Balanitis

　　Although there are many pathogenic bacteria that cause balanitis and the onset is complex, in clinical practice, some similar symptoms will appear, such as redness and burning of the prepuce, exacerbation during urination, and purulent discharge may come out from the prepuce opening. The glans penis may develop papules and erythema, gradually expand, with clear edges, and there may be small vesicles the size of a needle on the erythema, which finally form an erosive surface, or the glans penis may develop erythema papules and small vesicles, with clear boundaries and gradually expanding range, and the patient often feels itching.

　　In addition, some causes of balanitis are not clear, but phimosis, the stimulation of smegma, and its association with the occurrence of balanitis are often related. Balanitis seriously endangers the health of the reproductive system, and if not treated effectively in a timely manner, it may lead to mutual infections, causing great harm to the genitals. The following will give a detailed introduction to the two major causes of balanitis commonly seen in clinical practice:

　　1. Infection Factors

　　Clinically, infectious balanitis is more common. Infectious balanitis is often caused by unclean sexual intercourse, infection with Candida albicans, trichomonas, chlamydia, mycoplasma, gonococcus, or other bacteria, and symptoms should be treated promptly.

　　Candidiasis Infection: Candida is a conditionally pathogenic fungus, so candidal balanitis often occurs after diabetes, senile consumptive diseases, and after a large amount of antibiotic or hormone treatment. It can also be primary, usually transmitted from the candidal vaginitis of the spouse. The glans penis and the corona glandis may have shallow red erosions and thin-walled pustules, but Candida may not be found locally, which may be due to local allergic reactions caused by Candida.

　　Amoeba infection: The patient usually has an inflammatory lesion on the glans first, locally losing its normal barrier function, and then caused by the transmission of intestinal amoebiasis. Local erosion, ulceration, and tissue necrosis are obvious, and amoebae can be found in the direct smear of the secretion.

　　Trichomonas infection: Often transmitted from the spouse who has trichomoniasis. The symptoms are mild, mainly manifested as red macules, papules, small blisters on the glans, etc. The boundary is clear, and the range gradually expands. The patient often feels itchy. Trichomonads can be found in the secretion.

　　Young people have a strong sex drive and often have masturbation. Sometimes the masturbation action is too rough, causing varying degrees of prepuce breakage. The wounds on the prepuce are prone to bacterial contamination, thus triggering balanitis. Some young men have a strong secretion of prepuce sebaceous glands, and if they do not pay attention to cleaning the external genitalia regularly, or do not flip the prepuce during cleaning, the secretions of the prepuce sebaceous glands will accumulate under the prepuce, forming a kind of bean curd dregs-like smegma. Smegma is a good culture medium for bacteria, and if it is not removed in time, it is easy to trigger balanitis.

　　2. Non-infectious factors

　　Non-infectious factors include local trauma, friction, birth control pills, soap, and detergents, etc., which can cause edematous erythema, erosion, exudation, and even bleeding locally. If secondary bacterial infection occurs, it can lead to abscess and ulceration. The patient may experience significant pain and difficulty in movement.

　　On the other hand, non-infectious factors are mostly due to long prepuce, insufficient cleaning, unclean substances between the prepuce and the glans, that is, smegma, which accumulates and stimulates the local prepuce and glans mucosa to cause inflammation.

　　Balanitis has a relatively high incidence among male friends, so at the beginning of the onset, many male friends do not pay attention to it and are not aware of its harmfulness. Experts point out that balanitis can cause considerable harm. So, what specific harms does balanitis have?

　　1. Affect reproductive system health

　　Balanitis is prone to cause inflammatory infections in organs such as the prostate, testicles, epididymis, and seminal ducts. If timely and effective treatment is not received, the combined infections may cause great harm to reproductive health.

　　2. Cause urinary system diseases

　　Balanitis is also prone to cause ascending infection of the urinary system, which is generally cystitis, nephritis, pyelonephritis, and so on. Especially for those with long-term balanitis that does not heal, it is most likely to cause urinary system diseases. If the disease is not treated properly during the acute stage, it may even be life-threatening.

　　3. Cause sexual dysfunction

　　After getting balanitis, the patient's sexual sensory nerves are in a sensitive period, and in addition to the damage caused by inflammation, it makes them prone to premature ejaculation during sexual activity, which, over time, can lead to impotence.

　　4. Cause infertility

　　Due to the inflammatory secretions hidden under the prepuce, during sexual activity, they enter the vagina together with seminal fluid, reducing the quality of seminal fluid and damaging the oocytes, which may lead to male infertility.

　　Through the above introduction, I believe you must have gained a certain understanding. Since the harm of balanitis is so great, enough attention must be paid to the symptoms of balanitis, and timely treatment is the key.

　　Balanitis is a common urological disease. Due to many patients' lack of understanding of the symptoms of balanitis, they miss the best treatment time and delay the condition. So, what are the main symptoms of balanitis? The following is a detailed introduction by an authoritative urological expert for our patients.

　　1, Acute superficial balanitis

　　Acute superficial balanitis is an acute inflammatory condition of the glans, often caused by local irritation due to trauma, friction, soap, detergents, etc. The main manifestations are local edematous erythema, erosion, and exudation. In severe cases, blisters and bullae may appear. After secondary bacterial infection, ulcerative surfaces are formed with purulent secretions. The above symptoms can be exacerbated by local friction, poor prepuce inversion, and accumulation of secretions, stimulating the wound surface and increasing inflammation. There may be subjective pain and tenderness. In cases with significant local inflammation, there may be mild systemic symptoms.

　　2, Circinate erosive balanitis

　　Circinate erosive balanitis has two clinical presentations. One is an early manifestation of Reiter's disease, and the other is persistent, recurrent balanitis with annular or multi-annular damage. Initially, there are erythematous papules on the glans and prepuce, which gradually expand into annular or multi-annular shapes, and then form superficial ulcerative surfaces. Poor prepuce inversion can lead to secondary infection due to local accumulation of secretions, causing the symptoms to become more severe and losing the annular characteristics, making it difficult to distinguish from superficial ulcers.

　　3, Candidal balanitis

　　Candidal balanitis can be primary or secondary. The latter often occurs after diabetes, elderly耗损性疾病, and treatment with antibiotics and hormones. Clinical manifestations include erythema, smooth surface, mild desquamation at the edges, and satellite-like papules and pustules with a slow expansion around the periphery. The inguinal region may also be involved. In acute attacks, the mucosa of the glans presents with edematous erythema, the boundary is unclear, and there may be erosion and exudation. The lesions can be found to contain Candida by microscopic examination and culture. Recurrent candidal balanitis can cause the prepuce to become dry, fibrotic, and hardened.

　　4, Plasmacytic balanitis

　　Plasmacytic balanitis is a chronic inflammation of the inner prepuce and glans, accompanied by plasmacytic infiltration. There is only one to several well-defined erythematous papules on the surface, which are moist and shiny. Sometimes, there may be erosion and pinpoint bleeding. The appearance is like an unhardened caries preventive film, with fine spots resembling chili powder on the surface. Pathological sections show atrophy of the epidermis, disappearance of the stratum corneum and granular layer, abundant plasmacytic infiltration in the dermal papillae, dilatation of capillaries, and hemosiderin deposition.

　　5, Mica-like and keratotic pseudosarcomatous balanitis

　　Common in the elderly, often with a history of circumcision. The manifestation is warty hyperplastic tissue on the glans with overlying silver-white mica-like scales, resembling psoriasis-like damage, which can form fissures and ulcers. The affected area gradually loses elasticity and becomes atrophic over time. Histopathology shows hyperkeratosis of the epidermis, incomplete keratosis, pseudosarcomatous proliferation, thickening of the stratum spinosum, and chronic inflammatory cell infiltration in the upper dermis.

　　In addition, balanoposthitis can also be caused by amoebiasis and trichomoniasis infections. Amoebic balanoposthitis often comes from intestinal amoebiasis, and trichomoniasis balanoposthitis has a history of sexual contact with women infected with trichomonads. Amoebae or trichomonads can be found in the secretion.

　　Balanoposthitis is a common male infectious disease. If it is not treated or treated improperly, it can lead to recurrent inflammation, even extending to other adjacent organs through reproductive organ infection. Therefore, it is necessary to do a good job in the prevention and treatment of balanoposthitis in daily life.

　　I. Pay attention to personal hygiene in summer to prevent balanoposthitis

　　Summer is coming, the weather is getting warmer, and brothers should be careful of balanoposthitis. In summer, it is necessary to pay attention to local hygiene, wash the glans and foreskin every day, and here are some suggestions:

　　(1) Pay attention to local hygiene, wash the glans and foreskin every day. If the foreskin is long, it should be treated promptly, and a circumcision may be necessary if necessary. It is very necessary to clean the smegma in time.

　　(2) If one partner has a sexual reproductive disease, stop sexual life and treat it promptly. If both partners have trichomoniasis or candidiasis infections, they should be treated at the same time.

　　(3) Avoid unclean sexual contact and maintain good personal hygiene.

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

　　(5) Avoid using corticosteroid ointments for acute balanoposthitis to prevent more serious infections.

　　II.Who is prone to balanoposthitis

　　Balanoposthitis is a common disease in men's lives. The disease is serious, and if it is not treated in time, it will bring a burden to the patients with balanoposthitis. So, which men are prone to balanoposthitis?

　　1. Men with phimosis

　　This is an easily overlooked factor. Long foreskin can easily cause the accumulation of smegma, which can produce a strong irritation to the foreskin and glans, and finally lead to inflammation. This is the main reason for the onset and recurrence of balanoposthitis.

　　2. Men who do not pay attention to personal hygiene

　　After a busy day of work, men's bodies have been occupied by various bacteria, especially in the genital area. If they do not wash in time, bacteria will thrive and cause infection, leading to balanoposthitis.

　　3. Men who often have unclean sexual contact

　　Some men are emotionally rich and often go to various social places, have a one-night stand, and at this time, they may be infected with bacteria, thus causing inflammation, and balanoposthitis infected through sexual life has a strong infectiousness.

　　Because many male friends do not pay attention to hygiene and have phimosis, it leads to the condition of balanoposthitis, which is very harmful. If it is not treated in time, it may lead to male infertility and other conditions, so it is necessary to go to the hospital for an accurate examination and treatment in time.

　　I. Examination and laboratory tests

　　1. Candidal balanitis: The lesion can be examined under a microscope and cultured to find Candida.

　　2. Amoebiasis, when infected with trichomoniasis, the secretion can contain amoebae or trichomonads.

　　3, Plasma cell balanoposthitis: The pathological section shows atrophy of the epidermis, disappearance of the stratum corneum and granular layer, a large number of plasma cell infiltration in the dermal papillae, dilatation of capillaries, and hemosiderin deposition.

　　4, Mica-like and keratotic pseudocarcinomatous balanoposthitis: The histopathology shows hyperkeratosis of the epidermis, incomplete keratosis, showing pseudocarcinomatous proliferation, thickening of the stratum spinosum, and chronic inflammatory cell infiltration in the upper dermis.

　　Second, direct microscopy

　　Scrape the surface scales of the skin at the glans penis, the corona groove, or the prepuce as the specimen to be examined. The specimen to be examined is made into a film with 10% potassium hydroxide or physiological saline, 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.

　　Third, staining examination

　　It can also be stained with Gram staining, Congo red staining, or PAS staining and then examined under a microscope, and the positive rate is higher than that of direct microscopy. Gram staining, spores and pseudohyphae are stained blue; Congo red and PAS staining, spores and pseudohyphae are stained red.

　　Fourth, isolation culture

　　For patients with negative smears, Candida culture can be performed. Under sterile conditions, the tested specimen is inoculated on Sabouraud's medium. When inoculating, the slanting tube medium is slightly cut, 2-3 inoculation points are made in each tube, and 2 tubes are inoculated for each specimen. After incubating the medium in a 37℃ incubator for 24-48 hours, observe and see a large number of milky white colonies grow. Pick up a small amount of colonies with a inoculation needle, make a smear, and directly examine or stain and examine under a microscope, and see a large number of blastospores, which can be preliminarily diagnosed as Candida infection.

　　Fifth, Candida antibody test

　　White念珠菌antibodies can be detected by immune double diffusion or latex agglutination method.

　　Balanoposthitis, as the name implies, is inflammation of the glans. Over time, it may promote the hyperplasia and enlargement of the prostate, leading to prostatitis. During the period of balanoposthitis, comrades should pay attention to their diet, control their mouth, and some foods can no longer be eaten, otherwise balanoposthitis will become more serious. Below, the editor introduces nine dietary therapies that can treat balanoposthitis and foods that balanoposthitis patients should not eat, so that men can quickly get rid of balanoposthitis.

　　First, dietary therapy for balanoposthitis patients

　　1, red bean 50g, glutinous rice 500g. Cook as porridge and eat, which can clear heat and detoxify, and promote diuresis and reduce swelling.

　　2, fresh toon leaves 250g. Washed, chopped, mixed with a little flour paste and salt, 500g unsalted oil, heated, the paste is put into the oil, fried until golden and taken out, to be eaten. It can clear heat and benefit dampness, detoxify and reduce swelling.

　　3, fresh mung bean sprouts in appropriate quantity. Stir-fry with unsalted oil, mix with salt and seasonings, and eat as a side dish, which has the effect of clearing heat and detoxifying.

　　4, loofah 1 piece, glutinous rice 50g, sugar to taste. Boil the porridge until half-cooked, add loofah when the porridge is cooked, remove the loofah and add sugar, eat the porridge, which can clear heat and detoxify, cool blood and reduce boils.

　　5, green beans 50g, glutinous rice 100g. Cook together as porridge and eat, which can clear heat and detoxify, and reduce edema.

　　6, 4 pigs' feet cleaned. Add 50g scallion, appropriate amount of salt, and 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, Silver flower 15g, green bean skin 10g. Drink as tea, it has the effects of clearing heat and detoxifying, and reducing swelling.

　　8. Winter melon drink: One young winter melon (about 500g). Washed and sliced with green skin, add an appropriate amount of water, a little salt and seasoning, and cook until done. It has the effects of clearing heat and dampness.

　　9. Silver flower and mugwort roots in appropriate amounts. Boil and drink as tea, which has the effects of clearing heat and dampness, and detoxifying.

　　Tips: Men should pay attention to the hygiene of their personal reproductive organs after the cure of balanitis.

　　2. Foods that balanitis patients cannot eat

　　1. Leek

　　It has the effects of invigorating the stomach, invigorating the spirit, astringing sweat, tonifying the kidney and yang, and securing essence. In traditional Chinese medicine, leeks are known as 'Yang Invigorating Grass'. During the period of balanitis, the body is in a state of hyperactivity of虚 fire, and it is not advisable to take tonics. Therefore, eating leeks will only make the condition of balanitis worse.

　　2. Pumpkin

　　Pumpkin contains beneficial components such as polysaccharides, amino acids, active proteins, carotenoids, and various trace elements. The carotenoids can cause rapid ulceration of balanitis, so caution must be exercised.

　　3. Onion

　　Onions are warm in nature and have a pungent and sweet taste. They have functions such as invigorating the stomach, moistening the intestines, detoxifying, and killing worms. They can treat enteritis, abdominal pain due to worms, leukorrhea, and other diseases. However, their spiciness can stimulate the recurrence of balanitis, so they should not be eaten in large quantities.

　　4. Eggplant

　　Eggplant is also rich in nutrition, containing protein, fat, carbohydrates, and various other nutrients. It is especially suitable for those who are prone to boils and carbuncles. For those with poor digestion and diarrhea, it is not advisable to eat too much. Balanitis should not be eaten excessively as well.

　　5. Litchi

　　Litchi is hot in nature and eating too much can easily cause heat stroke and lead to 'Litchi disease'. It is not supposed to eat hot foods with balanitis, which is equivalent to adding fuel to the fire, making the condition worse. Therefore, litchi should not be eaten at all.

　　The treatment of balanitis mainly includes two methods: surgical treatment and medication. Among them, medication is best combined with other auxiliary treatment methods, which can better treat the condition, promote the effectiveness of treatment, and avoid recurrence. It should be known that if the treatment method for balanitis is single, the treatment is often not thorough. Below, a summary of the methods for treating balanitis is as follows:

　　1. General treatment for balanitis

　　1. Maintain local cleanliness, avoid irritation, and local treatment is very important. For those with dry desquamation, apply corticosteroid ointment. For those with erosion and exudation, change the dressing on the ulcer surface daily and perform physical therapy. For those with erosion, exudation, or purulent discharge, apply 1% chlorhexidine solution or 1:8000 potassium permanganate solution for wet敷. For those with dryness and desquamation, apply topical corticosteroid ointment.

　　2. For patients with clear etiology, special treatment should be given to the pathogenic factors, such as taking antiallergic drugs and applying corticosteroid ointments externally for allergic balanoposthitis. For candidal balanoposthitis, external application of nystatin powder, clotrimazole, econazole, miconazole cream, or oral antifungal drugs such as itraconazole, fluconazole, miconazole, and ketoconazole can be used. For trichomonas balanoposthitis, metronidazole, tinidazole, or crotamiton can be chosen. For amebic balanoposthitis, emetine, metronidazole, and tinidazole should be given. If the spouse also has candidal vaginitis or trichomonas vaginitis, simultaneous treatment is necessary.

　　3. For phimosis, circumcision surgery should be performed after the acute inflammation is controlled.

　　Especially pay attention to the last point. Generally speaking, balanoposthitis caused by phimosis should be treated first, and then phimosis should be treated. If phimosis is not treated, it is likely to recur. However, one should never treat phimosis first, as it is easy to be infected by balanoposthitis during the treatment process.

　　II. Treatment Methods for Candidal Balanoposthitis

　　Candidal balanoposthitis mostly occurs in young people between the ages of 20 to 50, due to the particularly abundant secretion of sebaceous glands during youth, the vulva is moist, and wearing thicker underwear, which is very easy to nourish the mold that remains in the air and lives here, making it easier for candidal balanoposthitis to occur and possibly transmit to the partner.

　　1. If there is purulent discharge during the treatment of balanoposthitis, you can first wipe the pus clean, then soak the affected area in diluted Erythromycin for about 15 minutes.

　　2. When using medication to treat balanoposthitis, if the inflammation is not just starting, you can also undergo intravenous fluid therapy while taking oral or topical medication. This can prevent the inflammation from worsening further, leading to ulceration or discharge.

　　3. Even if balanoposthitis is treated, it does not necessarily mean that the inflammation will not recur. Therefore, the most permanent way to deal with balanoposthitis is to undergo circumcision surgery, so that neither balanitis nor balanoposthitis will affect you again.

　　Experts say there are many situations that can lead to candidal balanoposthitis. This disease brings a lot of inconvenience to the physical health of men. Therefore, male friends should learn to identify candidal balanoposthitis in daily life so that they can receive timely treatment.