A descriptive study of the clinical and etiological profile of balanoposthitis

Abstract

Background: Balanoposthitis is defined as an inflammatory condition of glans penis and prepuce. There are wide variety of etiologies including both infectious and noninfectious conditions. This study attempts to throw light on information regarding clinical and microbiological aspects of balanoposthitis. Objectives: To study various clinical patterns, etiologies, and predisposing factors of balanoposthitis. Methodology: A descriptive study was undertaken on 106 cases who presented to sexually transmitted disease (STD) clinic with balanoposthitis between November 2017 and April 2019. A detailed history, physical examination, and investigations like KOH mount, leishman staining, gram staining, dark field microscopy, cultures, and other investigations were done wherever indicated. The data collected was tabulated and analyzed. Results: In our study, infectious etiology was the most common and was found in 77.36% cases. About 13.41% of cases with infectious balanoposthitis had multiple etiological agents. Noninfectious etiology was found in 22.64% cases. The most common infectious cause of balanoposthitis was candida, noted in 59.76% cases, followed by herpes simplex virus (19.51%), human papilloma virus (13.41%), and scabies (8.54%). Among noninfectious etiologies, adverse drug reaction (4.72% of total cases) was the most common, followed by lichen planus (3.77%) and psoriasis (3.77%). There was significantly higher incidence of phimosis in diabetic patients with candidal balanoposthitis. Conclusion: Identifying the etiology facilitates early treatment and hence reduces the infectivity and transmission of disease and also the disease complications like phimosis. In addition, multiple infectious etiologies should always be kept in mind while evaluating STDs.

Morphological patterns of balanoposthitis and their correlation with final etiological diagnosis

“…Out of 82 patients of infective balanoposthitis, 18.29% had a history of unsafe extra/pre-marital contact in the study by Jegadish et al . [ 7 ] In the same study,[ 7 ] 41.51% had poor, 20.75% had moderate, and 37.74% had good genital hygiene, whereas 63.6% patients of our study followed proper penile hygiene.…”

“…The mean age of our patients was 39.35 ± 15.15 years (range 2–72 years). In two other studies, these were 37 years (range 13–68 years)[ 7 ] and 42.2 years (range 20–83 years). [ 8 ] The maximum number (51.2%) of patients belonged to the age group of 21–40 years, similar to other studies.…”

“…[ 8 ] The maximum number (51.2%) of patients belonged to the age group of 21–40 years, similar to other studies. [ 1 , 7 ] It is expected as this age group is the most sexually active.…”

“…The maximum number of patients (87.6%) in our study were married, whereas in other two studies, a lesser number of patients (67% and 68.87%) were married. [ 7 , 8 ] Unsafe sexual exposure predisposes a person to balanoposthitis besides increasing risk of other conventional STDs. In our study, unsafe sexual practices were followed by 30.2% patients; most of these had infective balanoposthitis.…”

“…[ 8 ] In two other studies, 92% and 95.28% patients were uncircumcised. [ 1 , 7 ] Uncircumcised penis predisposes a person to increased risk of balanitis because of a larger surface area for transmission, more opportunities for epithelial microtrauma, and warm and moist niche under the prepuce favoring the persistence of fastidious organisms. The prevalence of balanitis was 68% lower in circumcised versus uncircumcised males.…”