Balanoposthitis

　　Balanoposthitis is a common disease. Balanoposthitis is divided into balanitis and glanitis, as they often occur simultaneously, it is called balanopreputial glanitis. This inflammation can be infectious or non-infectious, and infectious balanopreputial inflammation is more common in clinical practice.

　　Balanoposthitis can be caused by infection and non-infection. Infection can be caused by unclean sexual contact, infection with Candida albicans, Trichomonas, Chlamydia, Mycoplasma, and gonococcal infection. Non-infection factors are often due to the prepuce being too long, insufficient cleaning, the accumulation of unclean substances between the prepuce and the glans, that is, prepuce smegma, which stimulates the local prepuce and mucosa to cause inflammation. Balanoposthitis can also be caused by local physical factors such as a too long prepuce or poor inversion, trauma, friction, condom, soap, and cleanser irritation to the local area.

　　The two major complications of balanoposthitis:

　　Acute urethritis

　　The causative agents of balanoposthitis can retrograde into the urethra, causing acute urethritis, which is characterized by frequent urination, urgency, dysuria, urethral burning sensation, discomfort or distension in the lower abdomen. Urinalysis may show leukocytes, fungi, or trichomonads, and urine culture can detect the corresponding bacteria.

　　Acute orchitis

　　The purulent discharge of balanoposthitis can spread along the lymphatic vessels and infect the testicles, causing acute orchitis. The symptoms include redness and swelling of the affected testicle, severe pain, and radiation to the ipsilateral inguinal and lower abdominal areas. Palpation shows swelling and high tension of the affected testicle, with marked tenderness. When an abscess forms, there may be a fluctuation sensation.

　　Many patients with balanoposthitis have red spots or small papules on the glans of the penis, suspecting that they have a sexually transmitted disease. However, after seeing a doctor, they find out that it is balanoposthitis, in fact, balanoposthitis is a common disease.

　　The clinical symptoms of balanoposthitis are mainly divided into the following situations: Acute superficial balanoposthitis: Initially, the local area is red and the skin of the penis becomes red and swollen, with a feeling of heat and itching in the glans. When the prepuce is pulled back, the inside of the prepuce and the glans are congested and eroded, with discharge, even bleeding. Secondary infection may lead to small ulcers and purulent discharge with an unpleasant smell.

　　If there is pain when it rubs against the underwear, the patient often has difficulty moving. It may be accompanied by swelling and tenderness of the inguinal lymph nodes. Ring-shaped ulcerative balanoposthitis: On the glans and prepuce, there are red spots that gradually expand and form a ring shape, which can form a superficial ulcer surface. Candidal balanoposthitis: There are red spots on the prepuce and glans, the surface is smooth, and there are small blisters, the edges of the red spots are clear, and during acute attacks, there may be erosion and discharge. Trichomonas balanoposthitis: The glans develops papules and red spots, which gradually expand and the edges are clear, and there are tiny blisters the size of a needle on the red spots, which finally form an eroded surface.

　　How to prevent balanoposthitis;

　　(1) Pay attention to local hygiene, clean the glans and prepuce daily, and if the prepuce is too long, timely treatment is necessary. In some cases, circumcision may be required, and it is very necessary to clean the prepuce smegma in time.

　　（2）夫妇一方患性器官疾病要暂停性生活，及时治疗，如患有滴虫性或白色念珠菌的感染要夫妇同时治疗。

　　(2) If one partner has a sexual organ disease, stop sexual life and treat it in time. If both partners have trichomoniasis or Candida albicans infection, both should be treated at the same time.

　　(3) Avoid unclean sexual intercourse and keep oneself clean.

　　(4) If ulcers or erosions form, change the medicine in time, twice a day, to avoid uncomfortable stimulation.

　　龟头包皮炎需要做哪些化验检查

　　龟头炎需要做什么检查呢?龟头炎的检查有检查化验、直接镜检、染色检查、分离培养、念珠菌抗体检查这五种。

　　1, Examination and testing: Candidal balanitis (balanoposthitis) can be found by microscopic examination or culture of the lesion on the glans penis or prepuce. Trichomoniasis balanitis can be found in the secretion.

　　2, Direct microscopy: Scrape the surface scales of the skin lesions on the glans penis, prepuce, or prepuce as the inspected specimen. Prepare a slide with 10% potassium hydroxide or saline for the inspected specimen, and under the microscope, a group of oval spores and pseudohyphae can be seen. If a large number of pseudohyphae are found, it indicates that Candida is in the pathogenic stage.

　　3, Staining examination: Gram staining, Congo red staining, or PAS staining can also be used to stain and examine under the microscope, and their positive rates are all higher than those of direct microscopy. Gram staining: spores and pseudohyphae are stained blue; Congo red and PAS staining: spores and pseudohyphae are stained red.

　　4, Isolation culture: For patients with negative smears, Candida culture can be performed. Under sterile conditions, the inspected specimen is inoculated on Sabouraud's culture medium. When inoculating, slightly cut the slanting part of the tube culture medium, inoculate 2-3 places per tube, and inoculate 2 tubes per specimen. After incubating the culture medium in a 37℃ incubator for 24-48 hours, observe that a large number of milky white colonies grow. Use a loop to pick up a small amount of colonies for smearing, and directly examine under the microscope or after staining, a large number of spores can be seen, and an initial diagnosis of Candida infection can be made.

　　Patients with balanoposthitis should avoid smoking, drinking, and spicy刺激性 food, and maintain a light diet:

　　（1）The following dietary plans can be chosen; (1) Boil 50g of red beans and 500g of glutinous rice to make porridge and eat it. It can clear heat, detoxify, and promote diuresis and reduce swelling.

　　(2) Use 250g of fresh toon leaves, wash, chop, mix with a little flour paste and salt, 500g of vegetable oil, heat the oil, and then add the paste to the oil. Fry until golden and remove from the oil. It can clear heat, promote diuresis, and detoxify and reduce swelling.

　　(3) Use fresh mung bean sprouts in appropriate quantity, stir-fry with vegetable oil, mix with salt and seasonings, and eat as a side dish. It has the effect of clearing heat and detoxifying.

　　(4) Use 1 loofah, 50g of glutinous rice, and appropriate amount of sugar. Boil the porridge until half-cooked, then add the loofah and continue to cook until the porridge is done. Remove the loofah and add sugar, eat the porridge. It can clear heat, detoxify, cool blood, and reduce boils.

　　(5) Boil 50g of mung beans and 100g of glutinous rice to make porridge and eat it. It can clear heat, detoxify, and reduce edema.

　　(6) Wash 4 pig's feet, add 50g of scallions and appropriate amount of salt, then simmer in a pot over low heat until tender. Eat the meat and drink the soup in separate servings, which has the effect of detoxifying and reducing swelling.

　　(7) Take 15g of silver flower and 10g of mung bean skin, drink as tea, which has the effect of clearing heat and detoxifying, and reducing swelling.

　　(8) Winter Melon Drink: One young winter melon (about 500g), wash and peel, cut into slices, add an appropriate amount of water, a little salt and seasoning, cook and eat, which has the effect of clearing heat and promoting diuresis.

　　(9) Take a proper amount of silver flower and mugwort root, boil and drink as tea, which has the effect of clearing heat and promoting diuresis, and detoxifying.

　　(1) Treatment during Erythema Stage: Clear heat and purge fire, and cool blood to dissolve blood stasis. The herbal formula used is modified Daochi Powder. In the formula, Shengdi clears heat and cools blood; Mutong and Zhuyu reduce heart fire, promote urination, and provide an outlet for heat; Shenggancao purge fire and can reach the penis to relieve pain. If there are signs of blood heat, add Chishao, Danpi, and Zicao to clear heat and cool blood; for those with severe heat-toxin, add Zhizi and Luhui; for those with severe itching locally, add Difuzi and Baixianpi to expel wind and detoxify to stop itching.

　　(2) Treatment during Exudative Stage: Clear heat and promote diuresis, and detoxify. The herbal formula used is modified Longdan Xiegan Decoction. In the formula, Longdan Coptis clears damp-heat in the liver meridian; Zhizi, Huangqin clear heat and purge fire; Mutong, Zexie, Cheqianzi clear heat and promote diuresis; Shengdi clears heat and cools blood to stop bleeding; Chaihu relieves liver qi and promotes Qi. For those with a lot of local exudate, add Huangbai and Niuxi to enhance the effect of clearing damp-heat in the lower焦; for those with severe heat-toxin, add dandelion, purple bellflower, silver flower, Forsythia to clear heat and detoxify.

　　(3) Treatment during Ulcerative Stage: For those with strong physique and manifested primarily by damp-heat and real fire, treatment should be to clear heat and promote diuresis and detoxify; for those with weak spleen and stomach, treatment should be to invigorate the spleen and stomach, dispel toxins, reduce swelling, and promote muscle growth. The herbal formula for clearing heat, promoting diuresis, and detoxifying uses Longdan Xiegan Decoction combined with Wuwei Xiaodai Decoction with modifications. Longdan Xiegan Decoction clears heat and promotes diuresis; in Wuwei Xiaodai Decoction, the honeysuckle, chrysanthemum, dandelion, purple bellflower, and purple-back jimson weed clear heat and detoxify. If there is red urine and pain, add talc and tungstic acid to clear heat and promote diuresis; if there is a lot of secretion at the ulcerated and ulcerative site, add茵陈 and turmeric to clear heat, detoxify, and remove dampness; for those with constipation, add rhubarb to purge fire and promote bowel movement, and also cool blood and remove blood stasis. The formula for invigorating the spleen and stomach, dispelling toxins, reducing swelling, and promoting muscle growth uses Fufang Shenshu Sanhua Decoction with modifications. In the formula, Taiizi and Huangqi tonify qi and support the interior; Qiliyaoyizhi, Yuhuanhua, Suhua, Zaoji, and turmeric clear heat and detoxify, and promote pus externally; Chenpi and Juhui can invigorate the spleen and stomach and clear phlegm and turbidity. The combined use of these herbs tonifies qi and invigorates the spleen, dispels toxins, reduces swelling, and promotes muscle growth, which is more effective for late-stage balanopreputial inflammation with ulcers that do not heal after ulceration.