Penile Problems

A young man aged 18 turns up at the surgery worried about spots on his penis and scrotal area pointed out by his partner. Has adversely affected his relation and keen on getting them removed. He is asymptomatic otherwise.

Fordyce spotsSmall, painless, raised, pale or white spots

or bumps 1 to 3 mm in diameter that may appear on the shaft of the penis,labia, inner surface (retromolar mucosa) and vermilion border of the lips of the face.

The spots are a form of ectopic sebaceous glands.

Very common in adult males (apx. 80%). The condition can appear either as a single lesion or in a symmetrical group of up to one hundred

Treatment

Although treatment is not necessary, those with the condition can choose to apply tretinoin gel or cream to the affected areas each day.

TCA chemical peels, CO2 laser.

Mum of 4 year old boy comes worried that she is unable to retract the foreskin of the shaft. When she tries it causes pain otherwise the boy is fine.

PhimosisThe male foreskin cannot be fully retracted

from the head of the penis.Types Physiological – In children. Pathological Lichen Sclerosus Balanitis Scarring

TreatmentThe foreskin is reportedly retractable in

approximately 50% of cases at 1 year of age, 90% by 3 years of age, and 99% by age 17 in physiological cases.

Circumcision and Preputioplasty in pathological cases.

BalanitisBalanitis is an inflammation of the end of

the penis (the glans). Often the foreskin is also inflamed at the same time as the glans.

Balanitis is common and can occur at any age. Commonly affects boys under four years and also men who have not been circumcised.

Cause include poor hygeine, infections,STIs, skin conditions, allergies and irritation.

TreatmentFollowing is recommended regardless of the

cause:Avoid soaps when inflammation is present.Use of

emollient (moisturiser cream or ointment) . Use of luke warm water. The treatment depends on the cause of the

balanitis. An anti-yeast cream or a course of anti-yeast

tablets are a common treatment if the balanitis is caused by candida.

Antibiotics will clear infection caused by bacteria (including certain sexually transmitted infections).

A mild steroid cream to reduce inflammation is useful for balanitis caused by allergies or irritants.

Thank you