In men who have been circumcised, such inflammations are less common and limited to the glans penis (balanitis). Those with diabetes mellitus are particularly susceptible to this condition, and those who develop these inflammations should be evaluated for diabetes.
One must be aware of the real possibility that balanitis and balanoposthitis can be harbingers of other, more serious diseases and therefore cannot be dismissed as simple local unhygienic inflammations, especially if they become chronic or persistent.Causes
In almost every instance balanitis results from the presence of a foreskin, which may be redundant and phimotic, thereby predisposing to infections. This preputial cloak harbors beneath it normally desquamating epithelial cells, glandular secretions, and Mycobacterium smegmatis, and provides a warm, moist culture medium for any incidental organisms that may be present. It is obvious, therefore, that personal daily hygiene will prevent most instances of simple balanitis and balanoposthitis.Symptoms
The incubation period varies from 3 days to 1 week. The first signs of involvement may be small red erosions on the glans or undersurface of the prepuce, with concomitant development of much preputial exudation; the purulent discharge may be accompanied by phimosis. If the disease is unchecked, confluent ulcerations will develop along with considerable edema of the penis.Treatment
Since anaerobic conditions are necessary for growth of the offending organisms, simple exposure to air and local cleansing is most often effective. Formerly, this treatment, used with peroxide powder and arsphenamine and, in severe cases, a dorsal slit, was the extent of therapy. With the advent of penicillin and other systemic and local antibiotics, the treatment is specific and effective; however, even now a dorsal slit procedure is sometimes necessary.Questions
Do the signs and symptoms establish a diagnosis of balanitis?
Can any more serious diagnoses be ruled out?
What is the probable cause of the inflammation?
What hygienic measures should be taken?
Will you be prescribing antibiotics?
What is the best method of prevention?