Balanitis is an inflammation of the foreskin and occasionally the head of the penis. It is very common in boys and usually resolves in 2-3 days. Most cases settle down without any particular treatment and without any scarring. Occasionally it can recur and be a problem with pain, discharge and scaring.
Here at London Children’s Surgery we try to avoid surgery as much as possible in these patients but if conservative management fails then circumcision is warranted.
Most young boys will complain of penile discomfort. It can be itchy with a red and inflamed foreskin and difficulty passing urine. The foreskin can appear tight and a foreskin which was previously retractile is no longer so.
Balanitis in a small degree nearly affects all men with an intact foreskin. The vast majority of cases are quite mild. Most child get what’s called chemical balanitis which is just a small amount of redness associated with the foreskin releasing. True infected balanitis occurs in approximately 5% of the population of boys of less than 5 years of age.
Most children with balanitis can be managed conservatively and without surgery. Hygiene is very important to ensure the area is kept clean and retracting the foreskin is frequently not advisable. The penis should be kept as clean and as dry as possible. It should be washed with lukewarm water. There is an occasional role for antibiotics or for topical creams.
Most children who get balanitis will get a second episode. It is usually not severe and rarely is circumcision warranted. If it is very problematic a circumcision is warranted. See circumcision information.