10 Years' Experience in Balanitis Xerotica Obliterans: A Single-Institution Study

Abstract

Clinical correlation by surgeons has a high degree of accuracy (>90%). Meatal involvement is more common than previously reported. The use of pre- or postoperative steroids does not obviate the need for further surgical procedures. Patients can have recurrent symptoms 1 year following surgery, and prolonged follow-up is necessary.

Comparison of lichen sclerosus in boys and girls: A systematic literature review of epidemiology, symptoms, genetic background, risk factors, treatment, and prognosis

“…The referral diagnoses for boys with LS are mostly clinical features such as phimosis (52%), balanitis (13%), or buried penis (10%), regardless of whether or not the LS has been recognized 14 31 the largest cohort studies reporting 10–50% 15,18,32,33 . Boys with an acquired phimosis may have a greater risk of having LS than boys with congenital phimosis 17,31,34 .…”

“…To date, only one epidemiologic study has been performed to assess the prevalence of LS in girls, 12 whereas for boys many studies have been performed 7,11,14‐18 11 …”

“…14 The incidence of LS in non-circumcised boys with phimosis ranges from 2 to 95%, 31 the largest cohort studies reporting 10-50%. 15,18,32,33 Boys with an acquired phimosis may have a greater risk of having LS than boys with congenital phimosis. 17,31,34 Frequent symptoms subsequent to phimosis include urine retention, ballooning of the foreskin, dysuria, other urinary tract symptoms, and erectile pain.…”

Could a careful clinical examination distinguish physiologic phimosis from balanitis xerotica obliterans in children?

“…The diagnosis of BXO cannot rely only on the macroscopic appearance of the foreskin or symptoms, since diagnosis based on a clinical examination could underestimate its occurrence in up to 50% of cases [12,17]. However, a large published series estimated the diagnostic accuracy of an abnormal preputial appearance to be more than 80% [11,18] despite reports claiming that the initial stages of BXO might not show peculiar findings on clinical examination [19].…”

“…All the reported complications were classified according to the modified Clavien-Dindo scale [10]. Adverse events were defined as surgical site infections (SSIs), wound leaks and anomalies (such as granulomas or delayed healing of surgical wounds, which was estimated as 30 days) [11].…”