Treatment of Balanoposthitis

Most men are easily treated and cured from balanoposthitis. Symptoms usually resolve within 3 to 5 days of treatment. Treatment should be continued as prescribed even when symptoms disappear. Genital hygiene should be emphasized.

    topical cream

    An example of an antibacterial cream is Metronidazole cream

  • Topical creams
  • Topical creams with antibacterial, or antifungal properties may be beneficial. An example of an antibacterial cream is Metronidazole cream. Example of antifungal creams are Clotrimazole and Miconazole cream. Miconazole should not be used if the patient is on anticoagulant therapy. The patient should consult his doctor before treating himself even though antifungal creams are available over the counter without a prescription. A low-potency steroid creams may also decrease inflammation. A steroid cream is only used if the balanoposthitis is not caused by an infection. A steroid cream might worsen certain infections. The creams should be used as prescribed even when symptoms improve. This is to prevent a relapse of infection.

    fluconazole

    An oral antifungal like Fluconazole may also be taken

  • Medication
  • Oral antibiotics may be used. Broad spectrum antibiotics are usually the first choice. Examples of these are Metronidazole and Doxycycline. A fungal infection may worsen when antibiotics are used. An oral antifungal like Fluconazole may also be taken orally in cases of recurrent or non-resolving fungal balanoposthitis. Anti-inflammatory pills and pain medication will help to symptomatically relieve the patient.
     
     

  • Treatment of sexual partners
  • It is important to have the man’s sexual partner or partners treated as he may be re-infected if they are not treated. It may also create resistance to antibiotics if he has sex with an infected partner while receiving treatment. This may make it more difficult to treat his balanoposthitis in the future.
     

    proper hygiene

    Properly washing of the foreskin and area under the foreskin is important to prevent recurrent balanoposthitis

  • Proper Hygiene
  • Improvement of hygiene and properly washing of the foreskin and area under the foreskin is important to prevent recurrent balanoposthitis. Uncircumcised men should pull the foreskin back completely to wash under the foreskin. This should be done daily or at least every second day. Men who do not properly wash under their foreskin are more prone to develop infections. Poor hygiene has even been shown to increase a man’s risk of penile cancer.
     
     
     
     

  • Circumcision
  • circumcision

    Circumcision may be promoted in patients who get recurrent episodes of balanoposthitis

    Circumcision may be promoted in patients who get recurrent episodes of balanoposthitis. Studies have shown that circumcised men are less prone to getting sexually transmitted diseases than uncircumcised men. It also decreases the patient’s risk of developing HIV. Men who are circumcised are not immune to HIV or sexually transmitted diseases, their chances of developing them are just slightly less. There are potential complications associated with circumcision but these are few. Circumcised men have a less sensitive penile glans than uncircumcised men which may decrease sexual pleasure. The risks and benefits of circumcision should be weighed up and each patient should be individually assessed.

    Circumcision is a relatively quick procedure done with local anaesthesia. It may be done in young boys but because of the smaller size of the foreskin and penis it may be a more difficult procedure. Young boys who are not able to lie still will need general anaesthesia which also has its risks. The doctor usually does a ring block on the penis by injecting lignocaine superficially at the base of the penis. The foreskin is then removed and bleeding vessels are either cauterized or tied off with chromic sutures. Dissolvable sutures are usually inserted to attach the skin under the glans to the skin of the penis. The patient is advised to apply an antibiotic ointment on the wound for a few days and to abstain from sex for about 10 days. The patient should also not masturbate as this may cause the sutures to tear which may result in delayed wound healing and infection.

  • Control of chronic illnesses
  • Men with chronic diseases like HIV and diabetes should optimally treat their disease to help control balanoposthitis. Diabetics should make sure their sugar is optimally controlled with the correct medication, diet and lifestyle. If the man is HIV positive he should check his CD4 count and viral load and urgently start anti-retroviral treatment if necessary.

    comfortable-lose-fitting-clothing

    Wearing comfortable, lose fitting clothing may also be beneficial to allow the foreskin and glans to have more air exposure

  • Air exposure
  • When the foreskin is not regularly pulled back and cleaned it encourages the growth of various organisms including anaerobic organisms. Anaerobic organisms are bacteria or fungi that don’t require much oxygen to live. An unwashed foreskin provides the perfect conditions for anaerobic organisms to thrive. Exposure of the glans to air is achieved via circumcision, a dorsal slit procedure or applying a combination of peroxide power and arsphenamine under the foreskin. Wearing comfortable, lose fitting clothing may also be beneficial to allow the foreskin and glans to have more air exposure.

  • Dorsal Slit Procedure
  • A dorsal slit procedure is performed in severe or recurrent cases of balanoposthitis. It is also known as a superincision and is done by a doctor who makes a single incision of the foreskin without removing any tissues. A dorsal slit procedure is less invasive than a circumcision. It is done when a circumcision is unpractical or undesirable. Most men rather opt to have a circumcision done because the dorsal slit procedure is not considered to be aesthetically pleasing. Most men prefer the look of the circumcised penis than that of the slit procedure of the penis.

Balanoposthitis is a common condition but it is luckily also easily treated. Men are encouraged to consult with their doctor if they think they may have balanoposthitis. Proper hygiene and cleaning of the penis is very important in the prevention of balanoposthitis.