Posthitis Treatment - Types, Causes, Surgery & Recovery

Types of Posthitis

Posthitis can be caused due to a wide variety of reasons. Depending on the exact cause of your condition, posthitis is categorized into 3 types such as:

• Fungal Infection: Fungal infections are one of the most common posthitis causes in adult men. Often referred to as candidal posthitis, this type of foreskin infection generally occurs due to overgrowth of candida fungi either on or under the foreskin. 
• Bacterial Infection: Excess accumulation of bacteria under the foreskin can also lead to posthitis. Generally, antibacterial creams are effective in treating this type of penis skin infection, but severe or recurrent cases require surgery.
• Sexually Transmitted Infections: Sexually Transmitted Infections or STIs such as gonorrhea or trichomoniasis can also lead to posthitis. In such a case, your urologist may prescribe antibiotics for posthitis treatment. But if they fail to have any significant impact, your urologist may recommend surgery.

Causes of Posthitis

Some of the most common posthitis causes in adults are given below: 

• Penile yeast infections
• Bacterial infections such as Streptococcus, Haemophilus parainfluenza, Klebsiella, and Staphylococcus epidermidis.
• Chlamydia
• Fungal infections
• Poor hygiene
• Gonorrhea
• Herpes Simplex
• Human Papillomavirus (HPV)
• Syphilis

Surgical Treatment for Posthitis

Circumcision is often considered to be a safe and effective treatment for posthitis. Circumcision is a commonly performed urological procedure that involves the removal of the foreskin completely.  Before moving on to how a circumcision surgery is performed, let us discuss the diagnostic tests that your urologist may perform to understand your condition better. 

Diagnosis

Prior to circumcision surgery, your urologist will likely perform a series of simple tests and diagnostics to assess and evaluate your overall health and uncover any underlying medical conditions you may have. Preoperative diagnostics for posthitis is a simple procedure that usually concludes with a simple, routine physical examination. During this examination, your urologist will check for discharge from your penis and take samples of fluid and cells to test for infections. Once the reason behind your condition has been deduced, your urologist will be able to recommend a suitable treatment. However, your urologist may also perform some additional tests to determine the cause of your condition. Some tests your urologist may perform include:

• Skin Test: A skin test is a simple and commonly performed test that will help your urologist identify bacteria, viruses, and fungi. In this test, the urologist will gently rub a cotton swab over the foreskin. The swab will then be sent to a laboratory for analysis.
• Urethral Discharge Swab: A urethral discharge swab will help your urologist identify bacteria and viruses. In this test, the urologist will carefully insert a cotton swab (about 3/4 of an inch in size) into your ureteral opening and gently rotate it. The cotton swab will then be sent to a laboratory for testing and analysis.
• Urinalysis: A urinalysis or urine examination is a test that is performed to examine the visual, chemical, and microscopic aspects of your urine. Your urologist will look for different potential posthitis causes, including bacteria or high sugar levels in your bloodstream (which could be a sign of diabetes). In this test, you will be asked to simply urinate into a special cup by your urologist, which then will be sent to a laboratory for further testing.
• Blood Test: A blood test is one of the most common tests that your urologist may perform to monitor your overall health and check for signs of any infection that may have caused posthitis. In a blood test, the urologist will use a thin needle to draw a small amount of blood from a vein in your arm. This blood sample will then be sent to a laboratory for testing and analysis.

Posthitis Surgery

There are primarily 3 methods of performing foreskin infection surgery. While all 3 methods are considered safe and effective, they differ in their overall procedure and equipment.

• Laser Circumcision: A laser circumcision procedure is one of the commonly performed methods of foreskin removal surgery. Laser circumcision is an advanced and minimally invasive surgical procedure that utilizes Carbon Dioxide (CO2) laser to remove the foreskin. A laser circumcision is typically performed under local anesthesia and takes only about 10-15 minutes to complete. In a laser circumcision procedure, the laser is manually operated by the surgeon and slowly moved along a predetermined incision line. Laser circumcision is an extremely precise procedure and, as a result, is widely considered to be best for cleaner wound edges and preservation of surrounding tissue. Additionally, due to its high operating temperature, it also ensures minimal bleeding. This results in better cosmetic results, minimal risk of complications, and shorter recovery periods compared to traditional methods. Chances of complications in laser circumcision are minimal, and it has been proven to provide patients with a better postoperative quality of life.
• Stapler Circumcision: Stapler circumcision is another surgical procedure that your urologist may recommend to treat posthitis. Stapler circumcision is a surgical procedure that utilizes a stapler device (an advanced and disposable surgical tool) to remove the foreskin. Similar to laser circumcision, the procedure is typically performed under local anesthesia and does not take more than 15-20 minutes to complete. This stapler device is placed over the penis glans and fits snugly around the head of the penis. As the stapler device is fired, it cuts and removes the foreskin in a quick motion while simultaneously closing the incision wound with a silicone ring. This silicone ring helps minimize bleeding and promote healing. When the incision wound has completely healed (which generally takes anywhere from 7 to 14 days), the silicone ring will fall off on its own as well. Once the foreskin has been successfully removed, the device is taken off, and the penis is pressed with a gauge to stop any bleeding that may have occurred. The wound is dressed, and you will likely be moved to a recovery area. If your condition is stable after the surgery, you can go home.
• Open Circumcision: Sometimes referred to as the dorsal slit technique, open circumcision is a conventional method of circumcision. Unlike laser or stapler circumcision, open circumcision is typically performed under general anesthesia and can take 50-60 minutes to complete. In an open circumcision procedure, the surgeon uses a scalpel and surgical scissors to carefully cut and remove the foreskin by making incisions along the upper length of the foreskin from the tip of the corona to expose the penile glans. Due to its invasive nature, open circumcision typically requires slightly longer to heal (2-3 weeks). Compared to laser and stapler procedures, open circumcision also carries a slightly increased risk of potential complications such as excessive bleeding and infection. But, actual cases of any serious complications are very rare.

How to Prepare Yourself Before Posthitis Surgery

Prior to surgery, your urologist will likely instruct you to follow some simple tips and guidelines to ensure a smooth posthitis surgery, such as:

• Make sure to take a bath and thoroughly clean the groin area before arriving at the hospital. It is also advisable to trim your pubic hair short. This can help prevent hair from becoming trapped in the bandaging afterward. 

• Leave any jewelry, contact lenses, or other ornaments at home. You do not need them in a hospital, and they may interfere with the surgery.

• Wear comfortable, loose-fitting clothes that do not rub against your body, especially your groin. It is also advisable to bring a pair of tight-fitting briefs to wear after your procedure to help keep the surgical dressing in place.

• Posthitis surgery is typically performed under local anesthesia. Therefore, you can eat and drink as per normal. Drink sufficient water and stay well hydrated.

• Due to anesthetic after-effects, you won’t be able to drive yourself home after the surgery. It is advisable to ensure you have someone to drive you home or at least accompany you in a cab.

• Avoid consuming alcohol or smoking at least 48 hours before the surgery. These can slow down your recovery process and also lead to anesthesia-related complications.

• Take at least a few days off from work. Most patients can return to their daily routine in just 2-3 days after surgery, but each patient has different healing capabilities, and your posthitis surgery may take slightly longer to heal.

Recovery After Posthitis Surgery

In most cases, a complete recovery after posthitis treatment can take anywhere from 7-10 days. Most patients are able to return to their daily lifestyle in just 2-3 days after surgery. However, every patient has different healing abilities, and depending on various factors such as your overall health, method of surgery, and quality of postoperative care, the recovery time may differ.  After the surgery, your penis may also appear swollen and bruised. You may also have pain or a burning sensation when urinating. These side effects are to be expected and considered normal. They should subside on their own in a few days after surgery. If they continue to persist or worsen over time, contact your healthcare provider as soon as possible.  To ensure smooth recovery and minimize chances of any postoperative complications, your urologist may also advise you to follow some simple steps and guidelines, such as:

• Keep the surgical site clean and dry for at least the first 48 hours after surgery.

• Wear comfortable and supportive underwear that can hold the head of the penis towards the belly button lying flat.

• To minimize the chances of infection, avoid going to swimming pools or public lavatories for at least 4 hours after surgery. 

• Refrain from sexual intercourse for at least 5-6 weeks after surgery or until your urologist thinks it's safe to do so.

• Perform light exercises such as walking. However, strenuous exercises (such as running, weight lifting, or cycling) should be avoided. They can exert excessive force on the surgical site and cause discomfort.

• Avoid smoking or consuming alcohol for at least 48 hours after surgery. Doing so can slow down the recovery.

• Stay sufficiently hydrated. Make sure to drink at least 2-3 liters of water every day.

• Do not miss any postoperative consultations. If you are facing any persistent side effects that worsen over time, it is advised to inform your urologist about them as soon as possible.

Non-Surgical Posthitis Treatment

Typically, posthitis can be treated with antibiotics and antifungal creams. Therefore, before moving on to surgery, your urologist may suggest some non-surgical alternatives such as:

Antibiotics 

• Amoxicillin: Amoxicillin is a penicillin-type antibiotic that is commonly used to treat various bacterial infections. Amoxicillin typically comes as a capsule, chewable tablet, or liquid that can be taken by mouth every 12 or 8 hours, depending on the severity of your condition. However, consult your urologist before taking any medications or antibiotics.
• Doxycycline: Doxycycline is a tetracycline antibiotic that stops bacterial growth and is considered to have anti-inflammatory effects. Doxycycline can be used to treat various bacterial infections, including certain Sexually Transmitted Infections (STIs) such as chlamydia, gonorrhea, and syphilis. Doxycycline is typically taken with a full glass of water. It is also advised not to drink alcohol while taking doxycycline because it can stop it from working properly. Examples of doxycycline include Vibramycin-D, Efracea, and Periostat.
• Metronidazole: Metronidazole is an antibiotic medication that is considered effective for the treatment of anaerobic bacterial infections and protozoal infections. Metronidazole belongs to a class of drugs called nitroimidazole antimicrobials and works by killing the bacteria causing the infection. This relieves the infection.  In most cases, metronidazole 400 mg twice daily for one week is recommended for effective posthitis treatment.
• Clarithromycin: Clarithromycin is typically prescribed to treat certain bacterial infections. Clarithromycin is also known as a macrolide antibiotic and works by stopping the growth of bacteria. However, similar to doxycycline, this antibiotic works only on bacterial infections and will not work for viral infections.

Antifungal Creams

• Clotrimazole: Clotrimazole is a medicated antifungal skin cream that is used to treat certain kinds of fungal or yeast infections of the skin. Clotrimazole is an azole antifungal that works by preventing the growth of fungus. Clotrimazole is for external use only and should not be taken by mouth. Follow the directions on the prescription label and consult with your doctor if you have any queries.
• Econazole: Econazole topical cream is typically used to treat infections caused by fungus or yeast. This topical cream works by killing fungus or yeast and preventing its growth. Econazole generally comes as a cream to apply to the skin and should be used once or twice a day (in the morning and evening) for 2 weeks.
• Miconazole: Miconazole is an antifungal medication that generally comes as a skin cream. You can simply apply this cream to the affected area as directed by your urologist to treat fungal or yeast infections. Miconazole falls in the class of antifungal medications called imidazoles and works by stopping the growth of fungi that cause infection. 
• Elocon: Elocon contains a mild steroid named mometasone furoate 0.01% and has an anti-inflammatory effect on the tight foreskin. Elocon can help you get significant relief from swelling, redness, and itching caused by a tight foreskin. However, it is not recommended for children under the age of 2 years.

Home Remedies

• Tea Tree Oil: Tea tree oil is a known antibacterial, antifungal, and anti-oxidant that can help reduce inflammation. When applied on and around the penis head, the antifungal properties serve to treat posthitis caused by yeast infections. 
• Yogurt: Adding yogurt to your diet can help reduce posthitis symptoms. Yogurt is a natural probiotic that can help control candida overgrowth by increasing the number of healthy bacteria and yeast in the affected area. You can also apply plain yogurt directly to the area on the affected area. 
• Garlic: Garlic is known to have antifungal and antibacterial uses. Adding garlic to your diet can help you reduce symptoms of posthitis.
• Apple Cinder Vinegar: The topical use of apple cider vinegar provides relief from posthitis symptoms such as pain and swelling. Apple cider vinegar also has anti-fungal properties that help fight infection. If the smell bothers you, consider mixing it with a little water before applying.
• Coconut Oil: Lauric acid and caprylic acid present in coconut oil are very effective in soothing irritated skin. Therefore, coconut oil is one of the ideal remedies to get fast relief from posthitis. The best thing about coconut oil is that it is easily available while not being overly expensive.

Good Hygiene Practices that Can Help in Getting Rid of Posthitis

Maintaining good hygiene can not only effectively treat posthitis but also minimize its chances of recurring in the future. Some hygiene practices that your urologist may advise you to follow include:

• Make sure to thoroughly wash and clean your penis on a daily basis. Use mild soap and lukewarm water. 
• Avoid the use of any harsh soap to clean the penis. Harsh soaps or chemicals can cause irritation in the skin of the penis.
• You can also rely on using an emollient that is easily available. A good quality emollient can not only protect but also moisturize the penile skin. 

Benefits of Posthitis Surgery

Along with its ability to effectively treat posthitis, circumcision can have several potential health benefits, such as:

• Less risk of Urinary Tract Infection (UTI).
• Reduced risk of contracting certain Sexually Transmitted Infections (STIs)
• Protection against penile cancer and lower risk of cervical cancer in female partners.
• Prevention of various penis conditions and infections such as balanitis, balanoposthitis, phimosis, and paraphimosis.
• Easier maintainence of penile hygiene. Maintaining good penile hygiene is an excellent way to relieve posthitis symptoms and minimize the chances of future penile problems.

Frequently Asked Questions

Can I have sex with posthitis?

Posthitis is not an STI and, therefore, cannot spread through sexual contact. However, an STI could be a reason behind posthitis. Until you know the reason behind your condition, it is advisable to refrain from sexual intercourse. Sex may also cause further irritation and discomfort on the foreskin..

Is posthitis dangerous to life?

Posthitis is not a contagious condition and is typically not life-threatening. It is possible for posthitis to resolve on its own in a week. However, if it does not go away on its own, you may require medical or surgical treatment. 

What is the average cost of posthitis surgery in India?

On average, posthitis surgery costs in India can start from Rs. 26,000 and go as high as Rs. 35,000. However, as is the case with any other surgical procedure, the exact cost of your posthitis surgery may differ depending on various factors such as: 

• Consultation and operating fees
• Doctor's expertise
• Hospital charges
• City you are in
• Preoperative diagnostic tests
• Method of Surgery
• Postoperative care and follow-ups

Can posthitis cure itself?

It is not uncommon for posthitis to resolve on its own in just a week. Simple lifestyle changes such as maintaining good genital hygiene can also help you treat posthitis without any surgical or medical intervention. However, if the symptoms seem to worsen over time, it is advised to contact your healthcare provider.

Is posthitis surgery covered by insurance?

Yes, posthitis surgery is generally covered by most health insurance plans in India if it is deemed to be a medical necessity. If left untreated, posthitis can lead to a multitude of penis-related complications, such as phimosis and lichen sclerosus. Hence, posthitis treatment is considered to be a medical necessity by urologists.

Conclusion

Posthitis is a urological condition that is characterized by inflammation of the foreskin. Posthitis is a fairly common condition, with some studies suggesting that 12-20% of uncircumcised men struggle with posthitis at some point in their life. Posthitis is not contagious and is not considered to be very serious. In most cases, it can be treated with non-surgical treatments such as antibiotics, antifungal creams, and changes in lifestyle. However, severe or recurrent cases of the condition may require circumcision.  As mentioned previously, a timely treatment for posthitis can help you not only avoid future complications but also the potential need for surgical treatments. If you are exhibiting posthitis symptoms and seeking effective treatment, you can contact us and consult our highly qualified and experienced team of urologists. All our urologists are experienced and proficient in treating various urological conditions, including foreskin infection. So contact us today and undergo safe and minimally invasive posthitis treatment near you!