View source for Balanitis

{{Short description|Inflammation of the glans penis}}
{{Infobox medical condition (new)
| name = Balanitis
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| image = Inflammation of the glans penis and the preputial mucosa.jpg
| alt = A circumcised penis with an inflamed glans
| caption = Inflammation of the [[glans penis]] and the remaining [[preputial mucosa]] of a circumcised penis
| pronounce = 
| field = [[Urology]]
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'''Balanitis''' is [[inflammation]] of the [[glans penis]].<ref name="Eu2013" /> '''Balanoposthitis''' is the proper term when the [[foreskin]] is also affected.<ref name="Eu2013" /> Balanitis on boys in [[diaper]]s must be distinguished from redness caused by [[ammoniacal]] [[dermatitis]].<ref>{{cite journal |vauthors=Simpson ET, Barraclough P |title=The management of the paediatric foreskin |journal=Aust Fam Physician |volume=27 |issue=5 |pages=381–3 |year=1998 |pmid=9613002 }}</ref>

== Etymology ==
The word ''balanitis'' is from the Greek [[wikt:βάλανος#Ancient Greek|βάλανος]]'' {{lang|el-Latn|balanos}}'', literally meaning '[[acorn]]' because of the similarity in shape to the [[glans penis]].<ref>{{LSJ|ba/lanos|βάλανος|ref}}.</ref> ''-Itis'' is a suffix from the Greek for 'inflammation'. ''Posthe'' is the Greek word meaning 'foreskin'.

==Signs and symptoms==
* Small red erosions on the glans (first sign)
* Redness of the foreskin
* Redness of the penis
* Other rashes on the head of the penis
* Foul-smelling discharge
* Painful foreskin and penis

===Complications===
Recurrent bouts of balanitis may cause scarring of the [[preputial orifice]]; the reduced elasticity may lead to pathologic [[phimosis]].<ref>{{EMedicine|article|777539|Phimosis}}</ref> Further complications may include:<ref>{{cite web |url=https://www.clarewellclinics.co.uk/sexual-health-clinic/balanitis/ |title=Balanitis |website=clarewellclinics.co.uk |access-date=2024-11-08}}</ref> 
* Stricture of [[urinary meatus]]
* [[Paraphimosis]]

==Causes==
[[File:Balanitis caused by smegma.jpg|thumb|303x303px|Balanitis caused by [[smegma]]]]
[[Inflammation]] has many possible causes, including irritation by environmental substances, certain medications, [[Injury|physical trauma]], and [[infection]] such as bacterial, viral, or fungal.<ref name=Edwards>{{cite journal |author=Edwards S |title=Balanitis and balanoposthitis: a review |journal=Genitourin Med |volume=72 |issue=3 |pages=155–9 |year=1996 |pmid=8707315 |pmc=1195642 |doi= 10.1136/sti.72.3.155}}</ref><ref>[http://my.clevelandclinic.org/disorders/penile_disorders/hic_disorders_of_the_penis.aspx Cleveland Clinic: Penile Disorders]</ref> Some of these [[Sexually transmitted infection|infections are sexually transmitted]], however a [[yeast infection]], ''[[Candida (fungus)|Candida]] balanitis'', is generally not categorized as such.

It is less common among males who are [[circumcised]]; in many cases, a dysfunction of the [[foreskin]] is a causal or contributing factor.<ref name=Eu2013>{{cite journal|last1=Edwards|first1=SK|last2=Bunker|first2=CB|last3=Ziller|first3=F|last4=van der Meijden|first4=WI|title=2013 European guideline for the management of balanoposthitis.|journal=International Journal of STD & AIDS|date=August 2014|volume=25|issue=9|pages=615–26|pmid=24828553|doi=10.1177/0956462414533099|s2cid=127341}}</ref> Both not enough cleaning and too much cleaning can cause problems.<ref name=Eu2013/>

==Diagnosis==
Diagnosis may include careful identification of the cause with the aid of a good patient history, swabs and cultures, and pathological examination of a [[biopsy]].<ref name=Edwards/>

=== Types ===
* [[Zoon's balanitis]], also known as ''Balanitis Circumscripta Plasmacellularis'' or ''plasma cell balanitis'' (PCB), is an idiopathic, rare, benign penile dermatosis<ref name=Keogh>Keogh G. {{eMedicine|derm|45|Balanitis circumscripta plasmacellularis}}</ref> for which circumcision is often the preferred treatment.<ref name=Keogh/><ref>{{cite journal |vauthors=Pellicé i Vilalta C, Casalots i Casado J, Cosme i Jiménez MA |title=[Zoon's balanoposthitis. A preliminary note] |language=es|journal=Arch. Esp. Urol. |volume=52 |issue=1 |pages=69–72 |year=1999 |pmid=10101891 }}</ref><ref>{{cite journal |author=Buechner SA |title=Common skin disorders of the penis |journal=BJU Int. |volume=90 |issue=5 |pages=498–506 |year=2002 |pmid=12175386 |doi=10.1046/j.1464-410X.2002.02962.x |s2cid=45605100 }}</ref>  Zoon's balanitis has been successfully treated with the [[Carbon dioxide laser#Medical (soft-tissue surgery)|carbon dioxide laser]]; <ref>{{cite journal |vauthors=Baldwin HE, Geronemus RG |title=The treatment of Zoon's balanitis with the carbon dioxide laser |journal=The Journal of Dermatologic Surgery and Oncology |volume=15 |issue=5 |pages=491–4 |year=1989 |pmid=2497162 |doi= 10.1111/j.1524-4725.1989.tb03407.x}}</ref> and more recently, Albertini and colleagues report the avoidance of circumcision and successful treatment of Zoon's balanitis with an [[Er:YAG laser#Applications|Er:YAG laser]].<ref>{{cite journal |vauthors=Albertini JG, Holck DE, Farley MF |title=Zoon's balanitis treated with Erbium:YAG laser ablation |journal=Lasers Surg Med |volume=30 |issue=2 |pages=123–6 |year=2002 |pmid=11870791|doi=10.1002/lsm.10037|s2cid=33098632 |url=https://zenodo.org/record/1229277 }}</ref> Another study, by Retamar and colleagues, found that 40 percent of those treated with CO<sub>2</sub> laser relapsed.<ref>{{cite journal |vauthors=Retamar RA, Kien MC, Chouela EN |title=Zoon's balanitis: presentation of 15 patients, five treated with a carbon dioxide laser |journal=Int. J. Dermatol. |volume=42 |issue=4 |pages=305–7 |year=2003 |pmid=12694501 |doi=10.1046/j.1365-4362.2003.01304.x |s2cid=21305117 }}</ref>
* Circinate balanitis, also known as [[balanitis circinata]], is a [[serpiginous]] annular dermatitis associated with [[reactive arthritis]].
* [[Pseudoepitheliomatous keratotic and micaceous balanitis]]

==Treatment==
Initial treatment in adults often involves simply pulling back the [[foreskin]] and cleaning the penis.<ref name=Eu2013/> However, some topical antibiotic and fungal ointments may be used for treatment for mild cases. Depending upon severity, [[hydrocortisone]] and other steroidal creams may be used upon consultation.

==Epidemiology==
Balanitis "is a common condition affecting 11% of adult men seen in [[urology]] clinics and 3% of children" in the United States; globally, balanitis "may occur in up to 3% of uncircumcised males".<ref>{{EMedicine|article|777026|Balanitis}}</ref>

==Other animals==
[[File:Balanoposthitis_canine_prepuce_discharge.jpg|thumb|[[Penile sheath|Prepuce]] of a dog affected by balanoposthitis]]
In [[dog]]s, balanoposthitis is caused by a disruption in the [[integumentary system]], such as a [[wound]] or intrusion of a [[foreign body]]. A dog with this condition [[canine behavior|behaves]] normally, with the exception of excessive licking at the prepuce, and a yellow green, [[pus]]-like [[Mucopurulent discharge|discharge]] is usually present.

In [[sheep]] (rams/wethers), ulcerative enzootic balanoposthitis is caused by the ''[[Corynebacterium renale]]'' group (''C. renale, C. pilosum & C. cystidis'').

For the condition in [[bull]]s, caused by a [[virus]] see [[Bovine herpesvirus 1]].

Balanoposthitis is believed to have contributed to the decline to near-extinction of the marsupial [[Gilbert's potoroo]].<ref name="Rebecca Vaughan-Higgins 2011">{{cite journal |first1=Rebecca |last1=Vaughan-Higgins |first2=Nicky |last2=Buller |first3=J. Anthony |last3=Friend |first4=Ian |last4=Robertson |first5=Cree L. |last5=Monaghan |first6=Stan |last6=Fenwick |first7=Kristin |last7=Warren |title=Balanoposthitis, Dyspareunia, and Treponema in the Critically Endangered Gilbert's Potoroo (''Potorous gilbertii'') |journal=Journal of Wildlife Diseases |year=2011 |volume=47 |issue=4 |pages=1019–1025 |doi=10.7589/0090-3558-47.4.1019 |pmid=22102677 |s2cid=7279808 |url=http://researchrepository.murdoch.edu.au/id/eprint/6136/ |doi-access=free }}</ref>
{{Clear}}

==References==
{{Reflist}}

==Further reading==
*Edwards S. (for the Clinical Effectiveness Group) [https://web.archive.org/web/20041030063437/http://www.bashh.org/guidelines/2002/balanitis_0901b.pdf National guideline on the management of balanitis]. Association for Genitourinary Medicine (UK) and the Medical Society for the Study of Venereal Diseases (UK), 2001.

== External links ==
{{Medical resources
|  ICD10          = {{ICD10|N|48|1|n|40}}
|  ICD9           = {{ICD9|607.1}}
|  ICDO           = {{IPAc-en|b|æ|l|ə|ˈ|n|aɪ|t|ɪ|s}}
|  OMIM           = 
|  OMIM_mult      = 
|  MedlinePlus    = 000862
|  eMedicineSubj  = emerg
|  eMedicineTopic = 51
|  DiseasesDB     = 1229
|  MeshID         = D001446
}}
{{Commons category|Balanitis}}
*{{eMedicine|derm|45|Zoon's Balanitis}}
*[http://www.atlasdermatologico.com.br/ListaImagens/Balanitis_Candidomycetica1.jpg Dermatological atlas]

{{Male diseases of the pelvis and genitals}}

[[Category:Circumcision debate]]
[[Category:Inflammations]]
[[Category:Penis disorders]]
[[Category:Theriogenology]]