Indian Journal of Sexually Transmitted Diseases and AIDS
RESIDENTS PAGE
Year
: 2014  |  Volume : 35  |  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

Correspondence Address:
Ipsa Pandya
Department of Skin and VD, Baroda Medical College, Vadodara, Gujarat
India




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;35:155-157


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 Jan 22 ];35:155-157
Available from: http://www.ijstd.org/text.asp?2014/35/2/155/142415


Full Text

 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. [1] {Table 1}

 CLINICAL FEATURES



Symptoms and signs vary according to etiology. Descriptions of the typical appearances of infective balanitides are discussed in detail [Table 2].{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 dysfunctionTo minimize urinary dysfunctionTo exclude penile cancerTo treat premalignant diseaseTo diagnose and treat sexually transmitted disease.

*All persistent/undiagnosed genital lesions regardless of appearance must be evaluated for herpes[Figure 1]{Figure 1}

Take home message:

Predisposing factors include poor hygiene and over washing, over-the-counter (OTC) medications, as well as nonretraction of the foreskinMany cases of balanitis seen in practice are a simple intertrigo; that is, inflammation between two layers of skin with bacterial or fungal overgrowthRapid 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 paraphimosisSaline baths are also useful and medicated OTC talcum powders are helpful in drying the area. This advice is simple, but compliance may be challengingMany patients will present having tried antifungal creams, often obtained OTC. Such cases usually come with relapse. The simple measures have a more durable effectHIV should be ruled out in every case not responding to therapy/having atypical presentation.[3]

References

1Edwards S. Balanitis and balanoposthitis: A review. Genitourin Med 1996;72:155-9.
2Edwards 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.
3Yanofsky VR, Linkner RV, Pompei D, Goldenberg G. Current update on the treatment of genital warts. Expert Rev Dermatol 2013;8:321-32.