What is balanoposthitis

Background

Balanos means acorn in Greek and relates to the head or glans of the penis.  Posthitis is an inflammation of the foreskin.  The frequently occur together. If conservative treatment does not work for an adult, certainly cosmetic circumcision is usually curative.

Balanoposthitis is defined as the inflammation of the foreskin and glans in uncircumcised males, balanoposthitis occurs over a wide age range and may have any of multiple bacterial or fungal origins or be caused by contact dermatitides. Complex infections have been well documented, often from a poorly retractile foreskin and poor hygiene that leads to colonization and overgrowth. Treatment focuses on clearing the acute infection and preventing recurrent inflammation/infection through improved hygiene. Although not as necessary as in the past, circumcision may be considered for refractory or recurrent balanoposthitis. Balanoposthitis should not be confused with balanitis, which is inflammation of the glans penis.

Pathophysiology

Although multiple organisms have been incriminated as causative agents, the patient is empirically treated without obtaining specific organism etiology in most cases. The multicausal origin of balanoposthitis has been emphasized by Fornasa et al, who identified infectious, mechanical/traumatic, or contact dermatitides in 67% of their patients with balanoposthitis.  In one third of the patients, a specific cause could not be established even after clinical examination and microbiologic and serologic tests had been performed. Candidal infection appears to be the most common cause of disease. ] Older men often have other etiologies, including intertrigo, irritant dermatitides, or other fungal infections. Organisms that have been identified include Bacteroides, Gardnerella,  and Candidaspecies and beta-hemolytic streptococci. It may also occur as a manifestation of syphilis. 

(credit to Medscape)

The Reed Centre for Cosmetic Circumcision | Miami

Picture of balanoposthitis, note inflammation of both retracted foreskin and glans

 

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