Balanoposthitis in children and men

Balanoposthitis is an inflammatory disease of the foreskin and glans penis that occurs in men and children.

Table of contents: Causes of balanoposthitis Symptoms of balanoposthitis Clinical features of balanoposthitis

Causes of balanoposthitis

Balanoposthitis is of an infectious and noninfectious nature.

Infectious balanoposthitis is caused by microorganisms transmitted predominantly through the sexual path.

The following infectious pathologies can provoke a balanopostitis:

Gonorrhea caused by gonococcus is an acute venereal infectious disease that proceeds aggressively with genital lesions;
Trichomoniasis - one of the most common sexual infections, according to statistics it affects about 10% of the world's population;
genital herpes is a viral pathology that manifests by an inflammatory rash on the skin and mucous membranes;
candidiasis - fungal infection;
papilloma virus( HPV);
nonspecific pathogens of inflammatory processes, most commonly streptococci and staphylococci;

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gardnerellez is the cause of female vaginal dysbacteriosis caused mainly by a microorganism( Gardnerella vaginalis), which, upon contact with the male genital organs, can cause balanoposthitis.

Noninfectious causes of balanoposthitis:

Damage to the glans penis and foreskin with mechanical factors( friction, infringement - irrational balanoposthitis);
balanoposthitis caused by problems of small vessels in diabetes mellitus;
psoriasis is a common chronic disease of the body with predominant skin manifestations, including on the head of the penis and foreskin;
flat lichen is a chronic skin disease affecting the genitals with the development of balanoposthitis;
rare diseases - erythroplasia, Zan balanitis, Behcet's disease, etc.

Development of balanoposthitis is facilitated by:

hygienic problems - untimely toilet of genital organs, wearing dense and rubbing skin of clothing, hot season;
phimosis - impossibility of exposure of the glans penis due to fusion of the foreskin;
immunodeficiency states, allergic processes;
is a chronic infectious pathology in which microorganisms can be carried by blood flow to the genital organs;
promiscuous sex life;
infections of the bladder, urethra, prostate.

Symptoms of balanoposthitis

Symptoms of acute balanoposthitis can be detected both sequentially and in a complex manner. We list them for the greatest likelihood of occurrence:

burning and itching of the foreskin and glans penis are the most common discomfort that intensifies from touching, friction with clothing, during the act of urination;
redness and swelling of the foreskin, sometimes very significant;
occurrence of blisters - this symptom of balanoposthitis is caused by sweating under the skin of the fluid from the area of edema, blisters can be multiple and of different sizes;
skin defects - erosion, with a red bottom, covered with a thin whitish film, and often with a purulent rim along the edges of the erosive surface.After healing of erosions there are no traces;
discharge from the urethra( serous, bloody, purulent);
increase and soreness of inguinal lymph nodes - another frequent symptom of balanoposthitis.

An untreated disease or balanoposthitis in weakened patients can pass into a gangrenous form of .Erosions take the form of blood-purulent ulcers, pain and puffiness increase, in the foreskin, perforations may appear, the general condition of the patient-chills, temperature, weakness, nausea and vomiting, headache( symptoms of intoxication) is disturbed.In this case, an immediate hospitalization of the patient is required.

Clinical features of balanoposthitis

The gonorrheal variant always proceeds with inflammation of the urethra( urethritis), trichomoniasis - with a large accumulation of pus, among the symptoms of Candida balanoposthitis - a characteristic filmy curd of cheesy species.When a herpetic form occurs a large number of vesicles filled with liquid contents, with syphilis is determined chancroid, with papillomatous form - genital warts.

Balanoposthitis, which is based on diabetes mellitus, is characterized by the appearance of a large number of cracks, which, while healing, leave scar changes.With psoriatic balanoposthitis, nodules covered with scales are formed.

Features of balanoposthitis in children

Most often in children there is an irritative balanoposthitis, or a form that is caused by a nonspecific flora brought to the site of the disease through the bloodstream.Also the occurrence of the disease contributes to excessively overgrown flesh( hypertrophy) and phimosis.

Diagnosis of balanoposthitis

Diagnosis of balanoposthitis The definition of balanoposthitis is not difficult and is performed when examining the characteristic symptoms of the disease.The remaining methods are additional in nature and are used to detect the cause and severity of the course of the disease.

Laboratory diagnostic methods include:

a clinical blood test in which ESR and leukocyte counts will be increased;
clinical analysis of urine, for which balanoposthitis will be characterized by the appearance of leukocytes;
bacteriological examination of urine - will identify the causative agent of the disease;
polymerase chain reaction( PCR) - conducted in doubtful cases for more precise identification of the pathogen;
urethral scraping - used to identify pathological microorganisms localized on the mucous membrane of the urethra.

Please note: when identifying symptoms of balanoposthitis, always check the patient's sexual partner.

Treatment of balanoposthitis

Treatment measures are applied in combination with the cause, severity and type of pathogen.

Local treatment of balanoposthitis involves:

manganese baths.Manganese is a strong oxidizer, which exerts a disinfecting and deodorizing effect.Baths should be done 3 times a day for 5 - 10 minutes for adults and children;
furacilin trays.Furatsilin - a strong antiseptic, has a powerful antibacterial effect, a solution of furatsilina apply also 3 times a day, combining or alternating with a solution of manganese;
baths with medicinal plants( decoctions and infusions of oak bark, chamomile, sage).They have antibacterial action and improve healing.The procedure can be carried out every 3-4 hours.

Therapeutic ointments for the treatment of balanoposthitis:

Levomekol.One of the most effective ointments, has antimicrobial and regenerative properties.It is used for all forms of balanoposthitis, applied in a thin layer after applying the bath to the dried skin, for several days in a row, if necessary, repeat the course;
Xerogram ointment.Has an effect with the wetting forms of balanoposthitis.It is applied in the form of bandages, usually at night;
Lorinden.This ointment is effective for allergic manifestations.It is applied to the skin 2-3 times a day;
Hormonal ointments( Prednisolone, Hydrocortisone, etc.).Applied in the case of long-term illness with intense clinical manifestations;
Antibiotic ointments.Well help with the established infectious nature of balanoposthitis.Ointment is selected individually according to the doctor's recommendation;
Antifungal ointments.(Mikogal, Omoconazole).Are shown at a candidiasis balanoposthitis.Apply by easy rubbing 2 times a day, for a month, and if necessary, more.

Antibiotic therapy for balanoposthitis

Antibiotics are prescribed for the treatment of severe cases of balanoposthitis, with problems with the general condition of the patient and with sexually transmitted infections.

Antibiotics are strictly according to the rules:

prescribes the medicine only after determining the pathogen and its sensitivity to a specific antibiotic;
drugs are prescribed at the highest doses;
treatment of balanoposthitis is carried out in strict accordance with the time schedule, without a pass;
on the background of antibiotic therapy is prescribed from 5-7 days antifungal drug( to protect against complications);
self-replacement or the abolition of an antibiotic is strictly contraindicated( !).

We will not list the antibiotics used, in view of the large number of groups and the drugs themselves.They are appointed according to the principle of primary action, strength, generation of drugs, doctor's experience and other factors.

Surgical treatment of balanoposthitis

Surgical treatment is shown:

for recurrent and chronic forms of the disease, in cases when conservative treatment is ineffective or contraindicated;
for complications of balanoposthitis in the form of cicatrical changes in foreskin, fusion and constriction.

Please note: a complex of anti-inflammatory and decongestant procedures must be performed before surgery.

Treatment of balanoposthitis in boys at home

Important: The final treatment for balanoposthitis should only be performed by a doctor.

If, for any reason, there is no possibility to consult a doctor, then it is necessary to conduct the following treatment yourself:

of the child placed in a warm bath( to ease the pain);
treat the sexual organs with child soap varieties;
gently pull the skin of the penis so that a gap is exposed, into which a solution of furacilin in the amount of several milliliters is inserted into a plastic syringe without a needle.The procedure is carried out under pressure, trying to rinse the accumulated smegma( the contents between the head of the penis and the foreskin);
if washing did not happen the first time, the penis should be immersed in a heated solution of furacilin or weak manganese, herbal infusion for several minutes, then pour 7-10 drops of vaseline oil( or any other but pure).

At the first opportunity, you need to see a doctor!

Preventive measures for the prevention of recurrence and relapse of balanoposthitis

To avoid this unpleasant disease,

regularly and carefully observe the rules of genital hygiene;
Do not allow contaminated linen to be worn;
to refrain from accidental sexual intercourse;
for suspicious symptoms, it is urgent to see a doctor;
with a bad opening of the glans penis in boys should be before opening it to take a warm bath, or a bath.Painful opening, or its impossibility, requires a doctor to make a decision about surgical treatment;
to carry out bathing of small children in the baths with a weak solution of potassium permanganate;
boys undergo regular preventive examinations from a pediatric surgeon.

Complications of balanoposthitis

If improper treatment of balanoposthitis or in its absence, complications can occur in patients with a weakened body:

is the transition from acute to chronic balanoposthitis, which periodically causes recurrences of the disease.Chronic process requires long-term treatment;
prostatitis, urethritis, cystitis, pyelonephritis - the transition of the inflammatory process ascending way to the tissue of the prostate gland, urethra, bladder and kidneys.In this case, the main symptoms of balanoposthitis are associated with pain in the lower abdomen, general toxic effects, disorders of urination;
inflammation of inguinal lymph nodes, manifested by an increase in nodes and pain in them, reddening of the surrounding skin areas;
necrosis of the glans penis( gangrene).Complication requiring immediate treatment.It is manifested by blackening of the glans penis;
paraphimosis - infringement of the head narrowed by the foreskin.The head of the penis is cyanotic red, edematous, extremely painful.Requires immediate medical attention and surgical intervention.

Alexander Lotin, medical reviewer