Balanoposthitis in Children: Does Treatment Matter?

Abstract

Background: Balanoposthitis in children is a common problem, especially in uncircumcised boys. There is scant literature regarding the treatment, disease course and prognosis.

Objectives: We examined all cases of balanitis and balanoposthitis in children treated in our pediatric emergency department. Our intent was to describe differences in treatment and the incidence of treatment failure.

Methods: This study was a retrospective study of all patients less than 18 years, evaluated in our pediatric emergency department over 8 years with a diagnosis of balanitis or balanoposthitis. We evaluated each for symptoms, testing, and treatment. We reviewed the medical record for any visits in the following 30-day period. If a new treatment for balanoposthitis was prescribed on the return for worsening symptoms, this was considered an initial treatment failure.

Results: Four hundred sixty-three patients were diagnosed with balanitis or balanoposthitis during the treatment period. Fever was uncommon. Most patients were uncircumcised, and phimosis was present in 27% of these. Oral antibiotic alone was the most common treatment, prescribed in 23% of patients, followed by topical antibiotic alone in 20% then topical antifungal alone in 19%. Other treatments included combinations of oral and topical medications and supportive care alone. Eleven patients had a return visit within 30 days, with 5 of these having treatment change. No return patients required admission or intravenous antibiotics.

Conclusions: Pediatric balanoposthitis is treated with a variety of therapies including supportive care, antibiotics and topical agents. There is a very low rate of treatment failure, regardless of therapy prescribed.

Keywords: Balanitis; balanoposthitis; pediatrics; penile infection.