Balanitis

Question 1

What is balanitis?

Answer 1

• Inflammation of glans penis +/- foreskin

Question 2

At what age is balanitis common? Why?

Answer 2

• When the foreskin is separating from the glans (so there are little pockets that might contain urine), so it is rare in 1st year and in primary school (> 5 years) i.e. common from 1-5yo

Question 3

Cause of balanitis

Answer 3

Most often due to infection: candida in infants

Question 4

How to prevent balanitis?

Answer 4

By washing regularly in salt water. A handful of cooking salt in a bath is usually enough.

Question 5

Mx of balanitis

Answer 5

• Soak in warm bath with foreskin retracted if not too painful
• Mild cases: topical hydrocortisone 1% cream/ointment
  • Topical because the infection is on the outside, not inside! e.g. eye ointments
• Topical anti-yeast creams e.g. nystatin for candida infection
• Only occasionally systemic Abx
• Napkin rash Mx e.g. sudocream
• Education about foreskin retraction

Question 6

What can you educate parents about re:foreskin retraction?

Answer 6

• Most foreskins non-retractile in newborns
• May become retractile around 2yo, but can occur right up until puberty
• Should never be forcibly pulled back for cleaning - no need to clean in young boys

Question 7

What complication can balanitis lead to?

Answer 7

Scarring -> phimosis