Penile conditions Flashcards
What is balano-posthitis?
Inflammation of glans penis, and sometimes to the underside of the foreskin
What are the causes of balano-posthitis?5
Candidial Bacterial Contact/allergic dermatitis Eczema/psoriasis Lichen sclerosus
What is the presentation of candidial balanitis?
Very common
Usually post intercourse
Itchy with white, non urethral discharge
What is the presentation of bacterial balanitis?
Common
Usually staph. species
Painful and can be itchy
yellow, non urethral discharge
What is the presentation of contact/allergic balanitis?
Very common
Itchy, sometimes painful
Occasionally clear, non urethral discharge
Often no other areas affected
What is the presentation of eczema/psoriatic balanitis?
Very itchy
Np discharge
PMH eczema/psoriasis
Usually other skin areas affected
What is the presentation of lichen sclerosus?
White plaques, itchy
Can cause significant scarring
What investigations are done for balano-posthitis?
Usaully clinical diagnosis
Swab for microscopy and culture if suspect bacterial/candidial
What is the general management of balano-posthitis?
Gentle saline washes, ensuring to wash properly under foreskin
Severe= short course 1% hydrocortisone
What is the management of candidial balano-posthitis?
Topical clotrimazole for 2 weeks
What is the management of bacterial balano-posthitis?
Oral flucloxacillin
What is the management of dermatitis balanitis?
Mild topical corticosteroid
What is the management of lichen sclerosus?
High potency topical steroid
Recurrent= circumcison
What is hypospadias?
Opening of urethra on underside of penis
What is the management of hypospadias?
Surgery before age 2
DO NOT circumcise before this, foreskin can be used in correction
What is priapism?
Persistent penile erection, typically lasting >4 hours and is not associated with sexual stmulation
What are the 2 types of priapism?
ISchaemia= impaired vasorelaxation and reduced outflow --> congestion Non-ischaemic= high arterial inflow, due to fistula formation
What are the cause of priapism?
Idiopathic Sickle cell disease Erectile dysfunction medication Other drugs Trauma
What is the presentation of priapism?
Persistent erection
Pain localised to penis
What investigations are done for priapism?
Largely clinical diagnosis
Cavernosal blood gas analysis= distinguish between ischaemic and non-ischaemic
FBC and toxicology= distinguish cause
What is the management f ischaemic priapism?
Medical emergency
Aspiration of blood from cavernous, often with saline flush
Failure= injection of vasoconstrictive agent
Failure= surgery
What is the management of non-ischaemic priapism?
Observation
What is phimosis?
Foreskin cannot be pulled back past glans penis
Common in children, usually resolves by age 3 and almost always by puberty
What is the presentation of phimosis?
Ballooning during micturition
Pain during erection
Unable to retract foreskin
What is the management of phimosis?
Normally none until puberty
1st= topical steroid cream and gentle stretching
2= surgery
What are the complications of phimosis?
Paraphimosis
Balanitis
Urinary retention
