This article was translated from the original Portuguese. Português
Warts, HPV, inflammation, cracks, STDs (STIs), phimosis and balanoposthitis
by: Dr. Bruno Benigno (Urologist - CRM 126265 - São Paulo)
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See reviews Book a consultationInflammation of the penis. What should you do?
Inflammation or redness of the penis and genital area is a very common condition that leads thousands of men to see a urologist every year.
A wide range of diseases can cause very similar symptoms, such as redness of the skin.
The urologist's job is to distinguish the most common causes from rarer conditions and to propose the most appropriate treatment.
Fungi, viruses, bacteria, protozoa, chemical agents and even autoimmune diseases can cause a wide variety of clinical pictures.
When a diagnosis cannot be reached through physical examination alone, a biopsy may be necessary.
All lesions on the penis should be evaluated by a specialist physician — a urologist.
Self-medication is dangerous and can cause serious damage, both cosmetic and functional.
Injury after intercourse
Microscopic trauma to the skin of the penis commonly occurs during sexual intercourse. These small fissures are noticed only as areas of redness on the glans and on the foreskin (prepuce), which is the skin that covers the glans in uncircumcised men.
When these episodes are very frequent, or visible injuries appear after intercourse, it may be a sign that the skin of the foreskin and glans is losing elasticity.
Loss of skin elasticity is caused by chronic contact with drops of urine, moisture and high temperature, or by blockage of the glands responsible for lubricating the foreskin, known as Tyson's glands.
This process is slow and alternates with periods of symptom improvement, but in some cases it may present as chronic balanoposthitis.
This condition represents an advanced stage of loss of skin elasticity and can lead to permanent fissures in the foreskin, yellowish discharge, occasional bleeding or even areas of adhesion between the foreskin and the glans.
The scarred area usually forms a ring around the glans, making it difficult to expose the tip of the penis or even to carry out daily hygiene. This condition is called adult phimosis.
In this situation, treatment is usually surgical, by circumcision (posthectomy).
Healing ointment or cream
Ointments and creams are two ways of applying medication to the skin. We usually use ointments when the skin is dry and lacks moisture. Creams are preferred when there is a large amount of discharge and we do not want to increase the patient's discomfort with oil-based products.
Antibiotics, antifungals and antiviral medications can be given either as a cream or as an ointment. The choice depends on the preferences of the physician and the patient.
Penile diseases caused by fungi
Fungal infection is very common, and the most frequent agent found in clinical practice is the species Candida albicans.
Fungal infections generally occur in patients with low immunity or with a warm, moist environment under the foreskin, which favors the growth of various infectious agents.
Other diseases, such as cutaneous paracoccidioidomycosis, can cause infections in the genital area. However, these infectious agents are more common in rural areas and where access to medical care is poor.
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It means inflammation of the glans and the foreskin at the same time.
It can be acute or chronic. It is usually caused by chemical agents, fungi, bacteria or viruses.
Adult phimosis
Adult phimosis is a condition that usually develops after long periods of untreated chronic balanoposthitis.
It results from the gradual loss of elasticity of the foreskin, forming a narrow ring that surrounds the shaft of the penis and makes it difficult to retract the foreskin and expose the glans.
The condition is usually treated with surgery to completely remove the foreskin, known as circumcision (posthectomy).
Circumcision (posthectomy)
Posthectomy, or circumcision, is the surgical procedure that partially or completely removes the skin covering the glans (the foreskin).
This surgery is commonly performed in childhood, in boys who cannot keep the penis adequately clean.
In adults, it is usually indicated when there has been complete or partial loss of foreskin elasticity, leading to redness, irritation, superficial wounds or even the formation of a narrow ring of skin that makes it difficult to expose the glans.
The surgery is performed in a specialized clinic or hospital under local anesthesia. We usually add sedation for greater patient comfort during the procedure.
Full recovery after surgery usually takes three to four weeks.
Strenuous physical activity should be avoided for 45 days.
The surgery does not affect erectile function or the sensitivity of the organ.
How can penile diseases be identified?
Spots on the penis can be identified through a physical examination by the urologist, laboratory tests or a biopsy of the lesion.
Itching
Itching is very common in STIs such as genital herpes, proctitis or pubic lice, and it is usually associated with infections. Allergies are also a frequent cause of itching.
Redness
A common finding, usually associated with chronic balanoposthitis caused by fungi, bacteria or viruses.
Pain
Pain in the penile area is not rare and deserves immediate attention.
Local trauma, penile infarction, prostatitis, urethral infections or even episodes of renal colic can cause genital pain.
A urologist should always be contacted in this situation.
Blisters
The main cause of blisters in the penile area is infection with the herpes virus. Allergies, burns or drug reactions can mimic similar conditions.
Discharge
Urethral discharge is usually associated with infection by Chlamydia trachomatis or gonococcus (gonorrhea).
Treatment requires antibiotics.
Pain or burning when urinating
Burning when urinating may indicate inflammation of the prostate, bladder or urethra.
A urine test is needed to identify the specific cause and start the appropriate treatment.
WARTS
HPV
HPV is the main cause of genital warts. The diagnosis can only be confirmed by biopsy of the warts followed by genetic analysis, in order to identify the risk subtype of the virus (high risk or low risk).
To date, there are no blood tests that can confirm or rule out HPV infection.
For men who have not been exposed to high-risk HPV, vaccination may be recommended.
Small lesions can be treated with caustic substances (podophyllin). In cases with large or numerous lesions, we prefer cauterization techniques in the operating room, aiming to improve patient comfort.
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Dr. Bruno Benigno | Urologist | CRM SP 126265 | RQE 60022
Clínica Uro Onco Team - São Paulo - SP
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Dr. Bruno Benigno
Urologist and uro-oncologic surgeon (CRM-SP 126.265 · RQE 60022). More than 1,500 robotic surgeries. Member of the AUA, EAU and SBU. Meet Dr. Bruno · In the Media
This content is educational and does not replace a medical consultation. Each case must be assessed individually, based on AUA, EAU and NCCN guidelines.
