The main cause of balanoposthitis in boys is the lack of proper hygienic care of the genital organs. This leads to the accumulation under the foreskin of the secretion of preputial glands – smegma, which serves as a favorable environment for the reproduction of microorganisms that cause inflammation.
The development of balanoposthitis in boys is promoted by the so-called physiological phimosis, which occurs normally in children up to 3-5 years old and makes it difficult for them to take hygienic care due to the inability to completely expose the head when pulling off the foreskin. Often boys have balanoposthitis when parents try to force the head to be opened by themselves – in this case, various pathogens easily get into the preputial bag from the external environment.
Violation of self-cleaning prepucialny bag can contribute to the pronounced synechia of the foreskin. The most common causative agents of balanoposthitis in boys are streptococci, E. coli, staphylococcus, Proteus, herpes virus, yeast (candida).
However, in some cases, balanoposthitis in boys, on the contrary, may be due to excessive hygiene and frequent washing of the glans head with soap or other irritating agents. Allergic reactions (contact dermatitis) can result from the use of children’s creams, underwear with detergent residues, etc. Children’s cosmetics and household chemicals can provoke not only balanoposthitis, but also inflammation of the buttocks and perineum area in a child (so-called diaper dermatitis ).
The development of balanoposthitis in babies can be promoted by a rare change of diapers or their improper selection (using too large in size or too close diapers). At an older age, balanoposthitis in boys can occur with the constant trauma of the foreskin with narrow panties, stitches for underwear, etc. Endocrine diseases (diabetes, obesity), and urological diseases (cystitis, pyelonephritis, urolithiasis) can predispose to the appearance of balanopastitis in boys. ), hypothermia, avitaminosis.
Symptoms of balanoposthitis in boys
Balanoposthitis in boys often develops acutely. Usually after going to the toilet, the child begins to complain of burning and itching in the area of the glans penis, pain or difficulty urinating. Small babies become restless when they urinate and cry. Examination reveals redness and swelling of the penis head and foreskin; when exposing the head under the foreskin, accumulated smegma is detected, which has an unpleasant odor.
When balanoposthitis boys may have abundant cheesy or serous-purulent discharge from the preputial sac. Rash, cracks or diaper rash may be found on the skin and mucous genital organs. With the further progression of balanoposthitis in boys, the appearance of erosions and skin desquamation are possible.
In addition to local signs, boys have common symptoms of balanopostitis: malaise, lack of appetite, poor sleep, irritability. Often in children the body temperature rises to 37-38 ° C, the inguinal lymph nodes increase. Due to the fact that the child is trying to delay urination because of his pain, it is possible to develop day and night enuresis.
The symptoms of acute balanoposthitis in boys increase over 4-5 days; with self-opening of the preputial cavity and its clearing of smegma, self-healing is possible. However, more often in the absence of proper or proper treatment, acute balanoposthitis in boys is transformed into chronic. Chronization of inflammation is fraught with scarring in the foreskin with the development of pathological phimosis and paraphimosis, chronic urethritis, and deformation of the glans penis.
Diagnosis of balanoposthitis in boys
If you suspect balanoposthitis in a child should contact a pediatric surgeon, and better – a pediatric urologist for an individual solution to the problem. In most cases, the diagnosis of balanoposthitis in boys does not require special instrumental studies. The pediatrician receives the necessary information when analyzing complaints, examining the child’s genitals and performing a number of laboratory tests.
In the general analysis of urine, children with balanoposthitis show leukocytosis and bacteriuria. To identify the causative agent, bacteriological examination of the urine is carried out, as well as discharge from the preputial sac (if indicated, baccosis for candidiasis). In some cases, to clarify the type of pathogen may require PCR and ELISA diagnostics.
To exclude concomitant diseases, a child may need to be examined by a pediatric endocrinologist, pediatric nephrologist, pediatric dermatologist, blood glucose determination, ultrasound of the kidneys and bladder, and other studies and consultations.
Treatment of balanoposthitis in boys
In most cases, with acute balanopostitis in boys, local treatment is sufficient. Seating baths with antiseptics (potassium permanganate, furatsilinom) or decoction of herbs (chamomile, etc.) are recommended. It is possible to instil antiseptic solutions (chlorhexidine, Miramistina, etc.) under the foreskin. After washing the head of the penis, carefully remove the foreskin, remove the smegma and pathological secretions, put ointment in the preputial bag (linment of syntomycin, with fungal balanostitis in boys – clotrimazole) and return the foreskin to its normal position.
If it is impossible to independently expose the head of the penis, the separation of the synechiae of the foreskin and the cleaning of the preputial sac are performed by a pediatric surgeon or urologist.
To reduce pain and swelling, you can use NSAIDs, in particular ibuprofen. In severe forms of balanopostitis in boys, systemic administration of sulfonamides, antibiotics, and antifungal drugs may be required.
In chronic balanoposthitis in boys and the development of pathological phimosis, circumcision is indicated (circumcisio).
Prevention of balanoposthitis in boys
To prevent balanoposthitis in boys, it is enough to observe and teach the child to daily hygienic care of the genitals. Young children need careful selection and frequent change of diapers, regular toilet of the genitals and skin care for the perineum, the use of hypoallergenic hygiene products.
At an older age, hygiene showers, removal of excess smegma, and changing of underwear are useful everyday skills. Important for the prevention of balanoposthitis in boys is the normalization of body weight, the treatment of associated diseases.
Balanoposthitis in boys is an inflammation that captures the head of the penis and the inner leaflet of the preputial sac (foreskin). Balanoposthitis in boys is characterized by itching and burning in the region of the head, swelling and reddening of the foreskin, difficulty urinating, purulent discharge from the preputial sac.
Balanoposthitis in boys is diagnosed on the basis of external signs and laboratory data (OAC, OAM, results of bacteriological culture of discharge, PCR, ELISA). Treatment of balanoposthitis in boys includes local baths with disinfectant solutions, washing the glans of the penis, removing smegma and secretions, using antimicrobial and anti-inflammatory ointments; with chronic balanoposthitis, circumcisio is shown.
Balanoposthitis in boys is an inflammatory process involving the head of the penis and the inner leaflet of the foreskin. Balanopostitis is diagnosed in approximately 6% of boys and in 11% of adult men who have not previously been circumcised. Inflammatory diseases of the glans penis (balanitis) and foreskin (postity) are most common in boys under 5 years of age and in men who are sexually active.
Treatment of balanoposthitis in boys is a serious problem in pediatrics, pediatric urology and pediatric surgery. Prevention, timely and high-quality therapy of balanoposthitis in a child is the key to his reproductive and sexual health in the future.