Balanitis

Basic Information

Balanitis is an inflammation of the tissues at the head of the penis caused by a bacteria or yeast infection. It is the most frequent cause of penile swelling. It is seen almost exclusively in uncircumcised men whose foreskin as well as penile head may be affected. It is usually caused by poor or improper hygiene. Yet there can be a number of other causes including:

• trauma from pulling
• allergies to medications, creams, lotions
• catheter use
• irritation from dyes in clothing such as colored underwear
• irritation from latex condoms and/or nonoxynol-9 spermicide
• irritation from tight, ill-fitting condoms
• urine, if allowed to remain on the penis and/or to collect under the foreskin, can macerate this area
• tears on the penis

Also improper hygiene can lead to an overgrowth of yeast, a secondary infection sometimes associated with balanitis. In fact it is thought that at times balanitis can be transmitted by sexual contact with a partner who has a yeast infection. This is a disease that affects men only -- of all ages -- though the incidence of infection in the U.S. is not really known. What is known is that men who are sexually active, uncircumcised, are diabetic or who have improper or poor hygiene are at the most risk for getting balanitis.

Symptoms

Itching, edema (water retention), swelling, pain and redness are the primary symptoms of balanitis. Swelling of the penile head and foreskin may occur simultaneously. Occasionally a penile tip ulcer or an erosion of the head of the penis may be present. Rarely, there may be discharge from the penis from the balanitis itself, but discharge is more typically because of a candidia (yeast) infection or a strep/staph infection.

If left untreated, symptoms can include ulcerations on the penile shaft, sometimes severe, which can lead to additional bacterial infections. A burning during urination can occur, and in serious cases, a difficulty or even inability to urinate can be a complication.

Diagnosis/Treatment

Your health care provider can make a diagnosis based on physical examination in the office in which any of the symptoms listed above will be evaluated, along with your personal medical history. Your diagnosis may sometimes be made not only from primary symptoms, but from symptoms of a secondary infection, should one be present, such as an overgrowth of yeast.

If you are diagnosed with balanitis, your health care provider will want to assess you for evidence of sexually transmitted diseases (STDs) such as syphilis, gonorrhea, hepatitis B and herpes.

Also, if you are diagnosed with balanitis, a discussion about HIV testing and counseling is very important and indicated. When a person has at least one sexually transmitted disease, studies have shown that the risk for HIV transmission is much more likely.

Your health care provider will probably want to test you for diabetes if your infection is chronic or you have an overgrowth of yeast. As discussed, there is often a correlation between diabetes and balanitis. If you are a diabetic, please remember to take your diabetic medication.

The primary prevention for balanitis is meticulous hygiene on a daily basis and treatment of balanitis is generally a maintenance of meticulous hygiene, particularly in mild cases. Cleaning the penis and foreskin with warm water a few times a day is recommended, as long as you are comfortable doing so. After urination is considered the best time for a cleaning. Warm sitz baths are helpful too. But hot baths can irritate the infection and delay healing. Balanitis can recur and one of the best ways to prevent recurrent episodes is to continue warm water cleansing of the penis and foreskin several times a day.

Sometimes antibiotic or antifungal creams applied to affected areas are prescribed (especially in the case of secondary infections), as well as steroid creams which decrease inflammation or swelling.

As long as your penis is swollen, do not engage in sexual activity or use condoms. Do not engage in strenuous exercise if it is painful; instead get plenty of bed rest -- lying on your back with your penis in an elevated position can be beneficial.

Treatment for more serious cases of balanitis can vary and must be evaluated by your health care provider. Antibiotics by mouth may be prescribed. A biopsy to check for malignancies in lesions that do not heal may be indicated or an evaluation for circumcision if symptoms are severe or recur. In the most severe cases when there is an inability to urinate slit drainage may have to be performed promptly.

If you are diagnosed with balanitis your health care provider will want to evaluate your sexual partners for any coexistent infections.

Should you feel that you have balanitis or any sexually transmitted disease please see your health care provider promptly.

Additional Resource(s):

• American Academy of Dermatology 847-330-0230