Balanitis, a hidden ailment that is hard to resist.
Chapter Five
It's lamentable that diseases of the genitals are not merely a matter of wanting to stop but being unable to-Common Male Sexual Organ Diseases
Hidden ailments cause balanitis, which is unstoppable.
Spring awakens all things, even the moss growing in the shadows can't help but stir. These seemingly the smallest and most fragile mosses are actually extremely cunning and ruthless. They appear quiet and obedient, offering no resistance, only growing close to the "stones." But deep within them lies a wolfish ambition to corrode the stones. Only by "destroying" those stones can the moss obtain the world it has always desired, possess this world, gain power, and no longer have to live a humble life dependent on the stones...
Such terrifying moss! Even a normally carefree man would fear being corroded by this "moss." However, "moss" thrives in dark, damp places. Thus, a man's genitals become their battleground. Medically, men affected by this "moss" are diagnosed with balanitis.
Balanitis is divided into balanitis and posthitis, and because they often occur simultaneously, it is called penile balanoposthitis. This inflammation can be infectious or non-infectious, with infectious balanoposthitis being more common clinically. Infectious balanoposthitis is often caused by unclean sexual intercourse, resulting in infection with Candida albicans, Trichomonas vaginalis, Chlamydia trachomatis, Mycoplasma genitalium, Dicoccus, or other bacteria. Non-infectious factors are mostly due to phimosis (tight foreskin), insufficient cleaning, and the accumulation of smegma between the foreskin and glans, which irritates the local foreskin and mucous membrane, causing inflammation...
Balanitis refers to inflammation of the glans penis mucosa, foreskin, and their mucosal surfaces. Both conditions often occur simultaneously, hence the name balanitis. Of course, there can also be balanitis or foreskin inflammation occurring separately.
Balanitis is common in adolescents and children. It often results from phimosis (tight foreskin) and the accumulation of smegma under the foreskin due to poor hygiene, leading to bacterial infection. In the early stages, mild cases present with only redness of the glans penis and inner foreskin, accompanied by itching. Severe cases may experience pain and tenderness; in later stages, superficial ulcers may develop under the foreskin, with yellow or cheesy discharge, often accompanied by an odor; significant local redness and swelling can affect urination and cause painful urination.
In the early stages of balanitis, edema and congestion are visible on the surface of the glans and foreskin. Redness and erosions appear around the urethral opening, which may develop into superficial ulcers with purulent discharge. Patients experience itching or burning sensations at the glans, followed by pain. Ulcers may discharge purulent fluid with a foul odor. In severe cases, fatigue, low-grade fever, and swollen and tender inguinal lymph nodes may also occur.
In addition, candidal balanitis caused by fungal infection often presents as erythema of the glans mucosa, local edema, smooth surface, mild desquamation at the edges, and may include papules and small pustules that expand to form erosions of the glans. Recurrent candidal balanitis can cause dry and cracked foreskin, fibrosis, and sclerotic changes of the glans.
Balanitis, a type of lichenification, can be quite harmful. If not treated promptly, it can lead to the following complications:
1. May lead to sexual dysfunction: During the inflammatory stage of balanitis, the sensory nerves of the glans penis are in a sensitive period. Coupled with the damage caused by inflammation, premature ejaculation is more likely to occur during sexual intercourse, and in the long term, it can lead to impotence.
2. May lead to male infertility: Due to the long-term stimulation of the reproductive system by inflammatory factors, the regulation of sperm and sexual response, as well as the inflammatory secretions hidden in the foreskin entering the vagina along with semen during intercourse, semen quality is reduced and sperm and egg cells are damaged, leading to male infertility.
3. Harm to reproductive system health: Balanitis can easily lead to inflammation of organs such as the prostate, orchitis, epididymitis, and vas deferens. If not treated promptly and effectively, these infections can combine and cause significant damage to reproductive health.
4. Causes urinary system diseases: Balanitis can also easily lead to ascending infections of the urinary system, such as cystitis, nephritis, and pyelonephritis. In particular, chronic balanitis that is difficult to cure is most likely to cause urinary system diseases. Improper treatment during the acute phase can be life-threatening.
5. Leads to xerotic obliterative balanitis: xerotic obliterative balanitis is a more severe pathological damage of balanitis, which destroys the physiological structure of the foreskin and glans, affecting sexual life and appearance, and is also a common factor in premature ejaculation.
Traditional Chinese medicine believes that balanitis is mostly caused by damp-heat in the liver and gallbladder, or by poor local hygiene leading to the accumulation of toxins over time; or by exposure to external pathogenic factors. Patients may experience emotional distress, leading to stagnation of liver qi, which over time transforms into fire and generates damp-heat; or the liver may suppress the spleen, preventing the spleen from transforming and transporting fluids, resulting in the internal generation of damp-heat. This damp-heat in the liver and gallbladder descends to the glans and foreskin; or poor genital hygiene leads to the accumulation of damp-heat; or unclean sexual intercourse or external invasion of heat toxins can cause excessive heat and necrosis of the glans and foreskin, resulting in symptoms such as redness, erosion, and burning pain in the glans and foreskin. If the foreskin is too long, smegma irritates the area, or unclean sexual intercourse leads to the accumulation of toxins in the area, which can cause swelling, pain, and erosion of the penis and glans.
In short, the occurrence of this disease is nothing more than emotional distress, improper diet, phimosis, and unclean sexual intercourse. Therefore, the "Surgical Enlightenment" states: "The penis has sores that are itchy and painful, which is caused by not washing after intercourse, resulting in damp heat in the liver meridian."
Western medicine attributes this condition to phimosis, smegma irritation, local physical irritation, and various infections, especially vaginal infections from sexual partners, such as those caused by yeast, trichomoniasis, mycoplasma, and chlamydia. The subtypes are as follows:
1. Acute superficial balanitis: Localized edematous erythema, erosion, exudation, and bleeding. Secondary bacterial infection leads to the formation of rashes and ulcers with purulent discharge, manifesting as local pain and difficulty in movement. The infecting bacteria are often Escherichia coli, Chlamydia, or Mycoplasma.
2. Candidal balanitis: Characterized by erythema, smooth surface, mild desquamation at the edges, and satellite-like papules or small pustules that slowly expand outwards with clear borders. In acute attacks, the erythema on the glans mucosa becomes edematous with indistinct borders, sometimes accompanied by erosion and exudation. Recurrent attacks can lead to dry foreskin cracking, fibrosis, and sclerotic changes in the glans tissue. Candidal balanoposthitis is characterized by white, scaly scales on the surface, or fissures, or shiny lesions.
3. Trichomonal balanitis: It begins with papules or erythema on the glans penis, which gradually enlarge and have clear borders. Small blisters the size of pinheads or millet grains are seen on the erythema. After the blisters enlarge and merge together, they form a mild temporary erosion. Trichomonas can be found in the exudate.
Balanitis is often a localized condition, so treatment should primarily focus on local application of traditional Chinese medicine. Treatment methods mainly involve external washing and applying ointments. The principle should be to clear heat and dry dampness, detoxify, and kill parasites. Basic herbs include: Sophora flavescens, Phellodendron chinense, Atractylodes lancea, Kochia scoparia, Dictamnus dasycarpus, and borneol (added later). Decoct in water, let cool, and then soak the affected area 2-3 times a day. Apply a sulfur-containing ointment (such as sulfur ointment). If the foreskin is too long, balanitis often recurs, and circumcision should be performed. If the swelling, pain, and erosion of balanitis are not severe, oral medication may not be necessary. If severe, and in the absence of evidence of trichomoniasis or fungal infections, macrolide anti-inflammatory drugs can be used, along with oral administration of Gentiana scabra pills (Longdan Xiegan Wan).