Back to: Renal-Urinary Systems
Penis Conditions
Hypospadias
This is a developmental condition where the urethra opens on the under surface of the penis shaft, rather than the tip of the glans.
It occurs when the urethral folds fail to close.
Management
Surgical correction is the definitive treatment
Epispadias
This is a developmental condition where the urethra opens on the upper surface of the penis shaft, rather than tip of the glans.
It can be due to wrong positioning of the genital tubercle.
Management
Surgical correction
Balanitis
This is acute inflammation of the foreskin and glans, usually due to infection
Can also be due to systemic conditions, so important to note whether there is itching/discharge
Balanitis Causes
Non-specific
The most common in young boys, giving redness of the gland and skin/shaft of penis
It can lead to the growth of many organisms such a yeast and bacteria
Candida Albicans
This gives redness of the underside of the glans, with sparing of the urethral meatus
Can give small papules on the glans with a white yogurt discharge.
S. Aureus
Usually gives secondary infection giving painful red glans penis with purulent exudate
STIs
Chlamydia and Gonorrhea are suspected causes in sexually active people
Seborrheic dermatitis
This can give itchy redness but will also have scaly lesions elsewhere like scalp
Key tests
If suspected infection, take a swab for culture to grow the pathogen
Management
General cleaning, e.g., saline wash
Antibiotics are indicated for positive swab results
1% hydrocortisone (steroid) cream can be used]
Phimosis
This refers to when the foreskin covers the external urethral meatus.
It is usually asymptomatic but can cause glans inflammation resulting in painful intercourse as well as an increased risk of infection and ulceration.
Management
Treat if causing complications, may require surgical correction
Paraphimosis
This can occur when a tight foreskin is pulled over the glans. The foreskin may become irreplaceable, compressing the glans which leads to ischaemia.
It can occur if you fail to put back the foreskin after inserting a urinary catheter.
Management
Ask the patient to squeeze the glans so foreskin can be replaced
If unresolving, may require circumcision
Condyloma Acuminatum
This refers to benign warts on the genital skin.
They are usually pink in colour and can be painful
Often due to HPV type 6/11, giving genital warts
Management
Physical ablation (cryotherapy) or topical agents
