From the Research
The treatment of balanoposthitis in pediatric patients should primarily involve gentle cleansing with warm water, avoiding soap on the affected area, and keeping the area dry, with consideration of topical antiseptics or antibiotics based on the severity and suspected cause of the infection, as suggested by the most recent study 1.
Key Considerations
- The condition is common in boys with physiological phimosis, and treatment success is reported to be good for various forms, with baths being the best perceived treatment by the majority of participants 1.
- It is essential to avoid traumatizing manipulation, apply antibiotic stewardship, and adhere to families' preferences and feasibility when choosing a treatment 1.
- Topical antibiotics such as mupirocin 2% ointment or antifungal creams like clotrimazole 1% may be effective for bacterial or fungal infections, respectively, but the choice of treatment should be guided by the least invasive alternative that is effective 1.
Treatment Approach
- For mild cases, gentle cleansing and keeping the area dry are recommended.
- For suspected bacterial infections, topical antibiotics may be considered.
- For fungal infections, antifungal creams can be used.
- In cases with significant inflammation, a combination of antifungal and low-potency steroid cream may be used for a short period to reduce swelling and discomfort.
Important Notes
- Parents should be instructed to gently retract the foreskin only as far as it will go comfortably during bathing to clean underneath, but never force retraction as this can cause scarring.
- If phimosis is contributing to recurrent episodes, referral to a pediatric urologist may be warranted.
- Most cases resolve completely with proper treatment, but recurrence is common if underlying causes like poor hygiene or diabetes are not addressed. The most recent and highest quality study 1 provides the basis for these recommendations, emphasizing the importance of a gentle and least invasive approach to treating balanoposthitis in pediatric patients.