Balanoposthitis in Children: Does Treatment Matter?

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.