Balanitis & Balanoposthitis

Overview – Balanitis & Balanoposthitis

Balanitis refers to inflammation of the glans penis, whereas balanoposthitis involves inflammation of both the glans and the foreskin (prepuce). These are common urological conditions in uncircumcised males, typically due to infection, poor hygiene, or irritation. Early recognition and treatment are essential to prevent complications such as phimosis or secondary infection.

Definition

• Balanitis: Inflammation confined to the glans penis
• Balanoposthitis: Inflammation of both the glans and prepuce (foreskin)

Aetiology

Infectious Causes

• Bacterial:
  • Staphylococcus aureus
  • Escherichia coli
  • Neisseria gonorrhoeae
• Fungal:
  • Candida albicans (especially in diabetics)

Non-Infectious Causes

• Environmental irritation (e.g. soaps, detergents)
• Physical trauma or friction
• Allergic reactions

Risk Factors

• Phimosis – difficulty retracting foreskin increases retention of debris
• Poor genital hygiene – accumulation of smegma and pathogens
• Excessive washing – can dry or irritate the foreskin
• Poorly controlled diabetes mellitus – predisposes to Candida infections

Morphology

• Balanitis:
  • Erythema and inflammation limited to the glans penis
• Balanoposthitis:
  • Erythema and swelling of both glans and foreskin

Clinical Features

Symptoms

• Small, red erosions on the glans
• Pain, discomfort, or tenderness of the penis
• Erythema of glans ± prepuce
• Discharge or foul odour (occasionally)

Complications

• Phimosis – chronic inflammation may lead to scarring and tightening of the preputial ring
• Secondary infections if untreated

Investigations

• Clinical diagnosis via physical examination
• Swab for microbiological culture (if discharge or persistent symptoms)
• Blood glucose level – especially in recurrent cases to rule out diabetes
• STI screening if sexually active with risk factors

Management

Conservative Measures

• Improve genital hygiene (gentle daily cleaning)
• Avoid irritants (e.g. soaps, bubble baths)

Medical Treatment

• Topical antifungals – e.g. clotrimazole if Candida suspected
• Topical or oral antibiotics – based on likely pathogens or culture
• Topical corticosteroids – for inflammatory or allergic causes
• Treat underlying conditions (e.g. diabetes)

Summary – Balanitis & Balanoposthitis

Balanitis and balanoposthitis are inflammatory conditions of the glans and foreskin, often due to infection, poor hygiene, or irritants. Clinical presentation includes redness, pain, and erosions. Management focuses on hygiene, topical treatments, and addressing predisposing factors like diabetes. For a broader context, see our Reproductive Health Overview page.