What is it about ?
Balanitis is an infection of the lining that covers the glans penis. Usually the foreskin is also inflamed. Since the foreskin in children is naturally tighter than in adults, infections can develop there more easily. The cause is usually infectious, caused by bacteria or fungi. Often the problem is due to the manipulation of the foreskin with dirty hands.
How to recognize it?
The foreskin is red and swollen, it is strongly constricted and this prevents the glans from being exposed. Sometimes we see pus. Sometimes urinating is painful, difficult, or even impossible. The foreskin may swell when urinating. This reaction is caused by the skin of the foreskin sticking to the glans.
The child may not want to urinate because of the pain. As a result, the bladder is sometimes overstimulated and the child may lose urine involuntarily. The risk of a urinary tract infection is also greater.
How is the diagnosis made?
The diagnosis can be made on sight. No specific examination is necessary. The doctor will ask you how long the child has had the symptoms, how they started, if they can still urinate, what treatment they have already had, etc. He also examines the foreskin to assess the seriousness of the situation.
In case of urinary problems, a urinalysis is performed. However, the collected urine is almost always contaminated with pus due to the infection of the glans. Therefore, if the child is very sick, has a high fever, or refuses to urinate, a possible bladder puncture should be considered.
What can you do ?
Try not to force the foreskin cracking in babies. For the majority of children, this will get better spontaneously as they get older. By the age of 3, around 7 out of 10 children can retract and resize the foreskin on the glans without problem. By the age of 6, 8 out of 10 children can do this without any problem.
The usual treatment is to wash the inflamed foreskin in the form of baths several times a day without using soap. Avoid touching the foreskin too often with dirty hands. In general, good hygiene is sufficient.
What can the doctor do?
There isn’t really any scientific evidence on the treatment of balanitis. Usually, the doctor will prescribe an ointment against bacteria (antibacterial ointment) or against fungi (antimycotic ointment). This ointment should be applied two to three times a day under the foreskin. Sometimes an ointment intended for the eyes (ophthalmic ointment) is used because it is softer, more accommodating and because it sits more easily under the foreskin. If this treatment is not enough, antibiotics are sometimes prescribed.
If the child is no longer urinating, they may need to be hospitalized.
If balanitis is chronic or there is an underlying condition, circumcision may be considered.
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