Balanoposthitis: Difference between revisions
No edit summary |
|||
| (19 intermediate revisions by 8 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Balanitis = | *Balanitis = inflammation of the glans | ||
*Posthitis = | *Posthitis = inflammation of the foreskin | ||
* | *Balanoposthitis = inflammation of both glans and foreskin | ||
*Recurrent balanoposthitis can be sole presenting sign of [[diabetes mellitus]] | |||
*Recurrent balanoposthitis can be sole presenting sign of diabetes mellitus | |||
== | ===Risk factors=== | ||
*Glans | *Poor hygiene | ||
*Erythematous papular rash with satellite lesions = fungal | *Uncircumcised | ||
*[[Diabetes]] | |||
*Immunodeficiency | |||
*[[Phimosis]] | |||
===Etiology=== | |||
*Fungal (most common overall, [[candida]] most common species)<ref>McCollough M, Rose E. Genitourinary and renal tract disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018:(Ch) 173.</ref> | |||
*Irritant (soaps, lotions, lubricants) | |||
*Bacterial, which includes common skin organisms (Staph, strep) and STIs. | |||
*Trauma | |||
==Clinical Features== | |||
[[File:PMC3150172 ijgm-4-511f1.png|thumb|Candidal balanoposthitis in a diabetic]] | |||
[[File:Повреждённая крайняя плоть полового члена.jpg|thumb]] | |||
[[File:Balanite de Noon.jpg|thumb]] | |||
*Glans and foreskin may be swollen, erythematous, tender, or itchy | |||
*Severe cases may involve difficulty voiding, foul smell, and penile discharge/purulence | |||
*Erythematous papular [[rash]] with satellite lesions = fungal | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Nontrauma penile DDX}} | {{Nontrauma penile DDX}} | ||
{{Penile Trauma DDX}} | |||
==Differential Diagnosis== | |||
{{Nontrauma penile DDX}} | |||
{{Penile Trauma DDX}} | |||
==Evaluation== | |||
*Typically a clinical diagnosis | |||
*Consider blood glucose measurement to evaluate for diabetes | |||
*Consider swabbing for [[Sexually transmitted diseases]] in the appropriate setting | |||
==Management== | |||
===Reduce Irritation=== | |||
*Sitz baths BID-TID while inflammation persists | |||
*Hygiene | |||
**Clean between foreskin and glans with Q-tip and irrigate with water until resolves | |||
**Once resolved regular bathing of area in water is sufficient; soap may worsen irritation | |||
== | ===Antimicrobial=== | ||
{{Balanoposthitis Antimicrobial}} | |||
==Disposition== | ==Disposition== | ||
Discharge | *Discharge | ||
==See Also== | ==See Also== | ||
[[Paraphimosis | *[[Paraphimosis reduction]] | ||
== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Pediatrics]] | ||
[[Category: | [[Category:Urology]] | ||
Latest revision as of 23:16, 3 December 2025
Background
- Balanitis = inflammation of the glans
- Posthitis = inflammation of the foreskin
- Balanoposthitis = inflammation of both glans and foreskin
- Recurrent balanoposthitis can be sole presenting sign of diabetes mellitus
Risk factors
Etiology
- Fungal (most common overall, candida most common species)[1]
- Irritant (soaps, lotions, lubricants)
- Bacterial, which includes common skin organisms (Staph, strep) and STIs.
- Trauma
Clinical Features
- Glans and foreskin may be swollen, erythematous, tender, or itchy
- Severe cases may involve difficulty voiding, foul smell, and penile discharge/purulence
- Erythematous papular rash with satellite lesions = fungal
Differential Diagnosis
Non-Traumatic penile diagnoses
Penile trauma types
Differential Diagnosis
Non-Traumatic penile diagnoses
Penile trauma types
Evaluation
- Typically a clinical diagnosis
- Consider blood glucose measurement to evaluate for diabetes
- Consider swabbing for Sexually transmitted diseases in the appropriate setting
Management
Reduce Irritation
- Sitz baths BID-TID while inflammation persists
- Hygiene
- Clean between foreskin and glans with Q-tip and irrigate with water until resolves
- Once resolved regular bathing of area in water is sufficient; soap may worsen irritation
Antimicrobial
Common organisms are Candida, anaerobes, and Group B Streptococcus
Antifungal
- Clotrimazole 1% applied topically to glans q12hrs until resolution
- Nystatin cream 100,000 units/gm if infection is recurrent after clotrimazole therapy
Antibacterial
- Topical triple antibiotic ointment QID or mupirocin cream BID
Disposition
- Discharge
See Also
References
- ↑ McCollough M, Rose E. Genitourinary and renal tract disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018:(Ch) 173.