Find information on medical topics, symptoms, drugs, procedures, news and more, written for the health care professional.

* This is a professional Version *

Balanitis, Posthitis, and Balanoposthitis

by Patrick J. Shenot, MD

Balanitis is inflammation of the glans penis, posthitis is inflammation of the prepuce, and balanoposthitis is inflammation of both.

Inflammation of the head of the penis has both infectious and noninfectious causes (see Table: Causes of Penile Inflammation). Often, no cause can be found.

Balanitis usually leads to posthitis except in circumcised patients.

Balanoposthitis is predisposed to by

  • Diabetes mellitus

  • Phimosis (tight, nonretractable prepuce)

Phimosis interferes with adequate hygiene. Subpreputial secretions may become infected with anaerobic bacteria, resulting in inflammation.

Chronic balanoposthitis increases the risk of

  • Balanitis xerotica obliterans

  • Phimosis

  • Paraphimosis

  • Cancer

Causes of Penile Inflammation

Category

Examples

Infectious

Candidiasis

Chancroid

Chlamydial urethritis

Gonococcal urethritis

Herpes simplex virus infection

Molluscum contagiosum

Scabies

Syphilis, primary or secondary

Trichomoniasis

Noninfectious

Balanitis xerotica obliterans

Contact dermatitis

Fixed drug eruptions

Lichen planus

Lichen simplex chronicus

Psoriasis

Reactive arthritis*

Seborrheic dermatitis

*Reactive arthritis can cause shallow, painless ulcers of the glans (balanitis circinata).

Symptoms and Signs of Penile Inflammation

Pain, irritation, and a subpreputial discharge often occur 2 or 3 days after sexual intercourse. Phimosis, superficial ulcerations, and inguinal adenopathy may follow.

Diagnosis of Penile Inflammation

  • Clinical evaluation and selective testing

History should include investigation of latex condom use. The skin should be examined for lesions that suggest a dermatosis capable of genital involvement. Patients should be tested for both infectious and noninfectious causes, especially candidiasis. Blood should be tested for glucose.

Treatment of Penile Inflammation

  • Hygiene and treatment of specific causes

  • Sometimes subpreputial irrigation

  • Sometimes circumcision

Hygiene measures should be instituted and specific causes treated. Subpreputial irrigation to remove secretions and detritus may be necessary. If phimosis persists after inflammation has resolved, circumcision should be considered.

Resources In This Article

* This is a professional Version *