Balanoposthitis is the inflammation of the glans (or head of the penis) and the foreskin, which is the skin that covers the glans. It is associated with symptoms like swelling, redness, burning and itching in the area.

Balanoposthitis can occur for many reasons, but it is usually caused by a fungal infection (from Candida albicans, for example) or a bacterial infection (from Staphylococcus sp.). This inflammation can also be caused by an allergic reaction, autoimmune or malignancy.

It is important to identify the underlying cause of balanoposthitis, as this will help to guide the most appropriate treatment approach. The doctor may consider prescribing corticosteroid ointments or antibacterial creams, for example.

Common symptoms

The main symptoms of balanoposthitis are:

Itching, redness and burning felt in the glans and foreskin
Pain or discomfort when urinating
Malaise
Difficulty lifting the skin covering the head of the penis
Swelling in the area
Dry skin
Discharge
Sores on the penis

If you notice any signs or symptoms of balanoposthitis, you are advised to see a family doctor or urologist for assessment and treatment as necessary.

Confirming a diagnosis

A balanoposthitis diagnosis should be confirmed by a family doctor or urologist, who will evaluate your signs and symptoms as well as assess your health history and lifestyle habits.

The doctor may order blood and urine tests, as well as a swab of the discharge of any penile secretion or a urine test.

The doctor may order a biopsy for men with recurrent balanoposthitis to check for any signs of malignant cells. Surgical removal of excess foreskin may also be recommended to promote better hygiene and reduce and reduce moisture in the area.

Main causes

Balanoposthitis can have different causes and can therefore be classified into:

Infectious balanoposthitis, which occurs due to a fungal, bacterial, viral or parasitic infection. Many infections are related to the following microorganisms: Candida albicans, Staphylococcus sp.; Streptococcus sp.; HPV, Treponema pallidum, Mycoplasma hominis, Mycoplasma genitalium, Trichomonas sp.;
Inflammatory balanoposthitis, which occurs due to inflammatory and autoimmune diseases, such as lichen planus, scleroatrophic lichen, atopic dermatitis, eczema and genital psoriasis;
Pre-neoplastic balanoposthitis, in which the symptoms of inflammation are related to the proliferation of cancer cells, which may be related to Bowen's disease and erythroplakia of Queyrat;
Allergic balanoposthitis, in which inflammation occurs due to contact with a substance that causes local irritation or allergy, such as latex from condoms or chlorine present in swimming pools, for example. It can also occur due to poor genital hygiene.

Balanoposthitis is more common in men who use medications that reduce immune system activity, are over 40 years old, have not been circumcised, or have multiple sexual partners. It can also occur in men with poorly managed diabetes, as there is a larger loss of glucose in the urine, favoring the development of microorganisms in the urethra.

Treatment options

Treatment for balanoposthitis is guided by a family doctor or urologist according to the underlying cause. In most cases, the doctor may prescribe topical or oral antifungals or antibiotics, depending on the microorganisms causing the infection.

Treatment is often the same as that of balanitis, which is inflammation of only the head of the penis. The doctor may consider prescribing corticosteroid ointments, such as hydrocortisone, antifungals, such as ketoconazole, itraconazole or clotrimazole, or antibiotic ointments, such as clindamycin, is indicated.

In more serious cases, in which balanoposthitis is recurrent, and the patient presents with risk factors as well as a risk of other complications or worsening of symptoms, surgery for phimosis may be recommended. Phimosis surgery involves the removal of excess skin from the penis.

It is also important for men to always keep their genital area clean and dry, to avoid trauma and avoid using antiseptic soaps, as this can eliminate beneficial bacteria that are naturally found in the genitals.