Effective treatment of balanoposthitis in men with drugs. Fluconazole treatment regimen for candidiasis in men Chronic candidiasis balanoposthitis in men

A disease of the male genitourinary system, characterized by inflammation of the glans penis and the skin fold that forms the foreskin, or rather its inner sheet, is called balanoposthitis.

Balanoposthitis manifests itself in many forms, the most pronounced pathogenic properties of which today is considered to be candidiasis, caused by yeast-like fungi of the genus Candida, invisible to the naked eye, or rather not just by their presence, but by a pathological increase in their number.

Wherein A feature of this form of the disease is its conditional pathogenicity. This means that almost all representatives of humanity have microorganisms of the genus Candida in their bodies, making up the usual microflora of the colon and oral cavity, and in women, the vagina. And only in some cases, which give a kind of impetus, they begin to multiply intensively, producing endotoxins and enzymes that cause the corresponding symptoms.

Most often, this is caused by a general weakening of the immune system after a long illness or taking antibiotics, severe hypothermia, neglect of hygiene procedures, or exposure to a stronger strain of the virus from a sexual partner after unprotected sexual intercourse. Often, the development of candidal balanoposthitis in men is the first, clearly visible sign of diabetes mellitus.

Candidiasis balanoposthitis affects not only the stronger sex. Mostly women are susceptible to candidiasis, or, as it is also called, thrush., since in their genitals it is much easier for fungi to survive physiologically - approximately every third person has suffered it at least once in her life, and more than fifty percent of those who have previously been ill are affected by it two or more times. Children are also at risk; in most cases, they receive candida during childbirth, passing through the birth canal of an infected woman.

When infected with candidiasis balanoposthitis in men, swelling of the glans penis occurs, its redness, itching and burning are noted, but the most striking symptom, which appears after a few days in the absence of treatment, is the accumulation of curdled discharge under the foreskin, which has a specific unpleasant odor. In women, discharge appears in the vagina and on the labia.

Treatment of candidal balanoposthitis in men using various means and techniques

Symptoms of chronic candidal balanoposthitis in men include:

Persistent, muted itching.
Painful sensations when touched.
Edema.
Hyperemia.
Whitish films and cheesy discharge on the head of the penis and a particularly significant accumulation of them under the foreskin, which are quite easily removed mechanically, have an unpleasant sourish-putrid odor.
Copious mucous discharge mixed with pus from the urethra.
Ulcers and periodically bleeding erosive grooves surrounded by whitish rims of dead cells.
Painful erection.
Inability to have sexual intercourse due to extreme pain.

Chronic candidal balanoposthitis in men can occur in the following forms:

Indurative- it is characterized by drying out of the skin of the head and foreskin of the male penis, and then their painful wrinkling.
Ulcerative-hypertrophic- characterized by the appearance of multiple deep, poorly healing erosions, in extremely severe cases leading to perforation of the foreskin and gangrenous death of parts of the head, which reduces and in some cases completely eliminates its sensitivity.

Complications of chronic candidal balanoposthitis in men:

When inflammation penetrates the urethra (and this happens in 97% of men), the entire genitourinary system is affected, namely the urethra, bladder, prostate and kidneys.
Phimosis and paraphimosis.
Inflammation of the inguinal lymph nodes.
Cancer of the male genital organ.
Interdigital erosion.
Curd-like discharge on the tongue and in the mouth.
Candida paronychia in skin folds.
Change in shape, curvature of the penis.

Quite often, doctors use Orungal in the treatment of chronic candidal balanoposthitis, as it is a recognized remedy in the fight against candidomycosis affecting the skin and mucous membranes and with deep visceral candidiasis. Another convenient method of treatment is taking gelatin capsules once or twice a day, depending on the recommendations of the attending physician.

Features of the acute form of candidiasis balanoposthitis in men

The acute form of candidal balanoposthitis in men is characterized by an avalanche-like increase in symptoms and transience. Its duration does not exceed two months.

Candidiasis balanoposthitis - symptoms of the acute form of the disease:

Severe swelling of the glans penis.
Redness.
Increased sensitivity, which negatively affects the sex life of a man and his partner, as it significantly reduces the time of sexual intercourse.
Inflammatory processes on the head and foreskin.
Heat.
Fever.
Diaper rash that develops into ulcers and erosions on the constantly weeping softened surface of the head and foreskin.
Necrosis of the superficial parts of the glans penis.
Increased amount of smegma secreted.
Curdled discharge with an unpleasant putrid-sour odor.
Acute pain, itching and burning.
Abundant mucous, mixed with pus, discharge from the urethra.

Among the complications of acute candidiasis balanoposthitis, the following should be highlighted:

Development of the erosive form of the disease into a gangrenous form with further necrosis of the tissues of the male genital organ.
Intoxication.
Inflammation of the inguinal lymph nodes.
The growth of scar tissue on the foreskin and ultimately phimosis.

Until recently, it was believed that thrush was a purely female disease. But the Candida fungus can live, thrive and multiply completely unhindered on the male genital organs. But thrush is not a death sentence; it can be successfully treated with fluconazole.

Candidiasis in men (symptoms)

Male candidiasis occurs when the body's immune function decreases, stress, prolonged hypothermia, obesity, poor personal hygiene, sexual contact with a sick partner, and uncontrolled use of large amounts of antibiotics. Cracks in the mucous membranes also contribute to thrush.

Symptoms of thrush in men depend on the area affected by the fungus.

Balanoposthitis. The localization of the fungus is the glans penis and foreskin. The patient feels a burning sensation during urination, itching in the groin and glans penis, notes its redness, swelling and the presence of a milky white coating. The discharge is lumpy, cheesy, the smell from the perineum is sour. Sexual intercourse does not provide psychological release and is accompanied by pain or discomfort.
Candidal urethritis. The localization of the fungus is the mucous membrane of the urinary canal. It is characterized by inflammation of the urethra and feels similar to gonorrhea (gonorrhea): frequent and painful urination, sometimes with the release of mucus and blood. The discharge (especially in the morning) is thread-like and white in appearance.
Candidal pyelocystitis. Localization of the fungus is the bladder and kidneys. To the above symptoms are added general malaise, increased body temperature, pain in the bladder and kidneys. In this case, the patient is most often admitted to the hospital.

If a man has no symptoms, and his partner regularly struggles with thrush, then he is likely a carrier of a fungal infection. In this case, the man should also be examined and take measures to prevent carriage.

The disease must be confirmed in a laboratory, excluding sexual intercourse and oral sex during this period (and for the period of treatment). If there is a permanent partner, treatment should be carried out to both partners at the same time.

A doctor will tell a man how to treat candidiasis. Most often, complex therapy is prescribed, including a special diet, vitamin therapy and medications.

It is imperative to monitor the cleanliness of the body and genitals, wash them several times a day with a decoction or infusion of chamomile, change underwear daily (and even more often), and boil bedding.

Fluconazole (about the drug)

Typically, thrush in men is successfully treated with Fluconazole. At the same time, fluconazole is not only the name of the drug, but also the name of the active ingredient of a number of similar drugs, for example, "", "Diflazon", "Mycomax", "Diflucan". Therefore, a doctor or pharmacist may well advise you to purchase one of the listed analogues of Fluconazole. But the treatment process will not be affected by this.

The drug is approved by the World Health Organization and has a number of manufacturers around the world. It is produced (both here and abroad) in tablets and capsules of 50 and 150 mg (in cardboard packaging).

Fluconazole is dispensed in pharmacies without a doctor's prescription. You cannot buy the drug directly, in markets, or from dubious suppliers. Also, you cannot use a drug for its intended purpose that has expired (more than 3 years) or was stored incorrectly (at a temperature above 25°C).

The price of fluconazole in pharmacies depends not on its quality, but on the type of pharmacy and manufacturer.

According to its pharmacological action, fluconazole is a potent antifungal agent (not only against candida). It inhibits the vital functions of fungi, suppresses their ability to grow and reproduce. At the same time, there is no harm to the human body from taking the drug, and the effect on the liver is minimal.

It is especially important for men that during treatment with fluconazole there are no contraindications to driving.

The healing effect of this drug is much higher than that of “classical” drugs - “Clotrimazole”, “”, “Nystatin”, etc.

Fluconazole for thrush (use)

If you decide to treat thrush with fluconazole, you should know that this drug (and its analogues) should not be used together with medications that contain astemizole and terfenadine. If you have liver or kidney disease, or are pregnant, take fluconazole with caution (under the supervision of a doctor).

The instructions for use of the drug prescribe how to take it correctly. This is a one-time dose of 150-200 mg of fluconazole (usually 1 capsule) with repeated administration of the same dose after 10-15 days. This dosage suppresses the growth of candida, but does not destroy it as a component of the normal microflora of the mucous membrane.

It is known that with candidiasis, the severity of symptoms and the severity of the lesion can be different, and everyone’s health status is different, therefore, in order to avoid relapses and the disease becoming chronic, it will be better if the dosage and frequency of fluconazole administration (treatment regimen) is selected by a doctor.

This will prevent possible side effects of the drug from the heart, blood vessels, stomach, intestines, nervous system and protect you from overdose, which is manifested by fever and hallucinations.

In addition, in addition to tablets and capsules with fluconazole, men are often recommended to use external medications. They are sold at the pharmacy in the form of creams or gels (for example, with clotrimazole or with the same fluknazole).

In general, treatment lasts 2-4 weeks, but sometimes fluconazole for thrush in men is used for up to six months to achieve complete recovery.

Thrush is very sensitive to dietary nutrition, for example, sugar “feeds” the fungi. Therefore, throughout the entire period of treatment it is necessary to exclude alcohol, coffee, sweets, and baked goods. You can drink compotes, weak tea, juices, eat porridge, boiled meat and fish. Whether it is possible to eat vegetables and fruits is a controversial question. Some experts believe that in large quantities, especially fruits containing a lot of sugars, can only cause harm. Therefore, it will be better if the consumption of fruits and vegetables in the diet is present in moderation.

Laboratory results and the absence of symptoms of candidiasis for 12 months will indicate that you are healthy and the thrush has been completely defeated. During this time, sexual relations should be protected (with a condom) and kept to a minimum.

Before treating candidal balanoposthitis in men, it is necessary to establish a diagnosis. Usually it does not present any difficulties.

Based on the symptoms, the doctor may suspect a fungal pathology. He then takes it from the head of the penis and examines it under a microscope.

If yeast-like fungi are detected, the diagnosis is considered confirmed. However, there are other, more accurate research methods.

To diagnose candidiasis, your doctor may prescribe:

cultural examination (inoculation on a nutrient medium);
ELISA is a method for determining antibodies in the blood to the causative agent of candidiasis (for urogenital candidiasis it is practically not used).

The choice of method is determined by the clinical situation. PCR allows you to quickly determine the type of microorganism.

Tank sowing takes a long time, but makes it possible to identify the accompanying flora, the type of candida, as well as the degree of its susceptibility to various antimycotics.

PCR for atypical candida in balanoposthitis

The most common causative agent of candidiasis is candida albicans. But there are other fungi that are less common. Their detection is important, since different fungi have different sensitivities to antifungal drugs.

Atypical candida include Candida tropicalis, parapsilosis, glabrata, krusei, guilliermondii, kefyr. They are determined using PCR.

Determining the type of fungus facilitates the process of selecting an effective antifungal drug.

Sowing for candida in balanoposthitis

- not a very fast diagnostic method. The study takes up to 1 week.

Clinical material is placed on a nutrient medium. The growth of the colonies is then observed.

Antimycotics are added to the medium, which makes it possible to assess the sensitivity of the isolated candida to various fungicidal drugs.

Thus, cultural testing allows choosing the optimal therapy. Candida culture is especially important if the fungal infection is resistant to most drugs that have already been used.

Candidiasis balanoposthitis in men - treatment

Local and systemic therapy can be used to treat candidiasis balanoposthitis. Local remedies are used in the form of creams.

Names of drugs:

butoconazole;
clotrimazole;
miconazole

But if only local therapy is used, there is a high risk of relapse. Therefore, it is advisable to simultaneously use oral tablets.

Names of drugs:

itraconazole

Systemic antimycotics are usually prescribed for 3 days. Local preparations are used for 7-14 days.

Chronic candidal balanoposthitis in men

More difficult to treat chronic candidal balanoposthitis. It is characterized by constant relapses that occur with a frequency of once every 2-3 months.

Causes of chronicity:

reduced immunity;
diabetes;
improper treatment of acute candidal balanoposthitis (use of local antifungal drugs in short courses).

The treatment regimen for the disease necessarily includes systemic antimycotics. At the same time, there is a high risk of low sensitivity of candida to most fungicidal drugs. Therefore, a cultural study with determination of sensitivity to antimycotics, or empirical prescription of different drugs may be required.

Maintenance therapy can be used to prevent relapses. It consists of taking fluconazole 150 mg once a month for six months.

If signs of candidiasis balanoposthitis appear, contact our clinic. A venereologist or urologist will help cure this disease.

If you suspect candidal balanoposthitis contact a competent dermatovenerologist.

Alyaev Yu.G., Grigoryan V.A., Sultanova E.A., Allenov S.N., Shpot E.V.

Infections caused by yeast-like fungi of the genus Candida (Candida spp.) are the most common of all infections caused by fungi. Candida is often the causative agent of nosocomial infections and extremely rarely - community-acquired infections in patients without urinary disorders. Increasing importance infections caused by fungi of the genus Candida, is associated with a wide range of application invasive diagnostic methods and treatment, immunosuppressive therapy and antimicrobial drugs with a wide spectrum of antibacterial activity.

Asymptomatic candiduria and candidal cystitis in women

The detection of candida in urine is called candiduria. Candiduria is rarely found in healthy people. Risk factors for candiduria include:

Diabetes mellitus (DM). In patients with diabetes, the risk of uroinfections caused by fungi increases significantly. Diabetes is a predisposing factor for candiduria, since in patients with glucosuria, the intensity of fungal growth increases, resulting in active colonization of the women’s vagina by fungi of the genus Candida. Additional risk factors include decreased phagocytic activity and nonspecific resistance, as well as urinary retention in patients with neurogenic bladder. In addition, patients with diabetes are more often subjected to instrumental studies and receive antibacterial drugs.

Antibacterial therapy. In 30% of healthy individuals, Candida colonizes the mucous membrane of the gastrointestinal tract. However, in patients receiving antibiotics, colonization rates can be as high as 100%. There is no evidence that the administration of antibiotics directly leads to an increase in the proliferation or virulence of Candida, however, there is evidence indicating that suppression of the endogenous flora by antibiotics leads to Candida colonization of the intestines, genital tract, and urethra.

Bladder catheterization. A catheter inserted into the bladder is the point of entry for microorganisms into the urine collection system. All long-standing catheters are necessarily colonized by flora.

Other risk factors. Other risk factors for candiduria include older age, female gender, application immunosuppressive drugs, radiation therapy, installation of intravenous catheters, difficulty in the outflow of urine, tuberculosis of the genitourinary system.

Asymptomatic candiduria is usually discovered by chance, is not accompanied by clinical manifestations and does not require treatment, except for the presence of risk factors for generalization in patients infections.

IN urological at the MMA clinic we performed treatment asymptomatic candiduria in 15 patients: 9 patients suffered from diabetes (and their blood glucose levels were not sufficiently corrected); 2 patients had recently undergone chemotherapy for breast cancer, 4 patients were diagnosed with severe bladder dysfunction such as detrusor hypotension.

All patients underwent treatment: fluconazole orally 150 mg, once.

As a rule, a single dose of the drug was sufficient to eliminate candiduria. Repeated appointment fluconazole only 1 patient suffering from diabetes was required. The absence of candiduria was confirmed by double bacteriological examination of urine performed at an interval of 2 weeks.

Candidal cystitis, in addition to candiduria, is accompanied by the usual signs of inflammation of the bladder: pain during urination of varying severity, pain in the suprapubic region, frequent urination in small portions, burning in the external genital area, terminal gross hematuria.

IN urological At the MMA clinic, we examined 58 of the following patients:

in 48 of them, cystitis had a mixed etiology (i.e., bacteria of the predominantly intestinal group were sown at a titer of >103 CFU/ml in combination with fungi of the genus Candida at a titer of >104 CFU/ml);

In 10 patients, bacteriological examination of urine revealed only Candida fungi in a titer of 104 to 108 CFU/ml.

Patients in this latter group received long-term therapy with broad-spectrum antibiotics for chronic recurrent cystitis without sufficient antifungal prophylaxis.

All patients underwent treatment taking into account the sensitivity of microflora. Patients with cystitis of mixed etiology were prescribed an antibacterial drug in combination with fluconazole:

antibacterial drug + fluconazole orally 100–200 mg/day. (depending on the Candida titer and duration of antibacterial therapy), 7–14 days.

Patients with candidal cystitis were prescribed fluconazole in the form of monotherapy according to the scheme given above.

It should be noted that the treatment of candiduria turned out to be effective in 100% of cases, which is confirmed by the results of a double bacteriological examination of urine performed at an interval of 2 weeks.

Candidal balanoposthitis and urethritis in men

Candidal balanoposthitis is one of the most common mycotic infections of the penis. In addition to independent damage and development of balanoposthitis, there is a secondary addition of candidiasis infection against the background of already existing balanoposthitis of a different etiology. The clinical picture of balanoposthitis caused by Candida fungi is manifested by the presence of patchy erythema, swelling of the skin, and the appearance of erosive and ulcerative elements, while the pathological process can spread to the skin of the scrotum. Data from microscopic and bacteriological examinations allow us to establish the correct diagnosis.

One of the routes of infection for candidal balanoposthitis is sexual, but the presence of endocrinopathies (DM, thyroid disease, obesity, etc.), a decrease in the body’s immunological reactivity and other factors are of decisive importance.

IN urological The clinic has experience in treating 327 patients with candidiasis balanoposthitis.

Depending on the severity of the process, treatment was carried out with local or systemic drugs or a combination of both.

For mild forms of balanoposthitis, along with compliance with hygienic measures, the following was used:

clotrimazole, 1% cream, topically 2–3 times a day, 1–2 weeks. or econazole, cream or powder, topically 2 times a day, 1–2 weeks.

In the presence of risk factors for generalization of infection (for example, in patients with diabetes or patients with immunosuppression), as well as in cases of pronounced inflammatory changes, local therapy was supplemented with drugs for systemic applications:

fluconazole 150 mg orally, once or fluconazole 150 mg orally, on the 1st day, then 50 mg once a day, 7 days. or fluconazole 200 mg orally, on the 1st day, then 100 mg 1 time per day, 4 days.

This therapy was effective in 93–95% of patients, which was confirmed by the results of examination, microscopic and bacteriological examination. In 5–7% of cases, the course of treatment had to be repeated or prolonged.

Often candidiasis balanoposthitis is combined with candidiasis urethritis. In this case, patients experience pain when urinating, frequent urination, cheesy discharge from the urethra, and hyperemia of the urethral sponges.

The diagnosis is made based on the characteristics of the clinical picture and the results of laboratory methods:

microscopic examination of a native or Gram-stained preparation allows not only to detect the presence of Candida with a predominance of vegetative forms of the fungus (mycelium and budding yeast cells), but also to assess the composition of the urethral microflora (pathogenic and conditionally pathogenic microorganisms) and the severity of the leukocyte reaction;

Bacteriological examination makes it possible to determine the species of the isolated fungal culture and accompanying microorganisms, as well as to assess drug sensitivity. The growth of fungal colonies >104 CFU/ml is diagnostically significant.

In 55 of 327 patients with candidal balanoposthitis, candidal urethritis was also detected.

Treatment in this case necessarily included a systemic antifungal drug:

fluconazole 150 mg orally on the 1st day, then 50 mg 1 time per day, 7 days. or fluconazole 200 mg orally on the 1st day, then 100 mg 1 time per day, 4 days.

Prevention of fungal infections

Treatment experience urological patients with various inflammatory diseases requiring the prescription of broad-spectrum antibiotics, indicates that fluconazole is one of the main and most effective drugs used for the prevention fungal superinfections. Depending on the duration of antibacterial therapy, the presence of concomitant diseases (especially diabetes and immunosuppressive conditions), the drug is prescribed once, repeatedly or in prolonged courses:

fluconazole 150 mg orally, once (if necessary, repeat after 1 week, or fluconazole 50 mg orally, 1 time per day, daily or every other day, 7–14 days.

Conclusion

Fluconazole is widely used in urological practice.

The drug has a wide spectrum of action, including most species of Candida, Cryptococcus neoformans, dermatophytes, Malassezia furfur and the “classical” dimorphic pathogens Histoplasma capsulatum, Blastomyces dermatitidis, Paracoccidioides brasiliensis, Coccidioides immitis.

Among the fungi of the genus Candida, the most sensitive to fluconazole are C. albicans, which are the causative agents of most fungal urological infections. Resistance in C. albicans strains rarely develops during treatment.

Fluconazole is soluble in water and is quickly and almost completely absorbed from the gastrointestinal tract. More than 90% of the dose taken orally enters the bloodstream. Simultaneous food intake, as well as gastric acidity, do not affect the absorption of the drug. Peak concentrations are created within 1–2 hours, equilibrium concentrations are achieved by days 4–6 with 1 dose daily. The pharmacokinetic properties of the drug are the same when administered orally or intravenously.

In blood plasma, no more than 12% of the drug is bound to proteins, the main amount is in free form. Therefore, fluconazole penetrates well into all body fluids.

Fluconazole is excreted by the kidneys, mainly in unchanged form. Very high – more than 100 mg/l – concentrations of the drug are created in the urine. Excretion of the drug depends on the glomerular filtration rate. Fluconazole is very poorly metabolized by the liver. The half-life in plasma is approximately 30 hours; dosage and duration of therapy do not affect the half-life.

Thus, it is obvious that fluconazole can be considered the drug of choice for both treatment and prevention fungal infections in most urological patients.

Literature

1. Storfer SP, Medoff G, Fraser VJ et al. Candiduria: retrospective review in hospitalized patients. Infect Dis Clin Pract 1994; 3:23–9.

2. Leu HS, Huang CT. Clearance of funguria with short–course antifungal regimens: a prospective, randomized, controlled study. Clin Infect Dis 1995; 20: 1152–7.

3. Jacobs LG, Skidmore EA, Freeman K et al. Oral fluconazole compared with bladder irrigation with amphotericin B for treatment of fungal urinary tract infections in elderly patients. Clin Infect Dis 1996; 22:30–5.

4. Lundstrom T, Sobel J. Nosocomial Candiduria: A Review. Clin Infect Dis 2001; 32:1602–7.

5. Goeke TM. Infectious complications of diabetes mellitus. In: Grieco MH, ed. Infections in the abnormal host. New York: Yorke Medical Books, 1980; 585–600.

6. Fischer JF, Chew WH, Shadomy S et al. Urinary tract infections due to Candida albicans. Rev Infect Dis 1982; 4: 1107–18.

7. Stamm WE. Catheter–associated urinary tract infections: epidemiology, pathogenesis, and prevention. Am J Med 1991; 91 (suppl. 3B): 65S–71S.

8. Kauffman CA, Vazquez JA, Sobel JD et al. Prospective multicenter surveillance study of funguria in hospitalized patients. Clin Infect Dis 2000; 30:14–8.

9. Rational pharmacotherapy of skin diseases and sexually transmitted infections (edited by A.A. Kubanova and V.I. Kisina). M.: Litterra, 2005.

10. Sergeev A.Yu., Sergeev Yu.V. Fungal infections. Guide for doctors. M.: BINOM-Press, 2003.

Balanoposthitis (ICD 10 code N48.1) is an inflammatory disease, as a result of which the foreskin and head of the male penis are affected. According to statistics, about 11% of men have this diagnosis. But there are cases of the disease being detected in women and children. Your doctor can tell you how to treat balanoposthitis after an examination and some tests. The main therapy is the use of local medications (creams, ointments, etc.).

Treatment of the pathology can be quite long and continues until the symptoms and cause of balanoposthitis are completely eliminated. The duration of the course of therapy is influenced by the form of the disease, the severity of symptoms and the type of pathogen. Acute balanoposthitis is treated within 2-3 weeks.

Urologist Oleg Aleksandrovich Junker will tell you about the disease:

Before starting treatment, the patient needs to review the correctness of hygiene procedures and, together with his sexual partner, be examined for possible STDs. Only after this, the doctor (urologist and venereologist) will be able to prescribe the correct treatment.

If you do not pay attention to the problem in time, the disease can become chronic. Chronic balanoposthitis is much more difficult to treat.

Causes of the disease

All causes that can lead to the appearance of balanoposthitis are infectious and non-infectious in nature.

Infectious causes include:

Candidiasis.
Human papillomavirus.
Trichomoniasis.

Genital herpes is a viral infection of the genital mucosa, characterized by the appearance of a group of blisters, and then erosions and ulcers

Herpes is genital.
Streptococci.
Staphylococci.
Syphilis.
Gardnerellosis.

Non-infectious causes include:

Psoriasis.
Irritative balanoposthitis.
Lichen planus.
Diabetes.

Risk factors contributing to inflammation are:

Failure to comply with hygiene rules.
Decrease in the body's defenses.
Allergic diseases.

The presence of a chronic infection in the body.
Infections of the genitourinary system (urethritis, etc.).
Promiscuous sexual intercourse.

Symptoms of the disease

The main cause of balanoposthitis is considered to be the patient's failure to comply with personal hygiene rules. Signs of the disease depend on the stage of the pathological process.

Simple balanoposthitis

This is the mildest form of the disease. Its manifestations include:

Feeling of burning and itching. This symptom is considered the very first. When touching the head of the penis, urinating or rubbing against clothing, the unpleasant sensations intensify.
Discomfort when opening the head of the penis.
Redness of the affected area. Thus, the inflammatory process makes itself felt.

The table shows general and local symptoms, as well as complications of the disease

Swelling of tissues.
Formation of painful cracks and erosions (erosive balanoposthitis).
Discharge of pus from the urethra. This is how purulent balanoposthitis manifests itself.

Gangrenous balanoposthitis

This form of the disease is considered the most severe. Its signs are:

Phimosis.
Ulcers.
Violation of the patient's condition.
Appearance of scars.
Perforation of the foreskin.

Balanoposthitis caused by STIs

Symptoms of the disease will depend on the type of pathogen:

The gonorrheal type, in addition to the classic signs of balanoposthitis, is accompanied.
Chlamydial - characterized by clear red spots.
Trichomonas - pus accumulates under the foreskin. The head swells and turns red.

Candidiasis is accompanied by itching, burning and pain in the head area. After some time, a cheesy discharge from the urethra appears.
Herpetic. On the foreskin, bubbles with clear liquid inside can be noted. After opening them, red sores appear in this place. Often this type of disease is chronic.

Immunologist Ermakov Georgy Aleksandrovich will talk about the symptoms and treatment of the disease:

Syphilitic - diagnosed when a primary chancre is present on the skin.
Papillomavirus is accompanied by the appearance of condylomas.
Balanoposthitis with gardnerellosis occurs with virtually no symptoms. If the patient’s immune system works well, then after a few days the disease goes away on its own.
Circinar balanoposthitis appears as clear red spots on the head of the penis.

The disease is caused by nonspecific causes

In this case, the signs of balanoposthitis will depend on the primary disease:

With diabetes mellitus, the head of the penis turns red, its sensitivity increases, pain and cracks are possible, in place of which scars remain.
Psoriatic balanoposthitis is manifested by the appearance of red scales.
With lichen planus, irregularly shaped nodules appear on the head, covered with white scales. The skin becomes red.

Features of the disease in a child

Sometimes small children can also experience the disease. As a rule, they are diagnosed with irritative or simple infectious balanoposthitis, which lasts for 5-6 days, after which it goes away.

Among the reasons for its appearance in children are:

Developed foreskin, hanging down and difficult to move.
Phimosis.

Copious discharge of sperm, which accumulates in the fold between the foreskin and the head of the penis.
Failure to comply with simple hygiene rules.

Diagnostics

To make a diagnosis and prescribe treatment, the doctor will examine the patient and prescribe some tests:

A general blood test, in which you can see the presence of an inflammatory process by the number of leukocytes and ESR.
A general urine test, in which an increased number of leukocytes will indicate the presence of inflammation.

A blood test for ESR is a nonspecific indicator that makes it possible to detect inflammation of various origins

Bacterial urine analysis to identify the pathogen and its sensitivity to antibacterial drugs.
PCR will make it possible to isolate the DNA of the pathogen and determine its type.
Scraping from the urethra for the presence of Treponema pallidum.

If the inflammation is caused by a sexually transmitted infection, then it is necessary to examine the partner as well.

Complications

Patients whose immune systems are weakened, as well as those who do not observe personal hygiene rules and do not carry out treatment, may develop complications:

Chronic balanoposthitis can occur if treatment is not started on time or completed prematurely. In this case, remission is possible at first, but later the symptoms of the disease will worsen again. Treating chronic pathology is much more difficult.
Decreased sexual function. The inflammatory process can lead to receptor atrophy and decreased sensitivity. At the same time, potency decreases.
Cystitis, prostatitis and other diseases of the genitourinary system. Pathogenic bacteria that cause balanoposthitis can rise up the urethra and cause these diseases. As a rule, this occurs in people with reduced immunity and those who have not followed the principles of treatment.

Symptoms and complications of prostatitis

Lymphangitis is the transition of the inflammatory process to the inguinal lymph nodes.
Paraphimosis is compression of the head by the foreskin. In this case, there is a disturbance in the blood circulation of the organ, lymph flow and an increase in the size of the head of the penis, which becomes red and painful. This condition requires immediate medical attention, otherwise gangrene is possible.
Gangrene of the penis is characterized by the death of tissue that turns black. The disease begins suddenly for a man. As a result, his general condition worsens, the temperature rises and foci of necrosis appear.

Treatment

How to cure balanoposthitis? This question will be answered by the doctor after examination and passing the necessary tests that can identify the causes of the inflammatory process.

Each patient must follow certain rules:

Maintain penile hygiene.
Eliminate the causative agent of inflammation. For this, antiseptic solutions, herbal tinctures, etc. can be used.
Carry out antibacterial and antiviral therapy using medications. Only the attending physician can prescribe an individual treatment regimen.

Nikolai Konstantinovich Soloviev, urologist-andrologist at the Moscow Doctor medical center, will tell you what causes the disease and how to treat it:

Main methods of treatment:

Taking medications (tablets, ointments, solutions) prescribed by a doctor. So “Levomekol” for balanoposthitis is considered a fairly effective drug.
In case of complications, medications are used that can increase the body's defenses.
The fungal type of disease is treated with antifungal agents (Nizoral ointment, Clotrimazole, etc.).
For anaerobic form, antibiotics are indicated (Azithromycin, etc.).
A surgical intervention that involves excision of the foreskin. In such cases, the patient should not try to open the head on his own, as this can lead to microcracks and further aggravate the inflammatory process.
It is possible to treat balanoposthitis in men with folk remedies. Decoctions and infusions of medicinal herbs can alleviate the general condition of the patient and reduce the manifestations of the inflammatory process. Doctors recommend doing baths, compresses and rubbing the penis with such drugs.

Use of antibacterial drugs

Very often, the cause of inflammation is pathogenic microorganisms, including: E. coli, staphylococci, streptococci and other aerobic and anaerobic bacteria. In such cases, the doctor will prescribe the patient a course of antibacterial therapy. Depending on what caused the pathogen, broad-spectrum antibiotics are prescribed:

Antibacterial drugs are prescribed only in cases of severe forms of the disease or when balanoposthitis is caused by sexually transmitted infections.
Antibacterial therapy is not prescribed when allergic, viral or fungal balanoposthitis is diagnosed.
Antibiotics for balanoposthitis, which are considered the most effective, are Doxycycline and Levomycetin tablets.
The following drugs are often prescribed: Erythromycin, Roxithromycin and Oletetrin, quinol derivatives Nevigramon, nitrofuran Furagin or oxyquinoline Nitroxoline.

Azithromycin is an effective antibacterial agent. Price in pharmacies from 32 rubles.

Anaerobic balanoposthitis is treated with Azithromycin.
When diagnosing a specific infection, penicillins and cephalosporins (Tsiprolet) are prescribed.
Treatment of candidal balanoposthitis in men is carried out with Fluconazole or Clotrimazole.
Chlamydial and ureaplasma types of balanoposthitis are treated with metronidazole derivatives.

Along with tablets, injections and intravenous infusions of medications are used for systemic treatment, depending on the symptoms and severity of the disease.

If balanoposthitis is bacterial in nature, then both partners should take antibacterial medications. During treatment, you should avoid drinking alcohol and having unprotected sex.

Use of ointments

For local treatment of balanoposthitis, various ointments are widely used:

If the disease is fungal in nature, the ointment should have an antifungal effect. These drugs include: “Fluconazole”, “Candide”, etc. “Clotrimazole” for balanoposthitis is the most popular of this group of drugs. No less effective is the Pimafukort ointment, which incorporates the properties of antifungal and hormonal drugs. It is often prescribed if it is necessary to cure chronic candidiasis balanoposthitis.
In case of allergic or autoimmune inflammation, doctors recommend using hormonal ointments “Oxycort”, “Lamisil”, “Locacorten”, etc.

Bandages with ointment are applied to the damaged areas at night after careful hygiene of the genitals. This procedure is carried out within 5 days. Treatment must be carried out under the supervision of a doctor

"Triderm" for balanoposthitis is recommended to be used when a mixed type of infection is detected in the patient. The ointment has antibacterial, antifungal and hormonal effects.
For nonspecific bacterial infections, the combined ointment “Levomekol” is used. It contains chloramphenicol, which has an antibacterial effect, and methyluracil, which is capable of restoring damaged tissue.
Baneocin ointment for balanoposthitis has a powerful antibacterial effect. The bacitracin and neomycin included in its composition can cope with the infection and relieve the inflammation process.

Ointments should be used for a long period of time. In this case, they are applied to the affected area several times a day.

Ointments cannot be used to treat balanoposthitis if the patient has:

Malignant neoplasms.
Trophic ulcers.
Cutaneous tuberculosis.
Necrosis.
Allergy to individual components of the drug.

What ointments are used for the disease? Venereologist, urologist Sergey Gennadievich Lenkin will tell you:

Before you start using any drug, you need to do a test. To do this, apply a small amount of ointment to the back of the hand or near the elbow. If after some time redness, itching, rash or burning occurs in this area, then this remedy should not be used.

If you use the ointment in large quantities, symptoms of overdose may occur: redness, swelling, rash. Periodically, any drug must be changed, since long-term use can reduce its effectiveness.

Use of antiseptic solutions

For local treatment of the disease, various antiseptic solutions are often used. They can be used at home. The most popular are:

Water-based Chlorophyllipt solution. It has anti-inflammatory and antibacterial effects.
Erosive balanoposthitis, accompanied by the formation of ulcers and erosions, is treated with “Fukorcin” (Castellani liquid), which can cope not only with pathogenic bacteria, but also with fungi.
Chlorhexidine is used to disinfect and treat inflammation. The solution is used for washing, lotions, baths and applications. Miramistin has a similar effect. But when using these solutions you need to be careful, as there is a possibility of damage to the mucous membrane and dry skin.

Using baths

If the disease does not have complications such as phimosis, the doctor may recommend medicinal baths. To prepare them, you can use “Furacilin”, “Dioxidin” or “Miramistin”. The duration of the procedure should not exceed 15 minutes. To achieve maximum effect, the penis should be carefully moistened with the solution. After the bath, the site of inflammation is carefully wiped with a sterile napkin and treated with any antiseptic drug.

Chamomile decoction baths are prepared as follows: add about 20 grams of chamomile flowers to a liter of hot water. Use the resulting solution for disinfectant lotions.

A doctor may recommend the following baths:

If yeast-like fungi are detected in the test results, you should use baking soda, which dissolves in warm water.
If you have phimosis, then after surgery you should use baths with decoctions of medicinal herbs (chamomile, calendula or sage).
When balanoposthitis has become chronic, the patient is prescribed baths with Miramistin. Additionally, it is necessary to use corticosteroids (Prednisolone ointment, Oxycort, etc.).

Use of folk remedies

Treatment of balanoposthitis at home can be supplemented with folk remedies. It has been proven that some medicinal herbs can relieve inflammation, eliminate burning sensations and other signs of the disease. The most popular traditional medicines include:

Aloe leaves have anti-inflammatory effects. They are applied to the affected area, having previously been peeled.
Compresses with a decoction of chamomile. To prepare it, dried flowers are poured with boiling water and kept in a water bath for 5-10 minutes. After cooling, the broth is filtered and used to prepare compresses.

Preparation of a product from olive oil and calendula tincture

Treatment of erosive balanoposthitis involves the use of olive oil and tincture made from calendula. To prepare the product, one spoon of dried calendula flowers is poured with 70 ml of olive oil. You need to infuse the drug for 3 weeks, placing it in the sun. When the tincture is ready, wipe all the sores and cracks with it.
Plantain is considered an excellent anti-inflammatory agent. The leaf of the plant should be washed well and applied to the sore spot, secured with a gauze bandage. Every half hour, the bandage with the sheet should be changed to a new one.

Dear readers, from the video below you will learn some tips on how to treat pathology at home:

Sage, which is used to prepare baths, is considered a good remedy. To do this, pour a few tablespoons of dried herbs into 500 ml of boiling water and leave in a water bath for 5-10 minutes. After complete cooling, the broth is filtered and used for baths, rubdowns or lotions.
St. John's wort has medicinal properties. A decoction of it is prepared and used in the same way as the sage remedy.

Treatment of balanoposthitis with folk remedies will only be effective if used regularly over a long period of time. It is important to pay attention to the characteristics of your body and possible individual intolerance to traditional medicine.

List of popular medicines

Treatment of balanoposthitis is inextricably linked with the use of medications. A special place is given to local drugs:

"Miramistin" is the best ointment for treatment, which has a bactericidal effect. Due to its wide spectrum of action, it is prescribed for the treatment of any type of balanoposthitis. The ointment has one side effect - a burning sensation, which goes away on its own after a few minutes. The medicine is not prescribed to people with individual intolerance to its individual components.
"Levomekol" - helps speed up the healing process. The ointment has proven its effectiveness against many bacteria (aerobes and anaerobes). In case of individual intolerance to its components, an allergic reaction is possible.
"Triderm" is able to treat balanoposthitis not only at the initial stage, but also when the disease has become chronic. The active components of the ointment are able to relieve inflammation, have antiallergic, antifungal, and antibacterial effects. The drug should be used several times a day for 2-4 weeks. In case of intolerance to the components of the drug, irritation, itching, dry skin, and the appearance of a rash are possible. Triderm should not be used for skin tuberculosis, chickenpox, or skin reactions that occur as a result of vaccination.
"Furacilin" is used to prepare baths or lotions. The medicine has a broad antimicrobial effect. Skin reactions in the form of rashes and dermatitis are possible. With prolonged use, nerve inflammation may occur. People with kidney disease should be careful.

A very effective remedy. Its price is low, within 100 rubles

Chlorhexidine is an antiseptic that can be used for rinsing, lotions, baths or compresses. It is allowed to be introduced into the urethra. Adverse reactions are extremely rare and manifest themselves in the form of itching, rash or dry skin. Chlorhexidine does not cause an overdose.
Hydrogen peroxide is used for disinfection. To do this, it is used to treat the affected areas of the skin. Among the disadvantages of the product is a temporary effect that completely disappears a few hours after use. It is recommended to use peroxide when the first signs of balanoposthitis occur. It is not used if the patient has phimosis.
Clotrimazole is known for its antimicrobial effect. The medicine is prescribed for candidal balanoposthitis. To do this, the ointment is applied to the skin after hygiene procedures. The duration of use depends on the severity of the disease. In some cases, adverse reactions (redness and burning of the skin) were observed. In this case, the drug should be discontinued and reused only after the side symptoms disappear. "Clotrimazole" is not prescribed to children and people with hypersensitivity to its components.
Potassium permanganate has excellent antiseptic properties and accelerates the healing process of wounds. It can be used at different stages of pathology. But this must be done carefully, since undissolved grains of potassium permanganate can cause a severe burn. It has no contraindications for use.

In addition to treating inflammation, potassium permanganate baths can be prescribed as additional hygiene measures for patients

Fluconazole is effective only in the case of candidiasis balanoposthitis. It is quickly absorbed into the skin and acts for a long period of time. Analogues of the drug are ointments "Flucostat" and "Diflucan".
"Bepanten" is used to speed up the healing process of wounds. The ointment has an anti-inflammatory, moisturizing and regenerating effect. The cream is prescribed for the prevention and treatment of balanoposthitis. It is applied to clean and dry skin several times a day. The duration of use depends on the degree of damage and the individual characteristics of the patient. In some cases, a skin reaction may occur, so it is better not to use it for people with high sensitivity to the active components of the drug.
"Pimafukort" has powerful anti-inflammatory, antifungal and antibacterial effects and is effective against many pathogens. With prolonged use, stretch marks may appear at the site of application. The medicine is not prescribed to children under 1 year of age and to those who are allergic to certain components of the ointment.
"Fukortsin" is prescribed as an antimicrobial and antifungal agent. It is used to prepare baths, compresses and applications. After it dries on the skin, the treated area must be lubricated with cream. A possible side effect is burning. "Fukortsin" is not used in case of high sensitivity of the patient's body to its components. It is not recommended to treat large areas of skin with it, since the active components can penetrate the bloodstream and have a toxic effect.

Fukortsin is an antiseptic solution with high bactericidal and disinfectant properties. The average price in pharmacies is from 75 rubles.

“Syntomycin ointment” for balanoposthitis is a broad-spectrum antibiotic. It is active against many pathogenic bacteria. It is applied to the affected areas in a thin layer several times a day for 3-5 days. With long-term use, the medicine may cause side effects such as itching, burning and redness of the skin.
Tetracycline ointment has an antibacterial effect and can stop the proliferation of pathogenic microflora.

Is balanoposthitis contagious?

If not treated promptly, this disease can cause a lot of unpleasant consequences. Therefore, many men are interested in the question: “Is balanoposthitis contagious and can it be contracted from a partner?” Urologists assure that this disease is not contagious. However, there are a number of infections that are sexually transmitted and can cause inflammation of the foreskin and glans penis.

Another question that often arises among men: “Is it possible to go to a sauna or bathhouse if you have balanoposthitis?”

Water procedures have a good effect on the patient’s condition, but in this case, a sauna would not be the best option. This is due to the fact that:

In such places there is a risk of contracting various infections, which will negatively affect the patient’s condition.
At elevated temperatures, existing bacteria will develop more rapidly.

Therefore, until complete recovery, it is better to avoid visiting such places.

At first glance, balanoposthitis is a harmless disease. But if you don’t pay attention to it in time, the consequences can be extremely unpleasant. The course of treatment should be prescribed by a doctor after identifying the causes of the disease.