Balanitis

Balanoposthitis
Last reviewed: September 24, 2012.

Balanitis is swelling (inflammation) of the foreskin and head of the penis.

Causes, incidence, and risk factors

Balanitis is usually caused by poor hygiene in uncircumcised men. Other possible causes include:

Diseases such as reactive arthritis and lichen sclerosis et atrophicus

Infection

Harsh soaps

Not rinsing soap off properly while bathing

Uncontrolled diabetes

Symptoms

Redness of foreskin or penis

Other rashes on the head of the penis

Foul-smelling discharge

Painful penis and foreskin

Signs and tests

Your health care provider may be able to diagnose your balanitis by examination alone. However, you may need
skin tests for viruses, fungi, or bacteria. Sometimes, a skin biopsy is needed.

Treatment
Treatment depends on the cause of the balanitis. For example, balanitis that is caused by bacteria may be treated
with antibiotic pills or creams. Balanitis that occurs with skin diseases may respond to steroid creams. Anti-fungal
creams will be prescribed if it is due to a fungus.
In severe cases, circumcision may be the best option. If you cannot pull back (retract) the foreskin to clean it, you
may need to be circumcised.

Expectations (prognosis)
Most cases of balanitis can be controlled with medicated creams and good hygiene. Surgery is not usually needed.

Complications
Long-term inflammation or infection can:

Scar and narrow the opening of the penis (meatal stricture)

Make it difficult and painful to retract the foreskin to expose the tip of the penis (a condition called
phimosis)

Make it difficult to move the foreskin over the head of the penis (a condition called paraphimosis)

Affect the blood supply to the tip of the penis

Calling your health care provider

Tell your health care provider if you have any signs of balanitis, including swelling of the foreskin or pain.

Prevention
Good hygiene can prevent most cases of balanitis. When you bathe, pull back (retract) the foreskin to clean and dry
the area under it.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001865/

Orchitis
Epididymo - orchitis; Testis infection
Last reviewed: October 9, 2012.

Orchitis is swelling (inflammation) of one or both of the testicles.

Causes, incidence, and risk factors

Orchitis may be caused by an infection from many different types of bacteria and viruses.
The most common virus that causes orchitis is mumps. It most often occurs in boys after puberty. Orchitis usually
develops 4 - 6 days after the mumps begins. Because of childhood vaccinations, mumps is now rare in the United
States.
Orchitis may also occur along with infections of the prostate or epididymis.
Orchitis may be caused by sexually transmitted infection (STI) such as gonorrhea or chlamydia. The rate of sexually
transmitted orchitis or epididymitis is higher in men ages 19 - 35.
Risk factors for sexually transmitted orchitis include:

High-risk sexual behaviors

Multiple sexual partners

Personal history of gonorrhea or another STD

Sexual partner with a diagnosed STD

Risk factors for orchitis not due to an STD include:

Being older than age 45

Long-term use of a Foley catheter

Not being vaccinated against the mumps

Problems of the urinary tract that occurred at birth (congenital)

Regular urinary tract infections

Surgery of the urinary tract (genitourinary surgery)

Symptoms

Blood in the semen

Discharge from penis

Fever
Groin pain

Pain with intercourse or ejaculation

Pain with urination (dysuria)

Scrotal swelling

Tender, swollen groin area on affected side

Tender, swollen, heavy feeling in the testicle

Testicle pain that is made worse by a bowel movement or straining

Signs and tests

A physical examination may show:

Enlarged or tender prostate gland

Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side

Tender and enlarged testicle on the affected side

Tests may include:

Complete blood count (CBC)

Testicular ultrasound

Tests to screen for chlamydia and gonorrhea (urethral smear)

Urinalysis
Urine culture (clean catch) -- may need several samples, including initial stream, midstream, and after
prostate massage

Treatment
Treatments may include:

Antibiotics -- if the infection is caused by bacteria (in the case of gonorrhea or chlamydia, sexual partners
must also be treated)

Anti-inflammatory medications

Pain medications

Bed rest with the scrotum elevated and ice packs applied to the area

Expectations (prognosis)
Getting the right diagnosis and treatment for orchitis caused by bacteria can usually preserve the normal testicle
function.
If the testicle does not completely return to normal after treatment, further testing to rule out testicular cancer should
be done.
Mumps orchitis cannot be treated, and the outcome can vary. Men who have had mumps orchitis can become sterile.

Complications
Some boys who get orchitis caused by mumps will have shrinking of the testicles (testicular atrophy).
Orchitis may also cause infertility.
Other potential complications include:

Chronic epididymitis

Death of testicle tissue (testicular infarction)

Fistula on the skin of the scrotum (cutaneous scrotal fistula)

Scrotal abscess
Acute pain in the scrotum or testicles can be caused by twisting of the testicular blood vessels (torsion), which is a
surgical emergency. If you have sudden pain in the scrotum or testicles, get immediate medical attention.

Calling your health care provider

All testicle problems should be examined by a health care provider.
Call your local emergency number (such as 911) or go to the nearest emergency room if you have sudden pain in the
testicle.

Prevention
Getting vaccinated against mumps will prevent mumps-associated orchitis. Safer sex behaviors, such as having only
one partner at a time (monogamy) and condom use, will decrease the chance of developing orchitis as a result of a
STI.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002259/