What usually causes balanitis? 

Talking about the reproductive system should not be an embarrassment. This is especially true when there are symptoms affecting any of the organs associated with the reproductive system. Any problems to the reproductive system should be checked by a doctor and when doctors ask sensitive questions, patients need to answer it with honesty as this will help doctors to make accurate diagnosis and effective treatment such as medicine. In this article, we will be learning about one of the diseases associated with the reproductive system known as balanitis.

Balanitis is the inflammation of the head of the penis (glans penis). It is a common condition affecting 3 to 11% of the male population. It can occur at any age. Balanitis often involves the foreskin or prepuce that is termed as balanoposthitis. Balanoposthitis occurs only in uncircumcised male. However, since balanitis and balanoposthitis often occurs together, making the terms commonly interchangeable. Balanitis is more likely to occur if there is phimosis, a condition where the tight foreskin is unable to retract back over the penis.

The most common cause of balanitis is related to inadequate personal hygiene in uncircumcised males leading to infections. The warm moist environment under the uncircumcised of the penis foreskin favour the growth of organisms responsible for balanitis such as fungus. Majority of the infections are caused by fungal infections with Candida albicans being the most common one. Other potential causes of balanitis include bacterial infection, sexually transmitted infections, skin conditions such as eczema or dermatitis and irritants such as chemicals irritants in detergent or perfumed soap.

Although no direct causation of association exists between nonspecific balanoposthitis and uncircumcised penis, data does suggest that circumcision prevents or protects against common male genital skin conditions. Risk factors for balanitis includes presence of foreskin, obesity, poor hygiene, uncontrolled diabetes, usage of condom catheters, sensitivity to chemical irritants, nursing home environment, edematous condition such as from congestive heart failure or dilation of kidney (nephrosis), reactive arthritis, certain medicine, and sexually transmitted infections. When a person has one or more of the risk factors, he will have a higher chance of developing balanitis.

Symptoms of balanitis includes redness and/or itchiness around the head of the penis, sore around head of the penis, swollen gland near the penis, pain when passing urine, unpleasant smell from penis, difficulty pulling back the foreskin, thick discharge from under the foreskin and even bleeding around the foreskin. The inflammation may appear more dark blue as opposed to red in patients with darker skin colour. It is important to get checked by a doctor whenever there are symptoms of balanitis. A person should not be ashamed of asking for medical advice for this condition.

Diagnosing balanitis is based on the history of the patient including sexual history and physical examination. Swabs may be done to the head of the penis to test for infections. Blood tests may be done especially in those with severe symptoms. Treatment depends on the cause. Balanitis should clear on its own once the underlying condition is tacked on. Treatment may be prescription of topical steroid, antibiotics or antifungal cream. In case that balanitis often keeps coming back or medicine is not able to help, circumcision is considered. Female sexual partners of the men with balanitis should be offered with testing for candida or treatment to reduce the reservoir of infection in the couple.

When a person has balanitis, apart from using medication prescribed by doctors, it is important to really take care of hygiene. This includes washing the penis every day just by using water or aqueous cream, gently pulling back the foreskin and washing the area with warm water, dry the area gently after finishing with washing and to wash hands before touching penis or peeing. It is best to avoid using soap or shower gel when washing as it may be irritative to the penis. While it is important to wash the penis, avoid frequent washing. Saline baths, dilute potassium permanganate soaks, or Burow’s solution are helpful in drying the head of the penis with discharge conditions. Men who tend to develop balanitis after sexual intercourse should wash the penis after sexual activity. If irritants seem to be the triggers for balanitis, a person needs to identify what may have been causing it and avoid using it. Irritants can be from detergents, fabrics, shower gel, dyes, perfumes and even condom typically the one with lubricants or spermicide.

In essence, balanitis is inflammation of the head of the penis, commonly due to poor hygiene. It is more common for uncircumcised male to have this condition. Data shows that circumcised male have 68% lower chance of balanitis than uncircumcised males. Balanitis itself carries 3.8-fold of increase in penile cancer risk. Treatments involve practising good hygiene and medication to tackle the underlying issue. In some cases, circumcision is recommended instead. Most people with balanitis recover without complications with appropriate treatment and genital hygiene measures. It is common balanitis to recur in those who are uncircumcised.

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