(info below is general, not specific to pediatrics)
- inflammation of the glans penis
- balanoposthitis = Balanitis involving the foreskin or prepuce i
- the most common complication of balanitis is phimosis, or inability to
retract the foreskin from the glans penis.
- Pathophysiology: Uncircumcised men with poor personal hygiene are
most affected by balanitis. Lack of aeration and irritation because of smegma
and discharge surrounding the glans penis causes inflammation and edema.
Adherence of the foreskin to the inflamed and edematous glans penis causes
phimosis, which is the major presenting complication of balanitis seen in the
Emergency Department Care:
- Patients presenting with balanitis but without phimosis should receive the
following recommendations and treatment:
- Retract the foreskin daily and soak in warm water to clean penis and
- Apply bacitracin (not Neosporin) for pediatric patients.
- Apply topical clotrimazole for adult men with probable candidal balanitis.
- Obtain a culture of discharge in unusual cases, then treat the infection
with appropriate antibiotics.
Patients presenting to the ED with phimosis as a complication of balanitis
should receive the following care:
- Without damaging the glans penis, dilate the foreskin using a clamp. If
the glans penis is adherent to the foreskin, the procedure may be
contraindicated. Local anesthesia, analgesia, and/or sedation may be required.
- Dilate the foreskin opening.
- Perform a dorsal slit incision by cutting the foreskin over the dorsal
shaft of the penis to enlarge the foreskin opening. This procedure requires
local anesthesia and, possibly, sedation.
- Perform a formal circumcision (preferably in the operating room).
Also see Reiter Syndrome
eMedicine.com. Balanitis. Last Updated: March 25, 2005