Balanitis

Also known as: Balanoposthitis

Definition

Balanitis is swelling (inflammation) of the foreskin and head of the penis.

Causes, incidence, and risk factors

Balanitis is usually caused by poor hygiene in uncircumcised men. Other possible causes include:

  • Diseases such as reactive arthritis and lichen sclerosis et atrophicus
  • Infection
  • Harsh soaps
  • Not rinsing soap off properly while bathing
  • Uncontrolled diabetes

Symptoms

  • Redness of foreskin or penis
  • Other rashes on the head of the penis
  • Foul-smelling discharge
  • Painful penis and foreskin

Signs and tests

Your health care provider may be able to diagnose your balanitis by examination alone. However, you may need skin tests for viruses, fungi, or bacteria. Sometimes, a skin biopsy is needed.

Treatment

Treatment depends on the cause of the balanitis. For example, balanitis that is caused by bacteria may be treated with antibiotic pills or creams. Balanitis that occurs with skin diseases may respond to steroid creams. Anti-fungal creams will be prescribed if it is due to a fungus.

In severe cases, circumcision may be the best option. If you cannot pull back (retract) the foreskin to clean it, you may need to be circumcised.

Expectations (prognosis)

Most cases of balanitis can be controlled with medicated creams and good hygiene. Surgery is not usually needed.

Complications

Long-term inflammation or infection can:

  • Scar and narrow the opening of the penis (meatal stricture)
  • Make it difficult and painful to retract the foreskin to expose the tip of the penis (a condition called phimosis)
  • Make it difficult to move the foreskin over the head of the penis (a condition called paraphimosis)
  • Affect the blood supply to the tip of the penis

Calling your health care provider

Tell your health care provider if you have any signs of balanitis, including swelling of the foreskin or pain.

Prevention

Good hygiene can prevent most cases of balanitis. When you bathe, pull back (retract) the foreskin to clean and dry the area under it.

References

Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 538.

Link RE. Cutaneous diseases of the external genitalia. In:Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 15. 

Jordan GH. McCammon KA. Surgery of the penis and urethra. In:Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 36. 

Review date:
September 11, 2013
Reviewed by:
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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