1, General treatment of balanitis prepuce
Keep local cleanliness to prevent secondary infection; ② Infiltration erosion can be wet-packed with 3% boric acid water or 0. 1% nitrocellulose; ③ Corticosteroid cream can be used in noninfectious subacute stage; ④ Tetracycline cortisone ointment can be used for chronic or dry desquamation; ⑤ Infection is obvious, fever and lymph node swelling are obvious. Antibiotics can be applied to the whole body, such as cefalexin 0.5g, orally, 3-4 times a day, or fluoxetine 0.2g, twice a day; ③ If the foreskin is too long, circumcision should be performed after the inflammation subsides.
When the foreskin of balanitis has ulcer, it can be soaked in 1/5000 potassium permanganate solution and coated with anti-inflammatory ointment. Allergic prepuce balanitis requires oral antiallergic drugs and topical pine ointment. If phimosis or prepuce edema can't turn over and soak, and the drainage is not smooth, the inflammation can't subside after general treatment, and dorsal prepuce incision is feasible to facilitate drainage. Circumcision should be performed after the inflammation has completely subsided.
2. Syndrome differentiation and treatment of balanitis prepuce
Traditional Chinese medicine often divides the disease into three types, namely, toxic fire stagnation type, damp-heat insect-generating type and liver-kidney yin deficiency type. Different treatments are given according to different clinical manifestations.
(1) In the toxic fire stagnation type, the foreskin and glans are red and swollen, with erythema, papules, blisters or ulceration, conscious pain, dysuria, sores on the mouth and tongue, impatience and irritability. This is because the poisonous fire is stagnant and cannot be discharged. Treatment should clear away heat, purge fire and detoxify. The commonly used prescription is Daochidan: Coptidis Rhizoma 10g Scutellariae Radix 10g Gardenia 10g Akebia Akebia 10g Radix Rehmanniae 10g Lophatherum Bambusae 10g Alismatis Rhizoma 10g Radix et Rhizoma Rhei 6g Radix Glycyrrhizae 10g decocted.
(2) The biotype of damp-heat insects can be seen as flushing, blistering or erosion of glans penis and penile pain; Laboratory examination showed candida albicans or trichomonas infection; Most of them are accompanied by wet female private parts, pruritus in female private parts, bitter taste, sticky mouth and Huang Chi in urine. This is due to the evil of insects caused by damp-heat diarrhea of the liver meridian. Treatment should clear away heat and dry dampness, kill insects and relieve itching. The commonly used prescription is Longdan Xiegan Decoction: Longdan 10g Bupleurum 10g Scutellaria baicalensis 10g Gardenia 10g Plantaginis 10g Alisma orientalis 10g Akebia Akebia 10g Rhizoma Smilacis Glabrae 30g Stemonae/kloc-0.
(3) Yin deficiency of liver and kidney can be seen as plaque or hypertrophy of the foreskin and glans penis, or sclerosis, generally without itching and pain, accompanied by symptoms such as backache and premature ejaculation. This is caused by dampness-heat or dampness-toxin hurting the yin of liver and kidney. Treatment should be based on nourishing liver and kidney. The commonly used prescription is Liuwei Dihuang Decoction: 10g Cornus officinalis 10g Yam 10g Lycium barbarum 10g Cortex Moutan 10g Poria 20g Danshen 10g Alisma orientale 10g Dandelion 30g.
2. Types of balanitis prepuce
After many times of healing, it will cause scar hyperplasia, which will eventually lead to inflammatory thickening of the inner plate of the foreskin or adhesion with the skin of the glans penis, forming a hypertrophic narrow ring at the foreskin mouth. When the penis is erect, the glans penis pulls back, causing sexual dysfunction such as unstable erection and premature ejaculation.
The etiology of balanitis prepuce is related to excessive prepuce, skin scale irritation, local physical and chemical factors and various infections. In recent years, the number of adult patients with balanitis prepuce has increased significantly, which is related to people's open sexual concept, increased extramarital sex and abuse of various detergents. After having unclean sex, the chances of various infections are increased. In order to avoid sexually transmitted diseases, people often use some external disinfection and anti-inflammatory cleaners to clean and disinfect the vulva.
Some people directly apply undiluted detergent stock solution to the foreskin and glans skin repeatedly for thorough disinfection. In this way, the local skin is strongly stimulated by chemicals, resulting in redness and oozing blood, leading to acute inflammation. If acute inflammation is not handled properly, it will recur and eventually form chronic balanitis prepuce.
Chronic balanitis prepuce is caused by repeated attacks and treatment, which leads to thickening of the inner prepuce plate and narrowing of the prepuce mouth. According to the different degree of foreskin stenosis, it can be divided into three categories:
Mild: the foreskin can be turned up to the coronal groove, but it obviously tightens the penis in a rope shape.
Moderate: The foreskin mouth is obviously narrow. The caliber is about 0.8 ~ 1.2 cm, and the edge is thick, so it can't be turned up to the coronary sulcus. You can see the external urethral orifice.
Severe: the prepuce mouth is less than 0.8cm. Some cases are so small that urination is obviously affected, the urine line is thin and the urination time is prolonged. The foreskin mouth is often red and swollen, causing pain in urination. There is extensive adhesion between the inner prepuce plate and glans skin.
Chronic balanitis prepuce will affect sexual function to varying degrees. In the early stage, it was mostly the pain of the same room. After the same room, there are slight cracks and slight redness and pain in the skin of the inner prepuce plate and prepuce mouth. After external use of disinfectant lotion and anti-inflammatory treatment, the inflammation subsided and the wound healed, but there was an obvious tendency to scar. This repetition leads to skin hyperplasia, hypertrophy and scarring of the inner prepuce plate and prepuce mouth. Due to scar contraction and narrow prepuce mouth, the glans penis is pulled back and pressed when the penis is erect, causing sexual dysfunction such as unstable erection and premature ejaculation, and even the erectile instability cannot complete the sexual intercourse process. This further affects the patient's physical and mental health and the relationship between husband and wife.