In the group of glans infections, balanitis is as widespread as it is unpleasant and feared: from “balanus”, (glans), balanitis is an infection involving the terminal part of the penis, which often spreads to adjacent areas ( e.g. foreskin ) assuming the more precise connotation of balanoposthitis . Although this type of glans infection is very common among children, balanitis is also one of the venereal diseases , therefore even the woman, after a complete risky relationship with a patient affected by the infection, can be infected and undergo a genital infection.
Causes: bacteria , fungi and parasitesthey represent the most important etiopathological elements involved in the manifestation of the glans infection; it seems that syphilis and gonorrhea are the two most common sexually transmitted diseases in the field of glans infections. However, balanitis can also depend on extra-infectious, secondary causes, such as allergies , immune system alterations (e.g. diabetes ), contact dermatitis , phimosis , intertrigo and poor personal intimate hygiene .
Symptoms: although NON-infectious balanitis can also occur asymptomatically (e.g. diabetic balanitis ), the infectious form is ALWAYS characterized by peculiar symptoms, such as glans irritation, local itching and redness, also accompanied by urination disorders , edema , enlargement of the inguinal lymph glands , ulcerative lesions, whitish and/or foul-smelling secretions from the penis, sometimes associated with bleeding .
Therapy: for the treatment of balanitis dependent on bacterial infections , antibioticsthey constitute the therapy of choice, while the fungal insults must be eradicated with the topical application and/or the systemic intake of specific antifungal drugs . Corticosteroids are NOT indicated to treat glans infections related to bacterial balanitis . The sexual partner should also undergo specific drug treatment, even in the absence of symptoms . For more information: read the article on medicines for the treatment of balanitis .
Lichen planus is a chronic inflammatory dermatosis of immunological derivation that affects the skin and mucous membranes in general; among the various types of lichen planus, the genital one is probably one of the most unpleasant. Although it prefers women, the infection can be transmitted to men by sexual contact: in similar situations, the glans is involved, as well as the foreskin, causing burning, pain during urination and dyspareunia (sclero-atrophic lichen planus).
Causes: since it is an infectious variant, sclero-atrophic lichen can be favored by chronic infections in general, especially due to Herpes simplex ; however, in some cases, it is not possible to identify the predisposing factor with precision. Thedyslipidemia , immune system alterations, and anatomical alterations may favor the infection.
Symptoms: when glans infections manifest themselves in the form of lichen planus, the characteristic symptoms are those of a dermatosis, therefore papular lesions or pruritic, erosive and recurring plaques on the skin of the genitals, local itching with balanitis and postitis , and pain during intercourse (genital lichen planus).
Therapy: before undertaking any pharmacological treatment for the treatment of the glans infection caused by lichen planus, the differential diagnosis is important, since the pathology is easily confused with other similar ones. Treatment depends on the trigger; only rarely does lichen planus regress without the aid of drugs. For further information: read the article on drugs for the treatment of lichen planus .
Warts (or condylomata acuminata ) also fall into the category of glans infections. Typical expression of venereal diseases, genital warts occur especially among patients who are immunocompromised or in a state of serious deterioration. Despite the above, it is estimated that genital warts affect half of healthy sexually active people: from here we understand how the disease, however annoying, is generally not so alarming.
Causes: when warts grow at the level of the glans, they normally express a typical HPV virus infection , belonging to types 6 and 11. The transmission of the virusoccurs through sexual contact; it should be remembered, however, that an efficient immune system is able to eradicate the pathogen even before causing damage.
Symptoms: the glans appears to be one of the favorite male targets of the HPV virus : the infection manifests itself with pain, irritation and limited itching, even if it can cause dyspareunia and pain during urination . The possibility that HPV infection of the glans penis will lead to cancer and malignancies – however remote – is nonetheless real.
Therapy: glans warts do not always manifest themselves with symptoms; more often they are asymptomatic and tend to regress spontaneously. However, in case of diagnostic verification, it is recommended to treat warts withantiviral and immunomodulatory drugs . Alternatively, in the event of a particularly resistant or painful infection, it is conceivable to subject the patient to electrocoagulation , laser therapy or surgical excision, especially if the hypothesized risk of degeneration of the infection into a malignant form is important. For further information: read the article on drugs for the treatment of condyloma acuminata .
Quite rare in men, candida-dependent glans infections often run asymptomatically, unlike female candidiasis. In other cases, Candida infections in the glans predispose the victim (especially if diabetic ) to balanitis and balanoposthitis.
Causes: fungal infections of the glans are caused, in almost all cases, by Candida albicans , a fungus contracted mostly through unprotected sexual intercourse. Promiscuous use of infected towels or underwear can also promote Candida infection .
Symptoms: Candida infections of the glans, as well as those of the foreskin, can cause local burning, pain during intercourse and urination, localized erythema , itching and genital irritation.
Therapy: Candidiasis in general, as well as Candida glans infections , can be treated with the topical application of specific antifungals (eg Clotrimazole , Miconazole ), possibly associating antifungals with systemic action (Polyenes, Echinocandins). Following a similar therapy, the intestinal bacterial flora could be affected, altering the normal composition of microorganisms; for this reason, it is recommended to supplement the diet with specific lactic ferments . For further information: read the article on drugs for the treatment of candidiasis .
Among the most common sexually transmitted infections, we cannot forget gonorrhea, also called blenorrhagia, an infection that affects both sexes; from the statistical data, it seems that the infection occurs particularly among young people who, still inexperienced, tend to neglect the importance of the condom in sexual relations with subjects at risk.
Causes: in man, gonorrhea also and above all manifests itself at the glans level, as a consequence of an infection sustained by Neisseria gonorrhoeae , capable of surviving a few hours on the toilets. The beating can be transmitted, as well as by sexual contact, by maternal-fetal route.
Symptoms: gonococcus triggers a particular irritation in man, especially at the level of the glans, often associated with whitish-yellowish and foul-smelling discharge from the penis (typical symptoms of gonococcal urethritis ). In addition to these symptoms, the infection also involves pain when urinating , burning and itching. Only in the most extreme cases does this type of glans infection degenerate into prostatitis , epididymitis and infertility .
Therapy: even in case of temporary removal of the symptoms, the specific antibiotic therapy against Neisseria gonorrhoeae must be performed.
THE macrolides , quinolones and cephalosporins are the most suitable drugs for the treatment of gonorrhea : the removal of the bacterium produces, as a consequence, the remission of all the characteristic symptoms of the glans infection.