Balanitis a Public Health Challenge for Men

Balanitis is inflammation of the glans penis and is a common condition that affects an estimated 3-11% of males commonly in uncircumcised males. Balanoposthitis is inflammation of the mucosa of the glans and prepuce of the penis. Phimosis refers to the inability to retract the foreskin, while paraphimosis refers to foreskin trapped in the retracted position. Both these conditions are clinical diagnoses, they often occur secondary to Balanitis & Balanoposthitis & are considered are urologic emergencies warranting urgent surgical intervention. Balanitis in children and adolescents is mainly due to lack of personal or genital hygiene. Among sexually active adults Health care providers usually suspect a sexually transmitted infection (STI) as some STIs do cause balanitis. Balanitis is neither a STI nor it is contagious. The main symptoms of balanitis include inflammation and pain on the head of the penis. It might lead to complications of phimosis if not treated early. Patients with balanitis present with i) Penile discharge ii) Pain or difficulty with retraction of foreskin, iii) Erectile dysfunction, iv) Difficulty urinating /controlling urine stream v) Inability to insert a Foley catheter, vi) Tenderness and erythema of the glans penis, and vii) Itching. On Physical examination one can find i) Erythema and oedema of glans penis or foreskin ii) Foul odour iii) Discharge iv) Ulceration and/or plaque. In delayed care seeking individuals’, health care professional may also detect i) Phimosis ii) Meatal stenosis, iii) bladder distension, iv) ballooning of the foreskin when voiding v) Lymphadenopathy in rare cases. The aims of management are to minimize sexual and urinary dysfunctions, exclude penile cancer, treat premalignant disease, diagnose and treat sexually transmitted infections. The goal of the therapy is to reduce inflammation, prevent complications and eradicate infection. Topical antimicrobials (Clotrimazole & Bacitracin topicals), corticosteroids (Betamethasone topical), and immunosuppressants (Pimecrolimus) are used. Public health significance of Balanitis is due to its potential association with penile cancer, lichen sclerosis and scarring. Materials & Methods: This article is based on three cases managed in the recent months in an adolescent, adult and elderly individuals, supported by literature review on epidemiology & management practices.