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Balanitis

What is Balanitis?

Penis infections frequently occur on the skin or in the urethra

Balanitis is the medical term for inflammation of the glans penis (head of the penis). Balanitis involving the foreskin is termed balanoposthitis. We usually just use the term “balanitis”. This is a common condition that may affect as many as 1 out of 10 males and can occur in males at any age. As a men’s health doctor, I see the issue of balanitis on a daily basis.

 Most of my patients usually present with penile itch or pain, redness of the glans penis, penile discharge and difficulty with retraction of the foreskin.

 

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What are the Causes of Balanitis

The main cause is usually due to an infection, which can be bacterial or fungal in nature.

Poor personal hygiene is usually the main reason for infection and this is more apparent in uncircumcised men. We see balanitis commonly in patients with phimosis (tight foreskin) as well, as they are unable to retract the foreskin fully to clean.

With the foreskin always in the forward position, the lack of aeration and irritation caused by smegma and discharge around the glans penis can lead to inflammation and infection.

Besides infections, inflammation can also be caused by non-infectious causes such as overwashing, chemical irritants (eg, soap, gels), allergies and other skin conditions such as lichen sclerosis, lichen planus, psoriasis and eczema.

 

We also see balanitis commonly in diabetics. In diabetics, the patients’ urine contains sugar. If the patient’s glans penis is constantly surrounded by a coating of sugar, bacteria can easily grow off of it.

In diabetics who use a group of medications called ‎SGLT2 inhibitors, we see an increased incidence of balanitis as well because these medications cause more sugar to be excreted in the urine.

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Frequently Asked Questions (FAQs)

1) How Does Balanitis Affect You Long-Term (Complication)?

Balanitis is not completely benign. A complication we see in recurrent balanitis is Constricting Phimosis, where the foreskin can get tighter and tighter. Eventually, the patient may not be able to retract the foreskin from the glans penis.

This can lead to further episodes of balanitis and painful erections, affecting a patients’ sex life. Other less common complications of balanitis may include meatal stenosis and possible urethral strictures; urinary retention; and vesicoureteral reflux.

Rarely, these infections may get severe enough to cause sepsis.

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2) I seem to get this problem frequently - what should I do?

As the bulk of balanitis are due to infections, we can treat balanitis with antibiotics - topical or oral. If a fungal infection is suspected, an antifungal agent may be used.

The doctor may also take some swabs before the commencement of antibiotics so we can test for the organism that is causing the infection. It may also be useful to exclude sexually transmitted illnesses (STIs) at this point as some STIs may contribute to balanitis. Read: STD Screening

The doctor might also want to test your sugar levels to see if you have diabetes, which predisposes you to balanitis.

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3) Would I need a circumcision? - Balanitis Treatment

In recurrent cases of balanitis, circumcision can be curative. This involves the removal of the foreskin which can be done in an outpatient setting. No foreskin, no infection!

Circumcision is rarely needed to treat a penis infection. In certain situations like diabetes, or situations causing recurrent bacterial or fungal infections of his foreskin (recurrent balanitis), individuals may benefit from circumcision. 

4) How to Reduce your Risk of Balanitis? - Balanitis Treatment

It is recommended that all males gently retract the foreskin daily and wash with warm water to clean the penis and foreskin.

Proper personal hygiene, control of diabetes and other chronic medical disorders and weight reduction for patients who are obese can also reduce your risk of balanitis as well.

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