Balanitis | Blog de Medicina

Qué es?
Una balanitis es la inflamación del glande, el prepucio y el surco balanoprepucial. Los orígenes de las balanitis pueden ser múltiples, especialmente de causa infecciosa o irritativa. Cuando la balanitis es debida a una infección por una bacteria se denomina balanitis bacteriana.

Cómo se produce?
Existen diversos factores que pueden predisponer a padecer una infección del glande (balanitis) o bien del glande y el prepucio (balanopostitis), a saber, la irritación por restos de orina o esperma, la fricción por la ropa o el acto sexual, los penes no circuncidados y la ausencia de higiene.
La humedad es un factor que favorece el crecimiento no sólo de bacterias sino también de hongos, que suelen ser causa de balanitis con mayor frecuencia que las bacterias. Otros factores de riesgo son la diabetes mellitus, el síndrome de Reiter o el liquen escleroatrófico.
Las principales bacterias que causan balanitis son los estreptococos, seguidos en menor frecuencia por S. aureus, Klebsiella spp, Gardnerella vaginalis y algunos anaerobios.

Síntomas
Los principales síntomas de la balanitis son la irritación e inflamación del glande, que aparece rojo y eritematoso. En ocasiones no se afecta todo el glande sino que se produce una lesión roja, húmeda y dolorosa. Los bordes suelen estar mal definidos y frecuentemente se da maceración y supuración. En casos avanzados o por anaerobios puede haber ulceración.

Diagnóstico
El diagnóstico se basa en la exploración del paciente, visualizando la lesión en el glande, el prepucio o el surco balanoprepucial. Se debe tomar una muestra del exudado si lo hay para realizar un cultivo. Una balanitis de repetición sin antecedentes de contacto sexual de riesgo puede indicar que su origen sea irritativo.

Tratamiento
El tratamiento se basará en el uso de cremas de antibióticos asociadas o no a corticoides; en cualquier caso, los corticoides tópicos deben usarse solamente durante poco tiempo. Sólo en casos avanzados será necesario el uso de antibióticos orales.
Es esencial una correcta higiene de la zona afectada y procurar que no quede húmeda.

Medidas preventivas
La mejor medida preventiva contra las balanitis es mantener una correcta higiene de la zona y tomar medidas de precaución durante las relaciones sexuales.
En casos de balanitis de repetición podría plantearse la postectomía como tratamiento preventivo.
Fuente: Dr. David Cañadas Bustos – Especialista en Medicina General.

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