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Balanoposthitis in Children: Does Treatment Matter?
Christin J Tu1, Stephanie Torrez1, Brian G Chen1
1Department of Pediatric Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California.
Insights
Pediatric balanoposthitis, a common condition in uncircumcised boys, is effectively treated with various therapies. Studies show a low incidence of treatment failure, indicating good prognosis for childhood balanoposthitis.
Area of Science:
- Pediatric emergency medicine
- Dermatology
- Infectious disease
Background:
- Balanoposthitis is a frequent pediatric condition, particularly in uncircumcised boys.
- Limited literature exists on its treatment, course, and prognosis.
Purpose of the Study:
- To analyze treatment variations and failure rates for pediatric balanitis and balanoposthitis.
- To describe the clinical course and outcomes of these conditions in children.
Main Methods:
- Retrospective analysis of pediatric patients diagnosed with balanitis or balanoposthitis over 8 years.
- Evaluation of symptoms, treatments, and 30-day follow-up for treatment failure.
- Treatment failure defined as a change in therapy for worsening symptoms upon return visit.
Main Results:
- 463 pediatric cases identified; fever was rare.
- Most patients were uncircumcised; phimosis noted in 27%.
- Common treatments included oral antibiotics (23%), topical antibiotics (20%), and topical antifungals (19%).
- Only 11 patients returned within 30 days, with 5 requiring treatment changes; no admissions or IV antibiotics were needed.
Conclusions:
- Pediatric balanoposthitis management involves diverse therapies: supportive care, antibiotics, and topical agents.
- A consistently low rate of treatment failure is observed across different therapeutic approaches.
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.
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