Balanoposthitis

　　1. Etiology

　　The pathogenic bacteria are Streptococcus, Staphylococcus, Escherichia coli, and Candida albicans. Sometimes it can be caused by Trichomonas vaginalis. Candidal balanitis is caused by infection with Candida albicans. It is often infected due to the partner's candidal vaginitis, or secondary to diabetes, old age, weakness, and the use of corticosteroids, immunosuppressants, and antibiotics.

　　2. Pathogenesis

　　Phimosis refers to a narrow prepuce orifice, where the prepuce cannot be flipped over to expose the entire glans. In infancy, the prepuce is relatively long compared to the glans, and there is adhesion between the prepuce and glans, which is a physiological phimosis. As age increases, the penis gradually develops, the adhesion between the prepuce and glans gradually diminishes, the prepuce gradually recedes, and most phimosis disappears automatically. In children aged 5 to 7 years, phimosis accounts for about 27.3%. Due to the inability to clean locally, it often leads to prepuce inflammation, causing adhesion between the prepuce and glans, affecting penile development. Therefore, some people advocate for early circumcision. Otherwise, with age, the secretion of sebaceous glands and desquamation of the epidermis in the phimosis accumulate, forming smegma, and even calculus under the prepuce, which is easy to lead to bacterial infection, inflammatory adhesion, and adhesive stenosis of the prepuce and urethral orifice. Long-term chronic inflammation in the phimosis is an important factor in the occurrence of penile cancer.

　　Inflammatory edema makes the prepuce orifice tight and incarcerated the glans, aggravating the edema of the glans and prepuce. In severe cases, ischemic necrosis may occur, and urethral orifice stenosis may also occur.

　　Incarcerated phimosis is a complication of phimosis or long prepuce. When the prepuce is flipped over to the back of the glans and not复位 in time, the prepuce ring will block the venous and lymphatic circulation, causing edema, which prevents the prepuce from being复位, leading to incarcerated phimosis.

　　Long prepuce can be flipped up to clean the prepuce, usually not requiring circumcision, while phimosis is the main cause of balanoposthitis and incarcerated phimosis, and is also related to the occurrence of penile cancer. Therefore, circumcision for phimosis has a positive significance.

　　Phimosis should undergo the following examinations: secretion microscopy and culture can reveal pathogenic bacteria, and Trichomonas vaginalis infection can be found in phimosis of the prepuce. The diagnosis should be combined with the patient's clinical manifestations.

　　Dietary Health Care:

　　During the onset process and recovery period of balanoposthitis, it is more important to pay attention to the coordination of drinking methods, in addition to avoiding spicy foods, the following dietary methods can be chosen according to the condition.

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

　　2. Use 250g of fresh toon leaves, wash, chop, mix with a little flour and salt, heat 500g of unsalted oil, and fry the mixture until golden brown, remove it and eat it. It can clear heat and dampness, and detoxify and reduce swelling.

　　3. Use fresh mung bean sprouts in appropriate amounts, stir-fry with unsalted oil, mix with salt and seasoning, and eat as a side dish, which has the effects of clearing heat and detoxifying.

　　4. Use one loofah and 50g of glutinous rice, add an appropriate amount of sugar. First cook the porridge until half done, add the loofah when the porridge is cooked, remove the loofah and add sugar, eat the porridge, which can clear heat, detoxify, cool blood, and reduce boils.

　　5. Use 50g of mung beans and 100g of glutinous rice, cook together to make porridge, which can clear heat, detoxify, and reduce swelling.

　　6. Use 4 cleaned pork feet, add 50g of scallions and an appropriate amount of salt, cook in a pot over low heat until tender, eat the meat and drink the soup in several servings, which has the effects of detoxifying and reducing swelling.

　　7. Use 15g of honeysuckle and 10g of mung bean skin, drink as tea, which has the effects of clearing heat, detoxifying, and reducing swelling.

　　8. Use one tender winter melon (about 500g), wash and peel, cut into slices, add an appropriate amount of water, a little salt and seasoning, cook until done, and eat it, which has the effects of clearing heat and dampness.

　　9. Use appropriate amounts of honeysuckle and mugwort roots, decoct and drink as tea, which has the effects of clearing heat and dampness, and detoxifying.

　　I. Treatment

　　1. Local Treatment:Maintain local cleanliness, avoid irritation, soak or apply a damp compress with potassium permanganate solution at a concentration of 1:5000, and for those with poor drainage of purulent fluid in the prepuce sac, a longitudinal incision can be made on the back of the prepuce for drainage, cleaning, and circumcision after infection control.

　　2. Special Treatment:Special treatment should be carried out for infections with clear etiology, such as local application of 1% to 3% clotrimazole or ketoconazole cream for candidal balanoposthitis, and oral metronidazole for Trichomonas vaginalis infection.

　　3. General Treatment:Patients with severe infection, suspected to have necrotic balanoposthitis, accompanied by fever and enlargement of inguinal lymph nodes, should be treated with systemic antibiotics.

　　II. Prognosis

　　Patients with no serious complications have a good prognosis after treatment.