Balanoposthitis in children: Epidemiology and pathogenesis
- Matthew Tews, DO
Matthew Tews, DO
- Associate Professor of Emergency Medicine
- Medical College of Wisconsin
- Jonathan I Singer, MD
Jonathan I Singer, MD
- Section Editor — Pediatric Surgical Emergencies
- Professor of Emergency Medicine and Pediatrics
- Wright State University Boonshoft School of Medicine
- Section Editors
- Gary R Fleisher, MD
Gary R Fleisher, MD
- Editor-in-Chief — Adult and Pediatric Emergency Medicine
- Section Editor — Pediatric Signs and Symptoms
- Egan Family Foundation Professor
- Harvard Medical School
- Laurence S Baskin, MD, FAAP
Laurence S Baskin, MD, FAAP
- Section Editor — Pediatric Urology
- Frank Hinman, Jr., MD, Distinguished Professorship in Pediatric Urology
- Chief Pediatric Urology
- Professor of Urology and Pediatrics
- UCSF Benioff Children's Hospital
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Balanoposthitis describes inflammation of the glans penis and the foreskin (prepuce) in uncircumcised males (picture 1). Although the etiology is multifactorial in children, balanoposthitis typically results from poor hygiene that is sometimes complicated by secondary infection. (See 'Irritant balanoposthitis' below.)
With general treatment, most patients with balanoposthitis have complete resolution of symptoms. In selected cases, topical or oral antibiotic therapy may be indicated. Pediatric urologic consultation is reserved for patients with acute urinary obstruction, prolonged and refractory disease course, recurrence, or development of true phimosis.
Balanitis, inflammation of the glans penis only, often occurs in conjunction with diaper dermatitis in young boys, both circumcised and uncircumcised. Local care and topical treatment aimed at the most likely etiology is rapidly curative and similar to balanoposthitis.
Balanitis and balanoposthitis must be differentiated from lesions that are sexually transmitted, indicative of systemic disease, or precancerous. These lesions are more common in adolescents and adults. However, vigilance is required to recognize sexually transmitted infection in prepubertal victims of child abuse. (See "Evaluation of sexual abuse in children and adolescents".)
This topic will address the epidemiology, pathogenesis, and clinical features of balanoposthitis. Specific diagnosis and treatment of balanoposthitis and routine care of the circumcised penis are discussed separately. (See "Balanoposthitis in children: Clinical manifestations, diagnosis, and treatment" and "Care of the uncircumcised penis".)
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