Balanoitis

　　Balanoitis is the most common disease of the glans penis and prepuce. Patients almost all have phimosis or elongated prepuce. Between the glans penis and the elongated prepuce, due to the shedding of epidermal cells, glandular secretions, and bacilli of smegma, a warm and moist bacterial culture medium is formed, which can cause inflammation once bacteria enter. Some causes of balanoposthitis are not clear, but elongated prepuce and smegma stimulation are often related to the occurrence of balanoposthitis. Therefore, men should also frequently clean their lower body to keep the local area clean and avoid irritation. For those with elongated prepuce, circumcision can be performed after the inflammation is controlled. Below, experts will tell you about the causes of balanoposthitis.

　　1. Non-infectious factors

　　Including 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 become suppurative and form an ulcerated surface. Patients have significant pain and difficulty in movement. Clinically, it is called acute superficial balanoposthitis.

　　2. Candida infection

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

　　3、阿米巴原虫感染

　　患者多先有包皮龟头炎病变，局部失去正常的屏障作用，继而由肠道阿米巴病传染而引起。局部糜烂、溃疡、组织坏死明显，分泌物直接涂片可找到阿米巴原虫。

　　4、滴虫感染

　　多因配偶患有阴道滴虫病而被传染。症状较轻，主要表现为龟头部起红斑丘疹、小水疱等。境界清楚、范围逐渐扩大，患者常感瘙痒。分泌物中可找到滴虫。

　　5、手淫损伤所致

　　青年人性欲旺盛，常有手淫现象。有时手淫动作过于粗暴，会造成不同程度的包皮破损。由于手淫时精神高度兴奋，损伤又比较小，可能没有察觉，但包皮上的伤口极易受到细菌污染，从而诱发包皮炎。

　　6、不注意外生殖器卫生

　　青年男子包皮的皮脂腺分泌常常比较旺盛，如果不注意经常清洗外生殖器，或清洗时没有将包皮上翻，包皮皮脂腺的分泌物就会积存在包皮下，形成像豆腐渣样的包皮垢。包皮垢是细菌的良好培养剂，不及时清除就容易诱发包皮炎。

　　此外，还有一些龟头炎病因不明确，但包皮过长，包皮垢刺激多与龟头炎的发生有关。故男性也应经常清洗包皮和阴茎头，保持包皮腔内清洁和干燥。平时应注意养成良好的卫生习惯，对包皮过长或包茎（包皮不能翻转）者行包皮环切术等都有很好预防作用，若该病一旦发现，在患处将包皮翻转用高锰酸钾液浸泡清洗，适当应用抗生素，多在数天内治愈；若较严重则需在医生指导下进行有效治疗。

　　专家介绍，龟头包皮炎是龟头炎和包皮炎的统称，是指发生于龟头、包皮及冠状沟的炎症性病变。龟头包皮炎为临床上常见的男科疾病，专家提醒龟头包皮炎若得不到及时有效的治疗，其会并发严重的并发症。

　　那么临床上常见的龟头包皮炎的并发症都有哪些？下面就来为大家介绍一下，希望它们能够引起大家的重视。

　　急性尿道炎

　　引发龟头包皮炎的致病原可逆行侵人尿道，发生急性尿道炎，表现为尿频、尿急、尿痛、尿道烧灼感、下腹部不适或胀痛等。尿检可见白细胞、真菌或滴虫，尿培养可发现相应的细菌。

　　急性睾丸炎

　　龟头包皮炎的脓性分泌物可循淋巴管感染睾丸而引发急性睾丸炎，表现为患侧睾丸红肿，疼痛较剧，并向同侧腹股沟、下腹部放射，触诊可见患侧睾丸肿大，张力高，有明显的触痛，形成脓肿时，可有波动感。

　　包皮炎是指包皮内板与阴茎头的炎症，是男性人群中很常见的一种疾病，专家在临床上总结的经验里指明龟头炎和包皮炎同时发生。综合起来也就是包皮龟头炎。

　　A kind of lipid substance secreted in the normal prepuce cavity can accumulate into prepuce smegma to stimulate the prepuce and glans, causing balanoposthitis. Experts introduce that balanoposthitis is a common urological disease in clinical practice, which can generally be divided into the following types. The experts will introduce them one by one below.

　　1, Acute superficial balanitis

　　Local edematous erythema, erosion, exudation, and hemorrhage. After secondary bacterial infection, it forms redness, ulceration, and purulent discharge, presenting with local pain, difficulty in movement, and the infecting bacteria are mostly Escherichia coli, Chlamydia, Mycoplasma, and others.

　　2, Candidal balanoposthitis

　　It has erythema, smooth surface, mild desquamation, and satellite distribution of papules or small pustules, gradually expanding outward with clear boundaries. During acute attacks, the erythema of the glans mucosa is edematous with unclear boundaries, sometimes with erosion and exudation. Recurrent attacks can cause the prepuce to become dry, fibrotic, and the glans tissue to become hard. Candidal balanoposthitis is characterized by surface phosphorous-like white substances, or fissures, or bright skin lesions.

　　3, Trichomonas balanoposthitis

　　At first, papules or erythema appear on the glans, gradually expand, with clear boundaries, and there are small blisters the size of a needle or millet on the erythema. After the blisters expand and merge, a mild temporary erosive surface is formed, and trichomonads can be found in the exudate.

　　4, Acute superficial balanitis

　　It is often caused by friction, trauma, or local irritation from soap and cleaning agents. It presents with edema, erythema, exudation, erosion, secondary infection with purulent discharge, prone to form ulcers, and自觉 pain.

　　5, Ring-like erosive balanitis

　　The inflammatory lesions of the glans and prepuce present in a ring shape, or there is cheesy prepuce smegma in the ring, which is prone to ulcerate into superficial ulcers over time. If the ring-shaped feature is lost, it is not easy to distinguish from superficial balanitis. This disease can exist alone or as a mucosal symptom of Reiter's syndrome.

　　6, Plasma cell balanitis

　　More common in middle-aged people, it is a chronic inflammation that persists for a long time, with lesions showing plaque-like appearance, smooth or desquamated or moist surface, and obvious infiltration. The boundaries are clear and not easy to ulcerate, with visible small spots resembling pepper powder on the surface. It is difficult to distinguish from proliferative balanitis. If similar lesions occur in the vulva, it is called plasma cell vulvitis.

　　7, Cloudy and keratotic pseudodysplastic balanitis

　　The glans is damaged, infiltrated, thickened, with excessive keratinization and cloudy scab formation. The affected area loses its normal elasticity and gradually atrophies over time.

　　The clinical recurrence of male balanoposthitis is often due to irregular treatment, failure to address the root cause of the disease, and not choosing a regular and professional hospital for the treatment of balanitis and balanoposthitis, whether infectious or non-infectious. Patients must choose a regular and professional hospital to completely cure the disease and avoid recurrence and sexual dysfunction caused by treatment errors. At the same time, patients with balanoposthitis should pay attention to the hygiene of their genitals, and adult men should pay attention to a healthy sex life.

　　Balanoposthitis is a common disease困扰men, and the harm it brings is not negligible. It can not only affect one's own health but may also affect fertility in severe cases.

　　In the early stage of balanitis, the glans penis and foreskin may appear edema and congestion, the perineal area around the urethral opening may become red and there may be wounds and erosions, which can develop into superficial ulcers, with purulent secretions. The patient may feel itching or burning sensation at the glans penis, followed by pain. After ulceration, it may exude pus and have an unpleasant smell. Severe cases may have fatigue, low fever, inguinal lymphadenopathy and tenderness. In addition, if it is a candidal balanitis caused by candidiasis, it is often manifested as erythema of the glans mucosa, local edema, smooth appearance, mild desquamation at the edge, and there may be papules and small pustules expanding around to form balanitis erosions. Recurrent candidal balanitis can cause the foreskin to crack, fibrosis, and hardening changes of the glans penis.

　　Therefore, male friends must do a good job of prevention. So, how to prevent balanitis? Let's find out together below.

　　1, Pay attention to personal hygiene

　　It is necessary to clean the glans penis and foreskin every day, and those with phimosis and phimosis should undergo circumcision early to avoid urine residue stimulation. For those with severe phimosis, do not force the foreskin to be flipped up to avoid incision. If there is bacterial growth of smegma, clean it in time. In addition, it is necessary to take a bath frequently and change underwear frequently. If the foreskin can be flipped up, the secretion and pus inside the foreskin must be cleaned and kept dry.

　　2, Persistent exercise

　　Regular exercise every day can not only prevent the occurrence of balanitis, but also prevent all diseases, because as long as the body's immunity is enhanced and the body is strong, it can even achieve the effect of preventing all diseases. Therefore, men must exercise more in daily life to improve their resistance, which can help prevent the occurrence of balanitis.

　　3, Avoid unclean sexual intercourse

　　This is something that male friends must pay attention to, because the vagina is the easiest place for bacteria in women, so it is best to take protective measures during sexual intercourse.

　　4, Develop good living habits

　　Maintain good living habits in daily life, do not stay up late, drink heavily, etc.

　　5, Treatment of onset

　　Patients with severe illness should rest flat, and those with mild illness should tie the glans penis with a gauze band around the waist to prevent it from hanging down, which is conducive to reducing local friction. Keep the perineum clean, and change the clothing frequently for incontinence patients.

　　6, Local medication should be appropriate

　　Avoid using corrosive or strong irritant drugs. It is forbidden to use corticosteroid ointments during the acute stage, and hormone ointments can only be used after infection is controlled. For those with ulcers, it is recommended to change the dressing once a day.

　　7, Diet

　　Daily diet should be light, avoid spicy and刺激性 food, pay attention to rest, and avoid overwork.

　　Balanitis is completely preventable. It is necessary to develop good hygiene habits in daily life. It should be emphasized that those with phimosis and phimosis (the foreskin cannot be turned back) must undergo circumcision in a timely manner.

　　Many men feel ashamed to think that they have urological diseases, so they are not willing to go to the hospital for timely and effective treatment even when their bodies show symptoms, which may worsen the condition and be unfavorable for future treatment. When the glans penis has inflammation, the patient is very painful. This disease is balanitis, but many patients are not sure about this disease. Patients should be diagnosed and treated in a timely manner, but how should they be diagnosed?

　　Method one: The disease can be diagnosed by direct microscopic examination, scraping the scale from the surface of the skin damage of the glans penis, coronal sulcus or prepuce as the specimen to be examined. The specimen to be examined is made into a film with a certain concentration of potassium hydroxide or physiological saline, and a large number of ovoid spores and pseudohyphae can be seen under the microscope. If a large number of pseudohyphae are found, it indicates that the candida is in the pathogenic stage.

　　Method two: Use staining examination to check the disease, and can also use Gram staining, Congo red staining or PAS staining, and the positive rate is higher than that of direct microscopic examination. Gram staining, spores and pseudohyphae are stained blue, Congo red and PAS staining, spores and pseudohyphae are stained red.

　　Method three: Through isolation culture observation, for patients with negative smears, candida culture can be performed. In sterile conditions, the tested specimen is inoculated on Sabouraud's medium, usually using tube culture method. When inoculating, the slanting tube medium is slightly cut, 2 to 3 inoculation sites per tube, 2 tubes per specimen. After incubating the medium in a 37℃ incubator for 24 to 48 hours, observe and find a large number of milky white colonies. Pick up a small amount of colonies with a needle and make a smear, directly observed under a microscope or stained and observed under a microscope, a large number of blastospores can be seen, and a preliminary diagnosis of candidal infection can be made.

　　Method four: Use candida antibody test, immunodiffusion method or latex agglutination method can detect candida antibody.

　　Balanitis refers to the inflammation of the inner plate of the prepuce and the glans penis. Poor hygiene or infection of adjacent organs can cause balanitis, which will affect male health and lead to some urinary system diseases and male infertility. It is common for men to have balanitis, which is mostly related to men's neglect of personal hygiene, of course, we are not saying that everyone is this reason. There are many things to pay attention to during the onset and treatment process of balanitis. In addition to actively cooperating with the doctor for relevant treatment, patients with balanitis should also pay attention to the health care of balanitis. And the diet of balanitis is an important point in the health care of balanitis. Today, we will introduce several kinds of foods for treating balanitis.

　　I, Suitable diet for balanitis

　　1, Use one piece of loofah and 50g of glutinous rice, with an appropriate amount of sugar. First cook 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 eliminate boils.

　　2, Use 50g of mung bean and 100g of glutinous rice to cook porridge together, which can clear heat and detoxify, and reduce edema.

　　3, The raw material for winter melon drink is one young winter melon (about 500g), washed with green skin cut into slices, added with an appropriate amount of water, a little salt and seasoning, cooked and eaten, which has the effect of clearing heat and promoting diuresis.

　　4, Use 50g of red bean and 500g of glutinous rice to make porridge, which can clear heat and detoxify, and promote diuresis and reduce swelling.

　　5. Clean 4 pig feet, add 50g of scallions, an appropriate amount of salt, place in the pot, simmer on low heat until tender, eat the meat and drink the soup in portions, with the efficacy of detoxifying and reducing swelling.

　　6. Fresh toon leaves 250g, washed, chopped, mixed with a little flour and salt, 500g of vegetable oil, heated, and the paste placed in the oil, fried until golden and removed, for consumption. It can clear heat, promote diuresis, and detoxify and reduce swelling.

　　7. Fresh mung bean sprouts in an appropriate amount, stir-fried with vegetable oil, seasoned with salt and spices, for mealtime consumption, has the efficacy of clearing heat and detoxifying.

　　8. Lonicera 15g, green bean skin 10g, taken as tea, has the effects of clearing heat and detoxifying, and reducing swelling.

　　In this way, friends with balanitis can choose one or more of them according to their preferences as the material for breakfast, lunch, and dinner every day.

　　Second, balanitis patients should avoid the following foods

　　1. Goat fat: Goat fat is rich in a large amount of fat, which is easy to nourish bacteria, leading to exacerbation of inflammation and infection, which is not conducive to the recovery of the patient's body. It is advisable to eat low-fat foods.

　　2. Chilies: Chilies are spicy and stimulating foods that can easily stimulate the prepuce, leading to exacerbation of inflammation and infection, edema, and congestion, which is not conducive to the recovery of the patient's body. It is advisable to eat light foods.

　　3. Onions: Onions are a food that is easy to produce gas, which can lead to slow intestinal peristalsis, abdominal distension, affecting the absorption of nutrients, and is not conducive to the recovery of patients. It is advisable to eat gas-free foods.

　　Through proper diet and following medical advice, the rapid recovery of the disease can be promoted. In the details of life, attention should also be paid to local hygiene, cleaning the glans and prepuce daily, and if the prepuce is too long, timely treatment should be sought, and a prepuceplasty may be necessary if required. It is very important to clean the prepuce smegma in time. Avoid unclean sexual intercourse and maintain personal hygiene. If infected with trichomoniasis or Candida albicans, both partners should be treated simultaneously to prevent recurrence of the disease.

　　Balanoposthitis can occur at any age, but it is more common in those with active sexual activity, especially in people with phimosis or long prepuce, those with unclean sexual behavior, or those with poor hygiene who cannot clean regularly, or those with certain chronic diseases. It can also be caused by local contact with allergens, such as hair dyes, condoms, etc. Diabetics are more prone to candidal balanoposthitis.

　　It is important to receive timely treatment for balanitis, which can be treated with Western or traditional Chinese medicine.

　　First, Western Medicine Treatment

　　1. For redness, swelling, exudation, and erosion, 3% boric acid water or 0.1% lavender cold wet敷 can be used, twice a day, for 20-30 minutes each time; then, topical zinc oxide ointment or zinc oxide oil can be used.

　　2. For patients in the non-infectious subacute stage, corticosteroid cream can be used, once or twice a day.

　　3. In the chronic stage or with dry desquamation, tetracycline hydrocortisone ointment or crotamiton econazole cream can be used.

　　4. The infection is obvious with fever and lymphadenopathy, systemic application of antibiotics such as cefametin, 0.5g, orally 3-4 times a day, or norfloxacin, 0.2g, twice a day; topical use of mupirocin ointment or compound polymyxin B ointment, etc. Treatment for candidal balanoposthitis can be applied with ketoconazole cream externally, and fluconazole capsules 150mg, taken once every three days, for a total of three times.

　　5. Abstain from sexual activity during treatment, avoid friction, and control penile erection.

　　6. For those with longer foreskin, circumcision should be performed after the inflammation subsides. For allergic balanoposthitis, oral antiallergic drugs and topical corticosteroid ointments should be used. If the phimosis or edema of the foreskin cannot be flipped for immersion and washing, and the drainage is not smooth, and the inflammation still cannot be resolved after general treatment, circumcision of the foreskin can be performed to facilitate drainage. Circumcision should be performed again after the inflammation is completely resolved.

　　Second, Traditional Chinese Medicine Treatment

　　The treatment method for the erythema stage is to clear heat and purge fire, and cool blood to resolve 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 purges fire and can reach the penis to relieve pain. If there are signs of blood heat, add Chishao, Danpi, Zicao, etc. to clear heat and cool blood; for those with severe heat-toxin, add Zhizi, Luhui, etc.; for those with severe itching locally, add Difuzi and Baibai Pi to expel wind and detoxify to stop itching.

　　The treatment method for the exudative stage is to clear heat and promote diuresis, and detoxify. The herbal formula used is modified Longdan Xiegan Decoction. In the formula, Longdan Coptis clears the damp-heat of the liver meridian; Zhizi, Huangqin clears heat and purges fire; Mutong, Zexie, Cheqianzi clear heat and promote diuresis; Shengdi clears heat and cools blood to stop bleeding; Chaihu relieves liver depression and regulates qi. For those with a lot of local exudate, add Huangbai and Niuxi to strengthen the effect of clearing heat and promoting diuresis in the lower焦; for those with severe heat-toxin, add dandelion, purple daisy, silver flower, Forsythia, etc. to clear heat and detoxify.

　　The treatment method for the ulcerative stage is to clear heat and promote diuresis, and detoxify. For those with strong physique and damp-heat syndrome as the main manifestation, the treatment should be to clear heat and promote diuresis and detoxify; for those with weak spleen and stomach, the treatment should be to invigorate the spleen and stomach, promote detoxification, 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 daisy, and purple back chrysanthemum seeds clear heat and detoxify. If there is red urine and pain, add talc and tungus to clear heat and promote diuresis; if there is a lot of secretion from the ulcerated and ulcerated area, add茵陈 and turmeric to clear heat, detoxify and eliminate dampness; for those with constipation, add rhubarb to purge fire and relieve constipation while also cooling blood and removing blood stasis. The formula for invigorating the spleen and stomach, promoting detoxification, reducing swelling and promoting muscle growth uses Fufang Shenshu Sanhua Decoction with modifications. In the formula, Taiizi Shen and Huangqi tonify the body and invigorate the interior; Qiliyige Hua, Lahuamei, Suhua, Zaochai, and turmeric clear heat and detoxify, promote detoxification and promote the external drainage of pus; Chenpi and Juhui can invigorate the spleen and stomach and clear phlegm and turbidity. The combined use of these herbs tonifies the body, invigorates the spleen, promotes detoxification, reduces swelling, and promotes muscle growth, and is more effective for late-stage balanoposthitis with ulcers that do not heal after ulceration.