Balanoposthitis

Balanoposthitis is a disease that affects both women and men and even children.

Let's consider what is balanoposthitis, the main causes and symptoms of the disease. And also in what danger of a balanoposthitis and methods of its treatment.

Causes of the balanoposthitis

Balanoposthitis is an inflammation that affects the head and penis in men. The disease can appear at any age, as the cause of inflammation can become fungus, bacteria or contact dermatitis. Most often, children suffer from balanoposthitis. In childhood, the foreskin closes the glans penis, which significantly increases the risk of developing the disease. Inflammation affects boys with phimosis and narrow foreskin.

In some cases, inflammation appears due to violations of hygiene rules or poor mobility of the prepuce. Treatment of inflammatory disease is aimed at eliminating painful symptoms and maintaining normal hygiene conditions.

As a rule, in adulthood from balanoposthitis men suffer more often. The disease is a combination of prostate and balanitis, that is, two separate diseases. So, with balanitis, inflammation affects the glans penis, and if you forgive - the tissues of the prepuce. But most often, both problems occur immediately, so the disease is called balanoposthitis.

The causes of balanoposthitis are varied, but as a rule, inflammation appears due to a mixed infection. Precisely determine which bacterium caused the disease is very difficult and not always possible. The most common causes of balanoposthitis: yeast fungus (causative agent of candidiasis),  streptococci, bacteroides, gardnerella. For the appearance of balanoposthitis, it is necessary to combine two factors - an infectious stimulus and suitable conditions for its development. Thus, the infectious factor of the disease is the entry of the pathogen into the preputial sac.

The main causes and predisposing factors of balanoposthitis:

1. Unprotected sexual intercourse with a partner who has vaginal dysbiosis. (In dysbiosis, the female vagina contains many bacteria that cause inflammation of the glans penis).
2. Anal sex without a condom and oral sex with a partner who has oral diseases.
3. Failure to comply with the rules of intimate hygiene leads to the fact that under the foreskin starts to accumulate smegma, which is an excellent field for the growth of any infections. It is the smegma that causes inflammation and subsequently balanoposthitis.
4. Narrow foreskin and phimosis (the head of the penis opens with difficulty or does not open at all) complicate the process of hygiene, which leads to stagnation of the decomposing smegma in the preputial sac.
5. Metabolic disorders and chronic diseases, for example, diabetes mellitus - is another reason for balanoposthitis. At the head of the penis and foreskin, drops of urine with an increased sugar content, which creates conditions for the development of infection.
6. Trichomonas or gonorrhea urethritis can also be the cause of balanoposthitis. Because of purulent discharge from the urethra, the resistance of the mucous membrane of the glans penis decreases, which leads to inflammatory manifestations.

All of the above reasons and predisposing factors can cause balanoposthitis. Any infection that falls on the head of the penis immediately causes inflammation. The balanoposthitis proceeds for a long time, with the periods of an exacerbation that is worse gives in to treatment.

[1], [2]

Balanoposthitis after sex

Balanoposthitis after sex is not uncommon. Thus, the vaginal diseases in the partner and unprotected sexual intercourse are the main causes of balanoposthitis after sex in men. But the disease manifests itself not immediately, but begins to mature. Thus, the incubation period of balanoposthitis depends on its type and can last from 2 days to several weeks, or even months. The danger is that during sex, partners transmit each other pathogenic microorganisms that cause malaise. Moreover, even compliance with all rules and norms of hygiene is not a defense against balanoposthitis after sex.

At the first signs of the disease, as a rule, neither men nor women are in a hurry to seek medical help. But, despite the apparent painful symptoms, no one refuses sex. In some cases, concealing the symptoms of balanoposthitis in one of the spouses, this is the cause of treason. Timely diagnosis of the disease and treatment is an ideal option for preventing the development of infection and inflammation. But do not forget about the security measures that will help protect yourself from balanoposthitis.

[3], [4], [5], [6], [7]

Balanoposthitis after circumcision

Balanoposthitis after circumcision occurs extremely rarely, since the procedure removes the foreskin protects against the accumulation of bacteria and harmful microorganisms. Circumcision is the most effective and fastest method of eliminating balanoposthitis. Completely or partially removed foreskin, opens the head of the penis and solves problems of a physiological nature. In this case, the bridle, which is the center of nerve endings, lymphatic and blood vessels - is not injured. Thanks to this, the operation allows to avoid serious complications during the rehabilitation period.

If balanoposthitis is caused by phimosis, then circumcision allows solving two problems simultaneously. The operation opens the head of the penis and removes the foreskin, where bacteria and microorganisms accumulating causing inflammatory processes accumulate. Balanoposthitis after circumcision may occur if a man has a chronic form of the disease, impaired erectile dysfunction, squamous cell carcinoma or chronic prostatitis. In acute balanoposthitis circumcision is contraindicated. Before the operation, it is necessary to eliminate the inflammatory process.

[8], [9], [10]

Whether the balanoposthitis is passed?

Whether the balanoposthitis is transmitted and how contagious the disease is is a very topical issue for patients who first encountered such an inflammatory process. Despite the fact that balanoposthitis is caused by a fungal or bacterial microflora, the disease is not predominantly transmitted. So, for occurrence of inflammatory process presence of predisposing factors is obligatory. These factors include reduced protective properties of the immune system, damage to the integrity of the epithelial covering of the foreskin and glans penis.

Urologists note that balanoposthitis is transmitted sexually, that is, a man can infect a woman. This is due to the fact that balanoposthitis is peculiar to both men and women. But the viral or fungal infection that caused the disease can easily infect a woman. This is possible with unprotected intercourse, that is, without a condom. Pathogenic or infected microflora of the female vagina can also cause infection in a man and the further development of balanoposthitis.

The main forms of balanoposthitis, sexually transmitted:

• Fungal balanoposthitis - most often there is candidiasis balanoposthitis (thrush). The disease is transmitted during oral sex, as fungi are able to multiply and on the mucous membrane of the tongue and oral cavity.
• Gardnerella vulgaris is an inflammation caused by Gardnerella vaginali (anaerobic bacterium). The peculiarity of the bacterium is that it does not manifest itself for a long time. Unprotected sexual acts provoke the development of balanoposthitis, which can go to nonspecific urethritis.
• Tsirtsinarny balanoposthitis - most often due to infection with chlamydia. The peculiarity of this form is that red spots of a cylindrical shape with clearly delineated boundaries appear on the head of the penis. Infecting tsirtsinarnym balanoposthitis can be with unprotected sexual intercourse, oral and anal sex.

Symptoms of the balanoposthitis

Symptoms of balanoposthitis appear individually in each patient and depend on the form of the disease. There are not many typical manifestations of inflammation. The main symptoms are pain, localized on the glans penis and itching. Very often, at the beginning of the development of the disease, the patient does not notice signs of an inflammatory process. And this is not surprising, since balanoposthitis is characterized by an atypical, asymptomatic course at the first stages of development.

But in most cases, the symptomatology of balanoposthitis manifests itself as skin hyperemia, swelling of the glans penis, plaque in the vein and head, rash, enlarged lymph nodes in the groin, erosive and ulcerative lesions.

Stage of the disease	Complete symptomatic picture
The initial stage of balanoposthitis	General malaise. Redness, itching and swelling. Soreness and unpleasant odor. Allocations on the glans penis.
Progressive balanoposthitis	Erosion and ulceration. Peeling, crusts, cracks. Inguinal lymphadenitis. Phimosis.
Symptoms of running balanoposthitis	Pain in the joints and arthritis. General lymphadenitis. Conjunctivitis. Meatal stenosis (appears after surgical interventions). Rash on the skin, on the mucous membranes and in the mouth. Malignant transformation of balanoposthitis.

The peculiarity of balanoposthitis is that the disease can manifest itself with a large number of different symptoms, which at first glance are not interrelated. But professional urologists combine the symptoms of balanoposthitis in three groups:

1. Discomfort in the head of the penis, which causes discomfort (pain, itching, burning, pain). Some patients report increased sensitivity and premature ejaculation due to balanoposthitis, which adversely affects the duration of the sexual intercourse.
2. Cracks, ulcers, redness, dryness, irritation, red spots and other external signs of the disease.
3. Intensive discharge from the glans penis. Normally, the smegma is formed in a small amount, but because of balanoposthitis, the discharge can be so intense that the patient has to carry out hygienic procedures several times a day and change the underwear.

All the above symptoms can appear both simultaneously and separately. But the presence of any of the above symptoms may indicate the presence of balanoposthitis. Without proper treatment, the disease begins to progress and passes into a pustular-ulcerative, phlegmonous or gangrenous form. In some cases, patients have inguinal-femoral lymphadenitis. And because of the acute course of inflammation, chronic pain and flushing of the skin, phimosis may develop, as scarring of the skin occurs.

The incubation period of balanoposthitis

The incubation period of balanoposthitis is a period of time from the moment of infection to the appearance of the first symptomatology of the disease. If we talk about balanoposthitis, it is necessary to understand that infection can happen not only because of unprotected sexual intercourse, but also because of a weakened immune system and the presence of chronic diseases.

Most often, balanoposthitis is caused by nonspecific microorganisms: proteas, Candida fungi, staphylococci, streptococci, E. Coli. The appearance of inflammation can provoke the use of corticosteroids or prolonged therapy with antibiotics. In this case, it's pointless to talk about the incubation period.

Balanoposthitis is a disease that does not have a time frame for the appearance of the first symptoms after infection. The incubation period of balanoposthitis depends on such factors as:

• What microorganisms caused the inflammatory process. Urologists note that microbes and bacteria ureplazmy, chlamydia, mycoplasma, gardnerella and Candida fungi can be transmitted during anal and oral sex, causing symptoms of balanoposthitis.
• Individual features of the body and the protective properties of the immune system also play an important role in the incubation period of the inflammatory process.

So, if a patient's immune system is weakened, then due to external infection, the incubation period of the disease can last from a few days to a week. If the immune system is normal, the incubation period can last from three weeks to a month. But some types of balanoposthitis, for example, gardnerellez, in the first stages are asymptomatic.

[11],

Temperature with balanoposthitis

The temperature of balanoposthitis is a rare symptom that occurs only in the acute course of the disease or in patients with a weakened immune system. As a rule, high temperature arises from the progression of the disease and the intensification of painful symptoms. So, along with the high temperature, the patients may have hyperemia and swelling of the glans penis.

In some cases, the temperature with balanoposthitis indicates that the body has several foci of inflammation. With this symptomatology, it is necessary to urgently seek medical help. The doctor will prescribe a treatment to relieve painful symptoms and high fever. And after the delivery of tests and diagnosis, the urologist will prescribe treatment and preventive measures to eliminate balanoposthitis.

Allocations with balanoposthitis

Discharge of balanoposthitis is one of the symptoms of the inflammatory process in the body. At any healthy man, on a glans penis there is a formation smegma (a secret of sebaceous glands). As a rule, the allocation is not significant and if the hygiene rules are followed, they do not cause problems. With balanoposthitis, discharge increases, which makes it necessary to conduct hygienic procedures several times a day. In some cases, due to abundant secretions, a man must change his underwear.

If the hygiene rules are not respected, the discharge during balanoposthitis will intensify, causing concomitant symptoms: pain, burning, itching, swelling of the glans penis and so on. In any case, abundant discharges for men are not the norm and require consultation of a urologist.

[12], [13],

Forms

ICD 10 - is an international classification of diseases. Balanoposthitis refers to urological diseases, the registry and medical records have code N48.1

In addition to balanoposthitis, the ICD-10 group of urological diseases includes:

• N00-N99 Diseases of the genitourinary system.
• N40-N51 Diseases of the male sexual organs.
• N48 Other diseases of the penis.
• N48.1 Balanoposthitis.

[14], [15], [16], [17]

Balanoposthitis in men

Balanoposthitis in men is the most common sexually transmitted disease. Balanoposthitis presents two different lesions - postitis and balanitis. Postit is an inflammation of the tissue of the foreskin, and balanitis is an inflammatory process on the glans penis. Simultaneous presence of both diseases has received the name - balanoposthitis. There is a primary and secondary balanoposthitis, they differ in the nature of their origin. Let's look more closely at the etiology of balanoposthitis in men.

• The primary balanoposthitis in men develops because of non-observance of rules of personal hygiene. The disease can also appear due to phimosis and the accumulation of smegma in the preputial sac. Because of this, mechanical irritation of the mucous membrane occurs, and then during the decomposition and chemical irritation of the foreskin and glans penis. The causes of primary balanoposthitis can be associated with the use of strong antibiotics or the use of intimate hygiene products, which include chemicals.
• Secondary balanoposthitis in men develops on the background of chronic diseases (urethritis, diabetes, allergic diseases). Factor to the development of the disease can serve colds, mechanical trauma, temporary lack of hygiene measures, frequent changes in sexual partners or hypothermia. This category of balanoposthitis requires special treatment, as the disease can recur.

[18], [19], [20]

Balanoposthitis in women

Balanoposthitis in women is a trichomonoadic form of a fungal disease. Symptoms of balanoposthitis and the causes of its appearance in women are no different from the symptoms and causes of this disease in men. Balanoposthitis can appear due to a yeast fungus, be a symptom of urethritis or act as an independent disease. Balanoposthitis can appear due to chronic diseases, prolonged use of medicines or reduced protective functions of the body. That is, the disease is of an infectious nature and very often appears along with candidiasis, that is, milkmaids.

In order to diagnose balanoposthitis and prescribe effective treatment, a woman needs to undergo a series of studies, take tests and smears. Based on the results of the tests performed, the doctor determines the form of the disease and its cause, makes up a treatment regimen.

Treatment of balanoposthitis in women and men is the same. In the early stages of the disease, the doctor prescribes regular hygiene procedures with a solution of furacilin or hydrogen peroxide. In case of neglected cases, the doctor prescribes general or local antibiotics. As a rule, the duration of treatment does not take longer than 7-10 days.

[21], [22], [23], [24]

Complications and consequences

A question that interests many men who have been diagnosed with this disease. The danger of balanoposthitis is that without treatment, the inflammatory process from the head of the hollow member gradually affects the urethra, which leads to the development of urinary tract infections. And because of the inflammation of the foreskin, cicatricial phimosis may begin to form. If the disease is chronic and often recurs, this can lead to a decreased sensitivity of the glans penis and atrophy of the receptor apparatus. As a result, balanoposthitis negatively affects the quality of sexual life and potency in general.

Balanoposthitis is an infectious inflammation of the glans penis and foreskin. The disease has several varieties that depend on the course of the disease and the localization of inflammation. Etiological factors of balanoposthitis are harmful microorganisms (fungi of the genus Candida, staphylococcus, E. Coli, gardnerella).

Balanoposthitis is acute and chronic, and depending on the severity of inflammation: superficial, erosive and gangrenous. The danger of the disease and the fact that it is transmitted during sexual intercourse. So, if a partner has colpitis of different etiologies, then this can lead to infection of a man and the appearance of balanoposthitis.

Complications of balanoposthitis appear in those patients who refuse therapy or have not completed the prescribed treatment plan by a urologist. Complications also arise due to improperly selected therapy and exacerbation of chronic diseases. Let's look at the main complications of balanoposthitis:

• Lymphaghenitis is an inflammatory disease that affects the vessels of the penis and inguinal lymphadenitis. Because of the lack of treatment, this complication can lead to amputation of the penis or lead to gangrene.
• Gangrenous balanoposthitis is a serious complication that arises from the neglected erosive form of balanoposthitis. With gangrenous inflammation, the patient raises temperature, there is an intoxication of the body, swelling, necrotic purulent sores on the genital. It is this form that always causes phimosis, and can also cause perforation of the foreskin and slowly healing ulcers.
• Oncology is the most dangerous of all possible complications of balanoposthitis. Malignant tumors of the penis are irreversible, accompanied by prolonged inflammation and other pathological symptoms.

[25], [26], [27], [28]

Consequences of balanoposthitis

The consequences of balanoposthitis largely depend on the type and form of the inflammatory-infectious disease. The consequences are influenced by the age of the patient and the characteristics of the organism, the presence of chronic diseases and the symptomatology manifested in balanoposthitis. Incorrect and untimely treatment affects the consequences of the disease. Let's look at the effects of inflammation that most often occur:

• Atrophy of the receptors on the glans penis. This significantly reduces the sensitivity of the penis and leads to violations of sexual functions (problems with potency, decreased sensations during orgasm).
• A non-cured inflammatory process that occurs with balanoposthitis can go to other organs and cause a number of concomitant diseases.
• Urethritis, that is, the inflammation of the walls of the urethra is the most common consequence of balanoposthitis, causing pain and pain when urinating, as well as the accumulation of purulent masses in the urethra.
• A prolonged inflammatory process leads to deformation and densification of the genital organ tissues. On the penis there are scars, phimosis and paraphimosis (infringement of the glans penis). Paraphimosis causes severe pain, blueness and an increase in the glans penis.

[29]

Diagnostics of the balanoposthitis

Diagnosis of balanoposthitis begins with a visual examination in the urologist, microscopy, smears and bacterial culture to determine the pathogen and make up a treatment plan. The analysis is necessary for the exclusion of syphilis, as well as a blood test for determining the level of sugar and consultation with an allergist. The peculiarity of balanoposthitis is that the disease, as a rule, does not cause difficulties in diagnosis. If you suspect a balanoposthitis, the patient must pass and pass a number of the following tests and diagnostic methods:

• Visual examination of the urologist.
• Bacterial culture of excretions from the surface of the head of the penis and urethra.
• The level of sugar and glucose in the blood.
• Research on sexually transmitted diseases.
• Serological tests for syphilis.
• Smear-prints from the glans penis and foreskin.

In the process of diagnosing balanoposthitis, the doctor must differentiate such diseases as:

• Psoriasis.
• Cancer of the penis.
• Sclerosing lichen is a chronic lesion of the skin of the penis, which manifests itself in the form of whitish plaques.
• Leukoplakia of the penis.
• Reiter's disease is an annular lesion of the head of the penis, which causes erosion on the mucous membrane of the penis.
• Balanitis Zuna - reddening of the head of the genital organ, the appearance of red shiny spots.

[30], [31], [32], [33]

Analyzes with balanoposthitis

Analyzes in balanoposthitis is one of the diagnostic methods that allows you to accurately determine the type of inflammation and prescribe effective treatment. Let's consider the basic tests for balanoposthitis, which must be passed:

• Scraping from the damaged surface to identify pathogenic microorganisms and fungi. Most often, a culture method is used to differentiate bacteria.
• PCR (polymerase chain reaction) - used to determine vagino-associated microorganisms.
• Bacterial culture for the detection of anaerobic microflora (Gardnerella vaginalis, Mobiluncus spp.).
• Analyzes for sexually transmitted infections by PCR.
• Microscopy of smears-prints from intact vesicles for detection of genital herpes.
• Bacteriological studies of discharge from the head of the penis (streptococci, staphylococci).
• A blood test for sugar and an allergy test.
• Cultural and bacterioscopic examination for trichomoniasis and gonorrhea.

[34], [35], [36], [37], [38]

Treatment of the balanoposthitis

How to treat balanoposthitis - certainly interested in patients who have been diagnosed with this disease. First of all, it is worthwhile to know that balanoposthitis represents two different diseases - balanitis and postitis. But these diseases almost always complement each other, therefore in medicine the communities for this defeat have been created the term - balanoposthitis.

The balanoposthitis has several kinds and stages. It is from them that the type of treatment depends. So, at the first stage of the inflammatory process, the urologist appoints the patient the use of local disinfectants. The patient makes baths with disinfectant solutions and applies to the affected organ of the ointment. If the disease is deep, then antibiotic therapy is used for treatment. When complication of balanoposthitis with phimosis, the patient is excised foreskin.

Neglect or refuse treatment is prohibited. Since without appropriate medical care, balanoposthitis leads to negative consequences and serious complications. Balanoposthitis can cause atrophy and amputation of the hollow penis, as well as pathological diseases of the genitourinary system.

Sex with balanoposthitis

Sex with balanoposthitis is a question that interests many men who have experienced this disease. Patients who suffer from acute course or exacerbation of balanoposthitis understand that in practice, sex with an inflamed sex organ does not bring pleasure, but rather causes painful sensations and discomfort.

Itching and discomfort in the groin, thread, puffiness, ulcers and fissures of the foreskin, abundant purulent discharge with an unpleasant odor does not give sexual desire to a man with balanoposthitis. Urologists recommend abstaining from sexual intercourse until full recovery. The main arguments for refusing sex during the period of inflammation:

• Infectious lesions - during sexual intercourse, infections that caused balanoposthitis in a man, are transmitted to a woman and infect her.
• Mechanical effects on the damaged penis, enhance the inflammatory process and further injure the organ, which contributes to the spread of infection.
• Only with a mild form of balanoposthitis can you have sex, and only if you comply with the rules of hygiene before and after sexual intercourse, as well as the use of barrier contraception, that is, condoms.

Circumcision with balanoposthitis

Circumcision with balanoposthitis is the most effective method of surgical treatment of inflammation of the foreskin and glans penis. Circumcision is the fastest procedure, which allows you to quickly eliminate the cause of balanoposthitis. Completely or partially removed foreskin opens the head of the penis, which allows solving physiological problems. In the process of excising the foreskin, through which the nerve endings pass, the lymphatic and blood vessels are not injured. Thanks to this, you can avoid serious complications after the operation.

Timely circumcision performed with balanoposthitis, relieves the causes of the disease and prevents the development of phimosis. Circumcision is also carried out in cases when balanoposthitis caused phimosis, that is, narrowing of the foreskin. But, the acute form of the inflammatory process, is a contraindication to surgical intervention. In this case, only after elimination of inflammation, it is possible to cut off.

Preparation for circumcision with balanoposthitis consists of several stages, let's consider them:

• Before the operation, the patient undergoes ultrasound and diagnostic examination of the genital organ, hands over a series of analyzes. According to the results, the urologist makes a conclusion whether or not to carry out the operation.
• Circumcision is not a complicated operation, so it is performed by a urologic surgeon, without hospitalization of the patient, using a local anesthetic.
• Postoperative sutures are removed within a week, but before that, the patient is prescribed daily dressings.
• The rehabilitation period after the operation lasts 14 days. After that, a man can return to a full sexual life.

[39], [40]

Prevention

Prevention of balanoposthitis consists in observing the rules of intimate and personal hygiene. Let's look at the basic rules for the prevention of balanoposthitis for men and women:

• Mandatory sexual hygiene. At least once a day, you need to wash yourself with soap or gel for intimate hygiene.
• Hygienic procedures must be followed even after intercourse.
• Shortly cut or shave the hair on the pubic, scrotum and penis. This will prevent inflammation and infection.
• Any kind of sex is recommended in a condom. Especially, if it is a question of sexual contacts with casual partners.
• After unprotected sexual acts it is recommended to wash the genitals with the use of antiseptic drugs - Chlorhexidine, a solution of Manganese.
• At the first symptoms of the inflammatory process, it is necessary to go to the urologist.
• Timely diagnosis of the disease and treatment, will help protect against infections and pathological consequences of balanoposthitis and other genital diseases
• Since balanoposthitis can affect boys at any age and even newborn babies, let's look at the rules for the prevention of balanoposthitis in children.
• A newborn child needs to choose diapers that match his size. Since large or small diapers will rub the baby's skin and lead to an inflammatory disease.
• It is necessary to change diapers 4-6 hours after the bowel has been emptied by the baby. Before changing the diaper, the baby's skin should be thoroughly wiped, especially in the perineal region. The hygiene products used should be hypoallergenic, that is, do not irritate the skin.
• It is forbidden to try to open the head of the penis. As this will lead to tearing of the skin and microcracks. The child will feel pain and the inflammatory process may begin.
• Adult boys must observe the rules of hygiene, regularly wash their genitals, opening the head of the penis and change the underwear.
• At the first signs of the inflammatory process or any complaints of the child to the  pain when urinating  or itching in the perineum, it is necessary to contact the urologist.

[41], [42], [43]

Forecast

The prognosis of balanoposthitis depends entirely on what stage of the disease the patient has turned for medical care, and how much the inflammatory process is started. As a rule, the prognosis of balanoposthitis is favorable. But some forms of the disease can become chronic or recurrent. With neglected or acute balanoposthitis, the urologist can prescribe circumcision, that is excision of the prepuce. In especially difficult cases, an amputation of the penis is performed and drainage is placed to remove urine.

Balanoposthitis is an inflammatory lesion of the head and foreskin of the penis. The danger of the disease is that even newborn children are exposed to it. And some forms of inflammation are transmitted during sexual intercourse and can occur in women. Compliance with the rules of intimate hygiene, the change of underwear and the use of condoms during intercourse, will avoid inflammatory lesions. But with the first symptoms of inflammation and any other ailments in the genital area, you need to seek medical help and treat balanoposthitis.

[44], [45]