A Comprehensive Guide to the Prevention and Treatment of Balanitis and Analysis of Ten Common Testicular Diseases

The foreskin covers the glans penis in men and serves a protective function. The inner lining of the foreskin secretes fluid to lubricate it, preventing dryness of the foreskin and glans. However, problems with the foreskin itself can affect the glans, causing acute or chronic balanitis, the most common of which is balanitis. As the name suggests, balanitis refers to an inflammatory reaction of the foreskin and glans. The causes of inflammation vary with age. For example, balanitis in infants is often caused by poorly diapered clothing or fecal contamination, primarily from urine and feces. The release of bacteria from these substances, combined with high temperatures, humidity, and the fact that most infants have long foreskins, leads to redness, swelling, heat, and pain in the foreskin and glans under the combined influence of bacteria, urine, and smegma.

In adults, balanitis is partly related to phimosis, but unclean sexual intercourse, contact with certain chemicals, and trauma are also significant contributing factors. In short, smegma, urine irritation, certain chemicals, contact and friction from clothing, and trauma are important factors in the development of balanitis. Balanitis can be broadly classified into four categories: traumatic, contact-related, drug-induced, and infectious. Traumatic balanitis is mostly caused by blows, being caught in a zipper, or injury during intercourse. In these cases, the foreskin may be quite red, swollen, and painful. If it is caused by scratching due to a parasitic infection of the penis, itching may also occur. Contact-related balanitis mainly occurs after using topical antiseptics or ointments.

Drug-induced balanitis often presents with itching and burning sensations. Unlike infectious balanitis, the infection site is not large; instead, it manifests as a single or small patch of superficial abrasions with clear borders. The most important diagnostic criterion is the use of a certain medication, with tetracycline being the most common cause of this inflammation. Syphilis can also cause balanitis, but it usually appears as a white, fused surface on the glans penis after a chancre has formed, accompanied by edema. This differs from typical infectious balanitis, which presents with redness, swelling, foul odor, and discharge from the entire glans. If syphilis is suspected, blood tests, syphilis serological reactions, and agglutination tests can be performed to differentiate between syphilis and other bacterial or infectious balanitis.

Chancroid: A sexually transmitted disease caused by Haemophilus ducreyi infection. It initially presents as small inflammatory papules on the external genitalia. Within 24-48 hours, pustules rapidly form, and after 3-5 days, the pustules rupture to form ulcers with clear borders. The ulcers are round or oval with serrated edges and a cloudy appearance at the lower margin, surrounded by an inflammatory halo. The base of the ulcer has a yellowish, lard-like purulent coating covered with a large amount of purulent discharge; removing the coating reveals bleeding. Significant pain is present. While the causes of balanitis differ between children and adults, the principles of prevention and care are the same. Wearing loose-fitting pants and maintaining local cleanliness are important. Children with phimosis should retract the foreskin during bathing to remove smegma. The foreskin and glans should also be gently rinsed with water. For recurrent balanitis, circumcision should be considered. Adults should avoid unprotected sex and inappropriate sexual behavior. If you have allergies, especially when taking tetracycline or certain sulfonamide drugs, you may develop allergic balanitis. You should inform your doctor in advance.

The testicles are the most important male sex organs, producing sperm and secreting androgens, and have long been considered a man's "lifeblood." Here are some common clinical testicular diseases. Epididymitis: The epididymis is located at the posterior border of the testicle, where sperm are temporarily stored after production. Epididymitis is most common in men around 30 years old, mostly due to a persistent urinary tract infection, allowing bacteria to enter the epididymis through the vas deferens. It often occurs alongside posterior urethritis, prostatitis, seminal vesiculitis, etc. It can be unilateral or bilateral, and the onset can be acute or gradual. Clinical manifestations include redness, swelling, heat, and pain throughout the scrotum, sensitivity to touch, and burning pain during urination. Pain occurs when the scrotum is at rest, but symptoms are relieved when lying on the back.

Epididymis: Located close to the upper end and posterior border of the testis, it can be divided into three parts: head, body, and tail. The head is formed by the coiling of efferent ductules, the ends of which connect to an epididymal duct. The epididymal duct is 4-5 meters long, coiling to form the body and tail. The end of the duct abruptly turns upwards to directly continue as the vas deferens. In addition to storing sperm, the epididymal duct also secretes epididymal fluid, which contains certain hormones, enzymes, and specific nutrients that help sperm maturation. Orchitis: Mostly caused by the direct spread of epididymitis to the testis, it is caused by bacteria. Acute orchitis in children is usually caused by the mumps virus. The clinical manifestations are similar to epididymitis, but the redness and heat of the testis are not as obvious or intense. Unilateral or bilateral testicular swelling can be clearly seen, with pain upon pressure, and the scrotal skin is also obviously red and swollen, and feels warm to the touch.

Varicocele: Varicocele affects 10% of men aged 30-40. 90% of cases occur on the left side due to blood pooling in the spermatic veins, causing dilation, tortuosity, and elongation of the venous plexus. Varicocele can also be caused by kidney tumors. Varicocele is noteworthy because it may be accompanied by testicular atrophy and impaired sperm production, leading to infertility. Clinically, it may present as a dull ache, like a small bag of worms crawling into the scrotum, or it may be asymptomatic. However, the varicose veins can be seen or felt in the spermatic cord area when standing. Straining to increase abdominal pressure will worsen the varicose veins. A few cases may also be accompanied by neurasthenia. In more severe cases, there may be scrotal swelling and pain, and lower back pain after prolonged standing, which can be relieved by lying down. Seminal cyst: A benign cyst occurring in the testicle or epididymis. The swollen mass is often about the size of a sugar cube, jokingly referred to as a "third testicle," but fortunately, this condition is very rare. Clinically, there is no pain, but the swollen bulge resembles a ball growing above the testicle and can be felt independently. Under the light of a flashlight in a dark room, the seminal vesicle appears shiny.