Penis Conditions

Hypospadias

This is a developmental condition where the urethra opens on the under surface of the penis shaft, rather than tip of the glans.

– It occurs when the urethral folds fail to close.

Management:

Surgical correction + circumcision

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 the 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

i) 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

 

ii) 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.

 

iii) S. Aureus:

Usually gives secondary infection giving painful red glans penis with purulent exudate

 

iv) STIs:

Chlamydia and Gonorrhea are suspected causes in sexually active people

 

v) Seborrheic dermatitis:

This can give itchy redness but will also have scaly lesions elsewhere like scalp

Diagnosis:

If suspected infection, take a swab for culture to grow the pathogen

Management:

– Saline wash, Antibiotics + 1% hydrocortisone cream if needed

– Specific treatments for different infections

Phimosis

This is when the foreskin covers the external meatus

– Usually asymptomatic but can cause glans inflammation

Can lead to painful intercourse, infection and ulceration

Management:

Gentle retraction of the foreskin

– If unresolving may require surgical correction

Paraphimosis

This can occur if the foreskin is pulled over the glans

– If it is tight, it may become irreplaceable compressing the glans, cutting off venous return and causing ischaemia

– It is a thing to watch out for when performing catherization

Management:

– Ask the patient to squeeze the glans so foreskin can be replaced

– If unresolving, may require circumcision/dorsal slit

Condyloma Acuminatum

This is the presence of benign warts on the genital skin

– Usually pink in colour and cause few symptoms, but can be painful

– Due to HPV type 6 or 11, which gives genital warts

Management:

Physical ablation (cryotherapy) or topical agents