Balanitis (and Balano-posthitis)

Diagnosis

Diagnosis is made on clinical grounds. Diagnosis may be difficult for the inexperienced because of the diversity of clinical features, which may mimic a variety of conditions.

Management

Treatment

Although candida and bacteria may be isolated from the inflamed area, medication has a  limited role and is best avoided in most cases.  The basis of treatment is to keep the foreskin clean and dry.  The patient should clean the glans with water 2 to 3 times a day and pat dry. The foreskin should be retracted to expose the glans to the air, a fan or a reading light for 15 minutes.  Individuals prone to balanitis should routinely perform this procedure nightly or at least several times a week.  The patient should not retract a tight foreskin as paraphimosis is likely to occur.

If this procedure is not effective or if the foreskin is tight, circumcision should be considered.

Patient education

The following points should be discussed:

• The nature of the condition
• The need for hygiene rather than medications or creams
• Abstinence from sex during episodes as this may flare the condition
• Routine hygiene after sex will help to decrease the chance of developing balanitis
• The foreskin should always be retracted during urination
• Provide literature on balanitis.

Follow-up

Follow up is required only if symptoms do not resolve.