Balanitis is an inflammation of the head of the penis ( glans penis ) caused by various things. Infections caused by balanitis often also cause inflammation of the skin covering the penis on the uncircumcised penis ( prepuce ). Some things that can cause the occurence of balanitis include fungal infections, bacterial infections, infectious diseases, skin irritation, and other skin disorders. Balanitis can occur to anyone and at any age. Balanitis is common in children under 4 years old and in noncircumcised adult males. About one in 25-30 non-circumcised people develop balanitis.
Common symptoms that appear on the penis are affected balanitis include:
- Redness on the head of the penis in the form of red spots until reddened entirely.
- Blisters (ulcers) on the penis.
- Feels hard, dry, or stiff.
- The head of the penis swells.
- Sometimes a viscous discharge from underneath the prepuce compounds an odor caused by anaerobic bacterial infection or Streptococcus sp.
- Discomfort during urination.
- It is difficult to attract prepuce (phimosis).
- In some cases causes impotence.
- May cause lymphoadenopathy.
- It is difficult to install a Foley catheter .
- Systemic symptoms such as fever or nausea, but rare.
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Causes of Balanitis
There are several things that can cause a person balanitis, among others:
- Does not maintain genital hygiene. If a person who has not circumcised does not maintain the cleanliness of his genitals, then added to the tightness factor of the foreskin (preputium), can cause irritation due to fluid in the genitals (smegma). Smegma is a dirty liquid that forms under the foreskin at the end of the uncircumcised genitals. This factor is a major cause of balanitis.
- Sexually transmitted infections. Sexually transmitted infections can sometimes cause balanitis, especially if a person suffers from urinary tract inflammation (urethra). A wide range of STDs (eg genital herpes, chlamydia, or gonorrhea) can cause balanitis. Symptoms that appear in balanitis due to sexually transmitted infections are usually a pain in the urine and out of the urethra.
- Nonsexual infectious infections. Various kinds of microbes that normally live on the skin can cause infectious diseases. The main cause of balanitis due to nonseksual infection is the fungus Candida sp type. Candida sp is also a fungus that causes vaginal and whitish infections in women. Candida sp generally lives on the surface of the skin under normal conditions, but at certain times can cause infection. Several types of bacteria can also cause balanitis in both children and adult males. Infection is easier to occur if a person has the following conditions:
- Experiencing inflammation of the penis due to allergies or irritation.
- Have diabetes. Sugar content in the urine can be a source of food for bacteria if the remaining urine in the penis after urination is not cleaned properly.
- Suffering from phimosis. Phimosis is a skin condition that causes the foreskin (prepuce ) can not be pulled so that the head of the penis can not be cleaned. This condition generally occurs in children under 5 years old.
- Allergy and irritation. The scalp of the penis is very sensitive and can react to various chemical compounds or other substances. Examples of things that can cause irritation to the head of the penis are:
- Dead skin cells, sweat, urine and other objects can be collected under the foreskin.
- Several types of soaps and disinfectants.
- Rub or wash the head of the penis excessively.
- Condoms, spermicides, lubricants used during sexual intercourse.
- The chemical compound affected in the hand may affect the penis head if it is not cleaned prior to the toilet.
- Detergent or laundry soap that is not rinsed properly and left in panties.
Risk Factors Balanitis
Some factors that can increase a person's risk of balanitis include:
- Diabetes mellitus .
- Use of oral antibiotics.
- Poor hygiene in non-circumcised men.
- Low immunity.
- Irritation due to physical or chemical on the head of the penis.
The following are the types of microbes that can infect the penis and cause balanitis, including:
- Candida fungus sp
- Staphylococcus sp
- Streptococcus bacteria sp
- Gardnerella vaginalis bacteria
- Mushroom Trichomonas sp
- Bacteria Borrelia vincentii
- Treponema pallidum bacteria
- Bacteria Entamoeba histolytica
- Different types of anaerobic bacteria
- Human Papilloma Virus
Diagnosis of Balanitis
Doctors can diagnose balanitis by looking for signs of redness and inflammation of the head of the penis. With signs of inflammation on the head of the penis, doctors can immediately provide recommendations and standard treatment to patients to overcome the inflammation. Other diagnostic methods that can be done are:
- Take a sample using a cotton swab to determine the presence of infectious microbes that cause infections and inflammation.
- Perform blood glucose examination in diabetic patients.
- Gives a referral to a sex dermatologist if a balanitis infection is suspected to be caused by a sexually transmitted disease. Couples who engage in sexual activity should also be checked for fear of the disease.
- Gives a referral to a dermatologist if a balanitis infection is suspected due to a skin disorder.
- If inflammation persists, a penile head biopsy may be performed to examine the structure of the skin through a microscope.
- Perform microbial cultures derived from the fluid of balanitis infection to determine the cause of balanitis infection.
- Perform serological tests for syphilis.
- Checking virus titers Human Papilloma Virus and HIV.
- Perform potassium hydroxide check to determine the presence of Candida sp.
Balanitis treatment depends on the cause. Some methods of balanitis treatment are as follows:
- Anti-fungal creams and tablets for the treatment of balanitis caused by Candida infection. Examples of drugs that can be used are nystatin , clotriazole, fluconazole, miconazole, and imadiazol.
- Antibiotics for the treatment of balanitis caused by bacterial infection. Some types of antibiotics that can be used are penicillin , fluxoxacillin, and erythromycin. For anaerobic batkeri infections can be used metronidazole , koamiksoklaf, and klindamisin.
- Slight steroidal cream to treat inflammatory or allergic balanitis. Sometimes steroid cream is used as an adjunct to infectious balanitis treatment to reduce inflammation. But keep in mind that steroids should not be used alone because it will aggravate the infection that occurred.
- Circumcision. If balanitis often recurs and the patient has a condition of phimosis, the best treatment is circumcised.
- Avoid using soap in the genitals when inflammation occurs.
- Using a moisturizer cream instead of soap to cleanse the genitals.
- Using warm water to clean the genitals, then dried slowly.
- Bathing with salt water.
During a balanitis treatment that is not caused by a sexually transmitted infection, the patient may have sexual activity with a partner. But it would be nice sexual activity is avoided because it is feared can cause pain in the penis.
If balanitis is caused by a contagious infection, then the sufferer is not allowed to perform sexual activity, before treatment is completed and symptoms disappear, because it is feared will transmit disease to the couple.
Prevention of Balanitis
Balanitis can be prevented by the following:
- Clean the penis regularly every day using soap. For people who have not circumcised, make sure to clean the head of the penis and rinsed with water. After cleansing, dry the head and body of the penis before using the panties.
- If balanitis symptoms are associated with condom use, use a special condom made for sensitive skin.
- If working using harmful chemical compounds, be sure to wash your hands first before urinating.
- Use condoms during sexual activity with a new partner.
- Controlling the condition of diabetes and other chronic diseases that may have an impact on balanitis.
- Reduce weight if you are obese.
- If left untreated, balanitis can cause other health problems, such as:
- Joint pain.
- Rash on the other skin.
- Dry mouth.
- Swollen glands.