|Year : 2014 | Volume
| Issue : 2 | Page : 155-157
Approach to balanitis/balanoposthitis: Current guidelines
Ipsa Pandya, Maulik Shinojia, Dipali Vadukul, YS Marfatia
Department of Skin and VD, Baroda Medical College, Vadodara, Gujarat, India
|Date of Web Publication||9-Oct-2014|
Department of Skin and VD, Baroda Medical College, Vadodara, Gujarat
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pandya I, Shinojia M, Vadukul D, Marfatia Y S. Approach to balanitis/balanoposthitis: Current guidelines. Indian J Sex Transm Dis 2014;35:155-7
|How to cite this URL:|
Pandya I, Shinojia M, Vadukul D, Marfatia Y S. Approach to balanitis/balanoposthitis: Current guidelines. Indian J Sex Transm Dis [serial online] 2014 [cited 2020 Jul 11];35:155-7. Available from: http://www.ijstd.org/text.asp?2014/35/2/155/142415
| Introduction|| |
Balanitis describes inflammation of the glans penis and posthitis means inflammation of the prepuce. In practice, both areas are often affected together, and the term balanoposthitis then used. It is a collection of disparate conditions with similar clinical presentation and varying etiologies affecting a particular anatomical site [Table 1]. Balanitis is common in uncircumcised men as a result of poorer hygiene and aeration or because of irritation by smegma and in many cases preputial dysfunction is a causal or contributing factor. Balanitis may be more severe in the presence of some underlying medical conditions. It has been reported as a source of fever and bacteremia in neutropenic men and candidal balanitis may be especially severe in patients with diabetes mellitus. 
| Clinical features|| |
Symptoms and signs vary according to etiology. Descriptions of the typical appearances of infective balanitides are discussed in detail [Table 2].
| Approach to patient with balanitis|| |
Diagnosis [Table 2]
Balanitis is a descriptive term covering a variety of unrelated conditions, the appearances of which maybe suggestive, but should never be thought to be pathognomonic, and biopsy is sometimes needed to exclude premalignant disease.
Management [Table 2]
The objectives of management are:
- To minimize sexual dysfunction
- To minimize urinary dysfunction
- To exclude penile cancer
- To treat premalignant disease
- To diagnose and treat sexually transmitted disease.
*All persistent/undiagnosed genital lesions regardless of appearance must be evaluated for herpes[Figure 1]
Take home message:
- Predisposing factors include poor hygiene and over washing, over-the-counter (OTC) medications, as well as nonretraction of the foreskin
- Many cases of balanitis seen in practice are a simple intertrigo; that is, inflammation between two layers of skin with bacterial or fungal overgrowth
- Rapid resolution can be achieved most frequently in practice by advising the patient to keep his foreskin retracted if possible, having advised him of the risk of paraphimosis
- Saline baths are also useful and medicated OTC talcum powders are helpful in drying the area. This advice is simple, but compliance may be challenging
- Many patients will present having tried antifungal creams, often obtained OTC. Such cases usually come with relapse. The simple measures have a more durable effect
- HIV should be ruled out in every case not responding to therapy/having atypical presentation.
| References|| |
Edwards S. Balanitis and balanoposthitis: A review. Genitourin Med 1996;72:155-9.
Edwards S, Bunker C, Ziller F, van der Meijden WI. 2013 European guideline for the management of balanoposthitis. Int J STD AIDS 2014;25:615-26.
Yanofsky VR, Linkner RV, Pompei D, Goldenberg G. Current update on the treatment of genital warts. Expert Rev Dermatol 2013;8:321-32.
[Figure 1], [Table 2]