulation and metabolic processes are disturbed at the local level. Prolonged exposure to this condition can lead to men's health to dangerous consequences.

Alternative medicine

Traditional medicine is actively used in the treatment of inflammation of the head and foreskin in men. Their use is aimed at eliminating the unpleasant symptoms of pathology. Usually, alternative medicine drugs are prescribed as an additional method of exposure. In combination with drug therapy, they help speed up the healing process.

At an early stage of the inflammatory process, using folk methods, you can get rid of the disease for 1-2 weeks. If balanoposthitis was caused by pathogenic microorganisms, then treatment may take a longer period of time. Treatment is usually prescribed for about 1-3 months.

List of effective drugs

Modern pharmacology offers a significant number of medications aimed at eliminating inflammatory processes in men. Depending on the severity of the symptoms, the attending physician prescribes the following drugs:

1. Anti-inflammatory drugs. These include antibacterial ointments, creams, solutions. With proper and regular application, they relieve inflammatory processes.
2. Painkillers. Burning, itching and irritation of the foreskin in men is treated with the help of painkillers ointments.
3. Restorative drugs. They have a regenerating effect, so you can get rid of cracks in the penis.
4. Antimicrobial and antifungal medicines. These drugs suppress the activity of pathogenic microorganisms, that is, inflammation of an infectious nature.

Let us consider in more detail the most common and effective drugs that help relieve inflammation and pain in balanoposthitis.

Zinc ointment

This drug has an antimicrobial and anti-inflammatory effect. It is prescribed in the treatment of inflammation of the foreskin caused by infection. Regular use of Zinc Ointment helps to get rid of swelling, redness and irritation, and this medicine also has a drying effect.

Pimafucin

This is an antifungal ointment, which is prescribed for balanoposthitis caused by the active development of pathogenic microorganisms. Pimafucin is one of the most gentle antifungal drugs on the modern pharmacology market, therefore it does not cause side effects.

Triderm

This is a combined drug that contains antimycotics, glucocorticosteroids and antibiotics. It is highly effective even in severe balanoposthitis. Triderm helps to eliminate the unpleasant symptoms that accompany the disease, and also have a detrimental effect on the cause of its development.

Batrafen

One of the most effective antifungal drugs, but it is highly effective only in the early stages of the inflammatory process. In such cases, Batrafen quickly relieves inflammation, thereby relieving symptoms such as itching, burning, irritation on the penis.

Fluconazole

This medication is available in the form of tablets and ointments. Both types of Fluconazole have a pronounced antifungal effect. In a short time, it relieves inflammatory processes, as well as unpleasant symptoms of balanoposthitis in the form of burning, itching, irritation, swelling. It also has a soothing effect at the local level.

Dermozolon

This drug is prescribed in the treatment of erosive and simple balanoposthitis. It also helps fight fungal and viral infections. It has a healing, anti-inflammatory and anti-allergic effect when applied topically.

Levomekol

This remedy is available in the form of a gel for topical use. Relieves inflammation caused by fungal and bacterial infection. Levomekol is an antibacterial drug, so the recovery process takes a short period of time. It has an antiseptic effect.

clotrimazole

Helps to fight inflammation of the head and foreskin in men caused by the active vital activity of yeast fungi. Quickly removes inflammatory processes, thereby eliminating unpleasant symptoms.

Miramistin

Available in various forms, but treatment of inflammation of the foreskin in men used as a solution. It is highly effective in the development of balanoposthitis against the background of certain sexually transmitted diseases.

Also, such topical medications help fight inflammatory processes: Nizoral, Locasalen, Synthomycin ointment, and so on.

Important to remember! It is possible to use drugs for inflammation of the foreskin only after the appointment of the attending physician!

Features of alternative medicine

If a man has inflammation of the foreskin, treatment at home provides for the use of alternative medicine as a component of complex therapy. Decoctions based on medicinal herbs have a calming effect. That is, they are used in the form of symptomatic treatment. Consider the most popular homemade recipes.

Soda

This ingredient is used in the treatment of inflammation as local baths. To prepare them, you need 2 tsp. soda, which must be diluted in 0.5 liters of warm water. This remedy has a calming effect, relieving unpleasant symptoms.

Chamomile

This medicinal plant is actively used to relieve inflammation and disinfection. With the help of decoctions based on chamomile, local baths should be made or such a solution should be used to rinse the penis. To prepare it, you need 1 tsp. dried flowers of the plant, pour 1 cup of boiling water. Infuse for 15 minutes, then strain and cool slightly.

Oak bark

This medicinal ingredient is also used in the form of a decoction for a bath or rinsing of an inflamed penis. To prepare it, you need 1 tbsp. l. chopped oak bark and 1 cup water. Put the components to cook on fire for 15 minutes. After this time, the broth must be filtered and cooled.

succession

This medicinal plant is used in alternative medicine to fight viruses and bacteria. To prepare a solution for rinsing the inflamed foreskin of the penis, take 1 tsp. succession, pour it with 1 cup of boiling water. Leave to infuse for about 30 minutes.

It's important to know! To achieve the desired result, that is, to recover, baths and rinses must be done 2-3 times a day! Procedures should be carried out every day.

Possible Complications

Inadequate, untimely treatment of inflammation of the foreskin in men, as well as ignoring this pathology, can lead to dangerous consequences. Pathologies that can develop against the background of balanoposthitis:

• erectile dysfunction;
• causeless mood changes, mostly irritability;
• apathy;
• weakening of the sensitivity of the glans penis;
• the development of cracks, wounds and sores on the glans penis as a result of excessive dryness of the skin;
• violation of the microflora, resulting in a decrease in the protective functions of the skin on the genitals;
• pain in the groin at the time of sexual contact, when urinating, when walking;
• development of urethritis;
• the appearance of purulent formations.

The danger of balanoposthitis also lies in the fact that with insufficient treatment it can become chronic. And chronic balanoposthitis often causes oncological diseases.

Prevention

Like any other disease, inflammation foreskin in men it is easier to prevent than to deal with its complex treatment in the future. Experts recommend adhering to such rules that are aimed at prevention:

1. Change your underwear regularly. Men should do this at least 2 times a day. At the same time, one should not forget that men's underpants must be made of high-quality material. It is also necessary to choose the right size, the underwear should not press or cause any discomfort when walking.
2. Observe the rules of personal hygiene. Every young man should wash his genitals at least 2 times a day. However, soap should not be used every time. This can disrupt the microflora.
3. Have a permanent sexual partner. If at a certain stage of life this cannot be done, then the man should take care of using condoms with random partners.
4. Regularly visit a specialist urologist for preventive purposes. The optimal frequency of trips to the doctor is about 6 months. The same goes for regular partners. They should visit the gynecologist periodically, also every six months.

Also, one should not forget that at the first symptoms uncharacteristic of the penis, it is necessary to seek help from a doctor. He will help to carry out timely diagnosis, as well as prescribe the necessary treatment. Indeed, in the early stages, balanoposthitis can be cured quickly and painlessly.

Inflammatory processes of the foreskin are a common occurrence that can be repeated many times during a man's life. Sometimes it is almost asymptomatic, but in other situations it causes a lot of health problems. In any case, it is impossible to ignore the pathology in order to prevent the growth of inflammation.

Description of the disease

Inflammation of the foreskin is a very common disease that affects not only adult men, but also boys aged 3-7 years, and often it is combined with an inflammatory process in the glans penis. The tandem of diseases such as fasting and balanitis is called balanoposthitis by physicians. Concomitant symptoms of this disease may vary depending on the form of the disease and the prerequisites for its occurrence.

There are chronic and acute inflammation of the foreskin. The exacerbation phase is characterized by the most striking symptoms, due to which the pathology is divided into three types: simple, erosive and purulent balanoposthitis.

Simple inflammation is the safest and easiest type of disease in which the foreskin suffers.

It is characterized by the following features:

• burning and itching, which are aggravated by contact with underwear and during urination;
• swelling and wrinkling of the glans penis;
• redness of the tissues of the head and foreskin.

Erosive balanoposthitis is also characterized by a number of signs:

• the formation of small erosions on the head of the penis;
• the appearance of a red film, which bursts after a while, leaving a painful red spot in its place.

The third type of disease - purulent - is the most severe.

It is characterized not only by local signs of the disease, but also by a general deterioration in the condition:

• fever, general weakness;
• the foreskin is “adorned” with purulent abscesses and bleeding sores. In this case, the death of the skin of the foreskin is observed;
• phimosis often appears - a phenomenon in which it is impossible to expose the head of the penis.

Symptoms manifest themselves depending on the causes of the pathology and require different approaches to treatment.

Causes of the disease

Inflammatory processes in the region of the head and foreskin occur due to infectious and non-infectious diseases.

Most often, the foreskin is susceptible to infection with viruses of the following diseases:

• syphilis;
• gonorrhea;
• chlamydia;
• trichomoniasis;
• mycopalsmosis;
• genital herpes;
• candidiasis;
• coli;
• staphylococcus.

In most cases, sexually transmitted diseases lead to inflammatory processes. They provoke pathological conditions in many organs of the male reproductive system, including those affecting the foreskin. These pathologies can provoke redness and swelling of the tissues of the foreskin, frenulum and head of the penis.

However, there are also non-infectious prerequisites for the appearance of a complex of problems such as fasting and balanitis in men.

These include:

• low level of personal hygiene;
• diabetes;
• psoriasis;
• mechanical damage to tissues;
• lichen flat.

The peculiarity of the inflammatory process of the foreskin is that it can occur not only because of the listed ailments, but also without obvious reasons. The reasons why the pathological process develops in children are not always clear. The main version is the inability of the baby to provide a sufficient level of cleanliness.

Treatment options

The tactics of treating balanoposthitis in men depends on the causes and type of this phenomenon. In some cases, it takes several days to get rid of the disease, in others, the treatment takes several weeks. In the most severe cases, surgical excision of inflamed tissues is required to get rid of the disease and its consequences. In any case, it is by no means impossible to ignore the alarming symptoms so that a small nuisance does not develop into a serious problem.

Medical treatment

Infection of the external tissues of the penis can develop due to pathologies of other organs of the male reproductive system and in the same way it spreads to healthy tissues. To avoid this, it is necessary to promptly begin treatment, fortunately, in most cases, familiar and accessible external agents are suitable for this.

Before applying creams and ointments, thoroughly wash the diseased organ with running water and soap. Then it is recommended to treat the damaged tissues with a weak solution of potassium permanganate, Chlorhexidine or Miramistin.

Patients then use one of the following antimicrobials:

• Levomikol is one of the most popular ointments used to treat balanoposthitis. This ointment is a broad spectrum antibiotic to be applied 1-2 times a day in a thin layer. The duration of treatment is at least 7 days;
• Batrafen is a cream that shows good results if they are treated for inflammation of a fungal nature. It is used until the symptoms disappear 2 times a day;
• Hyoxysone is a combined drug that combines an antibiotic of the tetracycline class and a glucocorticosteroid. This drug not only fights infection, but also promotes the speedy healing of ulcers, relieving inflammation of the tissues of the penis;
• Advantan is a hormonal cream that is often prescribed to patients with inflammation of the foreskin. It effectively relieves swelling, redness and reduces pain.

The listed drugs fight most of the symptoms of balanoposthitis, however, adequate treatment also requires the elimination of the cause of the pathology. If we are talking about sexually transmitted diseases, then it is necessary to undergo a course of specific therapy, and treatment is needed not only for a man, but also for his sexual partner.

Folk remedies

Inflammation of the foreskin occurs in men quite often for various reasons, so alternative medicine has developed many recipes for this disease.

Some of them have a sufficient degree of effectiveness, but they should be used, as well as medicines, only in combination with careful hygiene.

1. One of the popular remedies for inflammation of the external tissues of the penis is aloe vera. The leaf of this plant is cut along the axis and the pulp is applied to the diseased areas as an application. You can carry out such activities 2-3 times a day until the cure.
2. In addition, decoctions of medicinal herbs are actively used. St. John's wort leaves and flowers give positive results. This plant has a pronounced anti-inflammatory effect, so a decoction of it well removes redness and damage to the skin of the penis.
3. Lotions from oak bark and plantain are also used. To prepare them, you need to take 2 tbsp. spoons of oak bark, boil for 15 minutes, then add 1 tbsp. a spoonful of dried plantain and insist plants for 20 minutes. The resulting slurry should be put on gauze and applied to diseased areas 2-3 times a day.

Folk remedies can be used for simple or erosive balanoposthitis. However, in severe cases or with a purulent variant of the disease, you should not rely on alternative medicine. Medications are more effective in dealing with severe inflammation.

Balanoposthitis is an inflammatory disease of the skin flap of the foreskin (preputium) and the head of the penis. The disease develops in men who have not gone through circumcision (circumcision).

The development of an infectious-inflammatory process in this area is possible at any age and can be associated with a variety of factors (bacterial, fungal infection, contact dermatitis, allergic reactions, etc.).

Most often, a combination of an etiological factor with predisposing conditions leads to the development of an inflammatory process: phimosis (a violation of the exposure of the head of the penis due to a narrowed preputium fused with the head) and a violation of the rules of personal hygiene.

In the treatment of balanoposthitis, good results are obtained by the use of local (creams, ointments, solutions) and systemic antibacterial / antifungal therapy. In a chronic, continuously relapsing course, resistance to drug therapy, it is possible to perform circumcision (circumcision).

Show all

1. Introduction to terminology



Isolated inflammation of the head or foreskin is a rare condition (the inflammatory process in the skin of the foreskin, as a rule, goes to the head of the penis and vice versa, that is, balanoposthitis develops).

As a rule, the initial empirical therapy of balanoposthitis leads to positive dynamics and resolution of the disease. If it is ineffective, the microorganism is isolated, its species is determined, and the therapy regimen is changed in accordance with its sensitivity.

If the inflammatory process persists, despite etiotropic therapy, it is necessary to exclude malignant degeneration of tissues. For this, a biopsy is performed.

The most common precancerous diseases that can mimic balanoposthitis are erythroplakia, Bowen's disease. One case report considered ulcerative balanoposthitis as a rare manifestation of promyelocytic leukemia.

Immunocompromised patients often present with a systemic fungal infection, including the penis. The infectious process in this case is characterized by a deep ulcerative lesion of the head and prepuce.

In the treatment of such patients, consideration should be given not only to systemic antifungal therapy (eg, treatment of an opportunistic infection in an HIV-infected patient), but also to the correction of immunodeficiency and underlying disease (eg, initiation of antiretroviral therapy in patients with advanced HIV infection).

The incidence of balanoposthitis in the population of men who have not undergone circumcision surgery is 3-7% per year.

2. Reasons for the development of balanoposthitis

The most common cause of inflammation of the foreskin and glans penis is candidal infection, which is detected in three out of ten cases of balanoposthitis. The second most common infectious agent is streptococci, which are determined in 13-25% of patients with balanoposthitis.

Rarely, balanoposthitis may develop against the background of infection with Bacteroides, Gardnerella, Bacteroides spp., Mobiluncus spp., Streptococcus pyogenes, Prevotella melaninogenica, Cordylobia anthropophaga, etc. In patients with immunodeficiency, balanoposthitis can occur when infected with Providenzia stuartii, Pseudomonas aeruginosa.

• Inflammatory dermatoses (lichen sclerosus, circinary balanitis, plasmacytic balanitis, allergic balanoposthitis).
• Allergic reactions, including condoms, hygiene products, intimate gels.
• Precancerous lesions (carcinoma in situ) - Bowen's disease, erythroplakia Queyrat.
• Side effects of taking drugs (for example, salicylates, anticonvulsants, warfarin, etc.).
• Mixed (injuries, for example, trauma when zipping pants, intimate piercing, exposure to sand on the beach, chemical burns).

Balanoposthitis in children often develops between the ages of 2 and 5 years and is primarily associated with infection with b-hemolytic streptococcus, which is introduced from the skin of the body.

Often, balanoposthitis in a child is the result of a mixed infection with Escherichia coli, Pseudomonas spp., Klebsella spp., Serratia spp, Streptococcus spp.

Parents bring children to the doctor with complaints of redness of the head, pain during urination, itching, and the inability to fully expose the head of the penis.

3. Main symptoms

When should you see a doctor? If you have the following symptoms, it is recommended to consult a urologist for advice.

Local symptoms of balanoposthitis in men:

1. 1 A rash, ulceration may appear on the head of the penis, the skin of the foreskin.
2. 2 Soreness in the head, foreskin at rest, during sex.
3. 3 Itching and discomfort in the head area.
4. 4 Unpleasant smell from the penis.
5. 5 Impossibility of removal of the skin from the head.
6. 6 Exudate (liquid discharge) from the surface of the head, from the preputial pocket.

Systemic symptoms may be associated with the symptoms described above:

1. 1 Rash all over body;
2. 2 Rash, ulceration in the mouth;
3. 3 Pain in the joints;
4. 4 General weakness, increased fatigue;
5. 5 Enlargement, soreness of the inguinal lymph nodes.

4. How to prepare for an examination by a urologist?

1. 1 It is important not to carry out hygienic treatment of the penis in the morning before the consultation, as this can lead to erasure of the clinical picture, an incorrect result of bakposev.
2. 2 The toilet of the genital organs and the shower are best left for the evening before the doctor's consultation (before going to bed).

5. History taking

To clarify the possible cause of the disease, the attending physician will ask the following questions:

1. 1 Presence of comorbidities.
2. 2 Have you experienced similar symptoms before? How long ago and how often, what kind of treatment was carried out?
3. 3 How long does the patient have symptoms of balanoposthitis? How was the treatment done at home?
4. 4 Were any irritants (irritants) used that could lead to the development of an inflammatory process (intimate gels, lubricants, creams, and so on). Did you buy new underwear?
5. 5 Have you recently had unprotected sex, including oral and anal. This issue is especially relevant if there are any symptoms of genital infections in a partner (discharge, itching, burning, smell, and so on).

6. Manual examination

During the examination of the head of the penis and the foreskin, the doctor pays attention to redness, swelling, soreness of the skin, the presence of inflammatory exudate, the nature of the discharge (purulent, cloudy, transparent, with a smell, and so on).

Lichenization (thickening of the skin, its roughness, pigmentation disorders) is more often detected with the association of balanoposthitis with the human papillomavirus.

In the presence of a running inflammatory process, ulcerative defects are determined in patients.

During the examination, the urologist may take a smear for subsequent microscopy and bacteriological culture.

7. Laboratory diagnostics

When making a diagnosis, in most cases, only an examination and manual examination is sufficient.

1. 1 In the absence of the effect of the initial therapy, a bacteriological smear is performed from the surface of the penis. Bakposev allows you to determine the species of the pathogen and its sensitivity to antibiotics.
2. 2 To diagnose a fungal infection, the swab is treated with a potassium hydroxide solution (KOH), which facilitates the visualization of fungal hyphae and allows the isolation of the fungal colony.
3. 3 Serological tests (blood tests for antibodies) are rarely used, which are often of academic interest and form the basis of research work.
4. 4 If the doctor or the patient himself suspects, has a history of unprotected sexual intercourse, ulcerative lesions of the genitals, screening for STIs (PCR diagnostics) is performed.
5. 5 Urinalysis is prescribed to detect inflammation in the urethra and bladder, the presence of sugar in the urine.
6. 6 For the diagnosis of "balanoposthitis" usually does not require the use of instrumental diagnostic methods.
7. 7 If there is a suspicion of a malignant neoplasm of the head of the penis and foreskin, a biopsy is performed followed by a histological examination. A biopsy is necessary to exclude precancerous or cancerous diseases, such as erythroplakia, Bowen's disease.
8. 8 If you suspect dermatoses, you may need to consult a dermatologist.

8. Patient management

1. 1 A patient with symptoms of balanoposthitis is advised to avoid the use of soap solutions, which can lead to excessive irritation of the mucous membranes and the progression of the inflammatory process.
2. 2, the patient is recommended daily during a shower / bath, retract the foreskin and wash the head and retracted skin with warm water.
3. 3 During the period of diagnosis and treatment, it is necessary to refrain from sexual intercourse.
4. 4 Based on complaints, examination data, anamnesis, a decision is made on the appointment of empirical therapy.
5. 5 Empiric therapy (that is, treatment until the results of laboratory diagnostics are obtained) can be carried out using Triderm ointment or cream (clotrimazole + gentamicin + betamethasone). Ointment Triderm has a greasy consistency, stains linen, but less irritates the foreskin and glans penis. Scheme of application of Triderm ointment for balanoposthitis in men - externally, 2 times a day with a thin layer on the affected surface.
6. 6 If the initial empiric therapy is ineffective, culture is performed to determine the sensitivity of the flora, antimicrobial therapy is adjusted. A smear on the flora can also be performed during the initial visit of the patient (taking into account the anamnesis of life and illness).
7. 7 With a recurrent course of the infectious process, it is possible to perform, which leads to a cure in most cases.

9. Candida infection



Rice. 1 - Candidiasis. Image source - Danderm

Symptoms of candidal balanoposthitis in men:

1. 1 Erythematous rash.
2. 2 Soreness, itching in the head of the penis and the skin above it.
3. 3 On examination, there is pronounced redness with small papules that can be eroded.

Laboratory diagnosis of candidiasis includes:

1. 1 Microscopy of a smear from the skin pocket between the prepuce and the head. Before the study, the smear is treated with a solution of potassium hydroxide (KOH).
2. 2 Smear culture.
3. 3 with glucose level determination.

The tactics of treating a patient with candidal balanoposthitis:

1. 1 Trays with isotonic sodium chloride solution (0.9% sodium chloride).
2. 2 Topical antifungal therapy (treatment regimens are presented in table 1 below).
3. 3 It is necessary to inform and examine the sexual partner, since in most cases urogenital candidiasis (thrush) is determined in women.

With a mild course, the absence of immunodeficiency in the observation of a urologist is not necessary. In case of recurrence of infection, it is necessary to exclude possible predisposing factors:

1. 1 Diabetes mellitus;
2. 2 Use of broad spectrum antibiotics;
3. 3 Immunodeficiency of any etiology (HIV infection, corticosteroids, chemotherapy, etc.);
4. 4 It is necessary to exclude re-infection from the sexual partner.



Table 1 - Treatment of candidal balanoposthitis in men

10. Aerobic infection

The clinic of aerobic balanoposthitis varies from slight redness to severe swelling, the appearance of cracks in the skin of the glans penis and foreskin.

To clarify the diagnosis, a scraping is taken for bakposev (bacteriological examination) from the subpreputial sac. Streptococci, staphylococci, Gardnerella are most often detected.

The scheme of antibiotic therapy depends on the isolated pathogen and its sensitivity to drugs.

Can be used:

1. 1 Erythromycin (orally 500 mg bid for 7 days).
2. 2 Fusidic acid in the form of a 2% cream (creams Fucidin, Fusiderm). Apply to the skin of the head and foreskin 3 times a day until the symptoms disappear.

Observation and additional examination by a urologist are mandatory if symptoms persist, despite ongoing etiotropic therapy, if STIs are suspected.

11. Anaerobic balanoposthitis

Symptoms of anaerobic balanoposthitis:

1. 1 Fetid discharge, pronounced swelling and redness of the head of the penis.
2. 2 During the examination, attention is drawn to the swelling of the foreskin, superficial erosion, enlarged painful inguinal lymph nodes.

Laboratory diagnostics:

1. 1 Dark-field microscopy for the detection of spirochetes.
2. 2 Gram smear staining.
3. 3 Smear culture from the subpreputial sac.

The treatment regimen for anaerobic balanoposthitis is shown in table 2 below.

In the presence of genital ulceration in the patient and / or his sexual partner, a full screening for infections with sexual transmission is necessary.

The patient needs dynamic monitoring by a urologist.



Table 2 - Treatment of anaerobic balanoposthitis in men

12. HPV (human papillomavirus)

When examining a patient with balanoposthitis against the background of papillomavirus infection, diffuse erythema (redness) is usually determined.

Laboratory nature of the infectious process is confirmed:

1. 1 Characteristic histological changes on biopsy;
2. 2 Detection of virus DNA in a smear-imprint by PCR.

It is desirable to screen for sexually transmitted infections in the patient and his sexual partner. It is necessary to inform the patient about the risk of HPV transmission to the sexual partner, the need to use barrier contraception (condoms).

Observation of the patient with a second consultation after a month from the start of therapy. In the absence of the effect of treatment, it is necessary to exclude sexual infections again.

13. STI

13.1. Trichomoniasis

Trichomoniasis is a protozoan infection that is sexually transmitted and can cause erosive balanitis.

Histological examination of lesions reveals dense lymphocytic infiltration in the upper dermis. To determine the pathogen, a smear is taken from the preputial sac, followed by microscopy. Balanoposthitis on the background of trichomoniasis responds well to metronidazole therapy.

13.2. Syphilis

Syphilitic balanitis is a multiple erosion on the surface of the head of the penis, which can pass ulcerative defects of various shapes and sizes.

These pathological changes can be characteristic of both the first and second stages of the disease.

Spirochetes (pale treponema) are easily determined by microscopy of smears and prints. In the treatment of balanoposthitis, standard treatment regimens for syphilis are used.

13.3. Genital herpes

Viral balanoposthitis can occur against the background of infection with the herpes virus.

In rare cases, a primary infection with the herpes virus can lead to the development of necrotizing balanitis with the formation of areas of necrosis, vesicles on the surface of the epithelium of the head of the penis. The infection is accompanied by general weakness, headache.

Specific antiviral therapy (acyclovir) leads to a gradual resolution of symptoms. Drugs can be administered systemically (oral tablets) and topically (in the form of ointments and creams).

13.4. Gonorrhea

Gonococcal balanoposthitis develops when the skin of the penis and the preputial sac are infected with Neisseria gonorrhoeae. Skin lesions in gonorrhea are quite rare (more often).

Tension ulcers, pustules can form on the surface of the skin of the head and foreskin, and inguinal lymphadenopathy develops.

The infection can develop without symptoms from the urethra. Repeated recurrences of infection can lead to hypopigmentation of the head.

The diagnosis can be established on the basis of microscopy of smears from the surface of pathological foci (Gram-negative diplococci are determined), bacterial culture.

The initiation of antibiotic therapy with cephalosporins (ceftriaxone, cefixime) leads to a gradual resolution of symptoms.

14. Circinary balanitis



Rice. 5 - Circinary balanitis. Image source - s3.amazonaws.com

The clinical picture of circinary balanitis is characterized by the appearance of grayish-white areas on the glans penis, which form "geographical" figures. The disease may be associated with Reiter's syndrome.

Laboratory diagnostics:

• Biopsy reveals spongioform pustules in the upper epidermis.
• Screening for STIs, especially C. trachomatis (chlamydia), is essential.
• Bakposev from the preputial sac.

Treatment:

1. 1 Hydrocortisone cream 1%.
2. 2 Etiotropic therapy in establishing the exact cause of the disease.
3. 3 If an STI is confirmed, the patient and sexual partner should be treated.

15. Rashes associated with medication

Balanoposthitis that occurs while taking medications is characterized by:

1. 1 Erythematous, well-demarcated lesions may show bullae with subsequent ulceration.
2. 2 To confirm the diagnosis, it is necessary to collect a medical history. Most often in the anamnesis there is an indication of taking tetracyclines, salicylates, phenacetin, hypnotics.
3. 3 It is necessary to examine the mucous membranes of the eyes, mouth, as often there is a lesion of several parts of the body at once.
4. 4 Repeated use of the drug leads to new rashes, which can help confirm the diagnosis.

Treatment tactics in this case include:

1. 1 Cancellation of the drug that caused the rash.
2. 2 Topical application of corticosteroid-based ointments (eg, applying 1% hydrocortisone ointment to lesions 2 times a day until symptoms resolve).
3. 3 In severe cases, systemic administration of glucocorticosteroids (dexamethasone, prednisolone) may be required.

16. Allergic balanoposthitis

Clinical manifestations of allergic balanoposthitis vary from mild erythema to severe edema of the head, penis shaft, foreskin.

The described symptoms may be associated with atopy (predisposition to an immediate allergic reaction) or frequent washing of the genitals with soapy water. Treatment includes:

1. 1 Stop contact with the allergen.
2. 2 Hydrocortisone ointment (1%), topically applied 1-2 times a day until symptoms resolve.

17. Lichen sclerosus

With lichen sclerosus, white spots appear on the head of the penis, the foreskin may be involved in the pathological process. Vesicles with hemorrhagic contents may occur, less often blisters and ulcerations.

Laboratory diagnostics:

• A biopsy is the main study for suspected lichen sclerosus: a thickened epidermis is detected, with a long course, the epidermis atrophies, foci of follicular hyperkeratosis appear. Biopsy reveals tissue edema, loss of elastin fibers, perivascular lymphocytic infiltrate.

Treatment for lichen sclerosus includes:

1. 1 Local application of ointments based on corticosteroids (betamethasone, clobetasol) 1 time per day until the onset of remission of symptoms, followed by gradual withdrawal. To maintain remission, continuous use once / week may be required.
2. 2 With the development of phimosis against the background of tissue sclerosis, circumcision is performed.
3. 3 Examination of sexual partners is not required.
4. 4 The patient needs to be seen by a urologist. The frequency of visits to the doctor depends on the severity of the disease. The minimum frequency of visits is once a year, since there is a small risk (less than 1%) of malignant degeneration of pathological foci.

Rare forms include plasmacytic balanitis (Zoon balanitis) and erythroplakia Queyra.

18. Plasma cell balanitis (Zoon)



Rice. 3 - Plasmacytic balanitis. Illustration source - medicine.academic.ru

A typical picture of plasmacytic balanitis: well-demarcated orange-red areas on the head with multiple dotted red spots. Outwardly, it may resemble erythroplakia Queyrat (Keyra), which is a precancer and requires histological examination. The patient is usually over 30 years of age

1. 1 Biopsy reveals epidermal atrophy, rhomboid keratinocytes, spongiosis, subepidermal infiltration with plasma cells.
2. 2 Standard treatment includes topical corticosteroid ointments, possibly combined with topical antibiotics 1-2 times a day until symptoms resolve.
3. 3 Circumcision may lead to resolution of lesions.
4. 4 The frequency of follow-up examinations depends on the severity of the course of the disease, response to local therapy, the need for long-term topical steroid therapy, biopsy results.

19. Erythroplakia Queyrat (Keira)



Rice. 4 - Erythroplakia Queyrat. Image source - Medscape.com

Typical appearance of erythroplakia: red, purple, well-demarcated areas of the skin of the head of the penis.

1. 1 If erythroplakia is suspected, a biopsy of the affected area of ​​the skin is mandatory. If a histological examination reveals squamous cell carcinoma in situ, the diagnosis is confirmed.
2. 2 For cure, as a rule, surgical excision of the pathological focus is sufficient.
3. 3 Alternative treatment regimens include the use of 5% fluorouracil cream, laser resection, and cryotherapy to remove the lesion.
4. 4 It is necessary to regularly monitor the patient due to the possibility of recurrence of the disease.
5. 5 There is no need to examine the sexual partner.

20. Possible complications

1. 1 Formation of pathological cicatricial phimosis.
2. 2 Stenosis (stricture) of the external opening of the urethra.
3. 3 Malignant degeneration.
4. 4 Necrosis of the head of the penis.
5. 5 Sepsis.

21. Prevention of pathology

Daily hygienic care of the head of the penis and foreskin should include:

• During bathing, hygiene procedures, the foreskin must be retracted.
• The glans and retracted skin are washed with water at a temperature equal to body temperature.
• After washing, the skin is dried with a towel and returns to its previous state, covering the head of the penis.
• The use of concentrated soap solutions, shower gels for the hygiene of the head and foreskin is not recommended.

It is important to avoid casual relationships, unprotected oral and anal sex. With pathological phimosis over the age of 16, it is recommended.