Balanoposthitis in a Toddler

Kimberly P. Toole; Catherine Frank


Urol Nurs. 2018;38(5):237-239. 

In This Article

Abstract and Introduction


This case study describes a 2-year-old male with balanprosthitis presenting to primary care. Balanoposthitis is an inflammatory condition affecting the glans penis and prepuce usually caused by a bacterial or fungal infection, or sometimes trauma. Symptoms may include pain, fever, edema, erythema, and/or irritation of the glans penis and prepuce, along with possible discharge. The condition is more common in uncircumcised males. Diagnosis is usually made by physical examination and the etiology determined by clinical findings, culture, and/or imaging. Treatment can be topical or systemic depending on etiology and severity of symptoms. Nurses should instruct in proper care of the uncircumcised penis.


Balanitis is inflammation of the glans penis that results in swelling and infection. It is a common condition affecting an estimated 3% to 11% of males, with the majority being uncircumcised adults (Leber & Tirumani, 2017). The infection is termed balanitis when only the glans penis is involved and balanoposthitis when the prepuce is also affected. Symptoms of balanoposthitis include erythema and edema of glans penis and prepuce, foul odor, discharge, ulceration and/or plaques, lymphadenopathy, and rarely phimosis and/or urinary obstruction.

The general initiating factor in the inflammatory process of balanoposthitis is the lack of aeration in an uncircumcised male, with resulting irritation and inflammation (Porche, 2007). Causes of balanoposthitis include infection, irritation, trauma, premalignancy, or malignancy, or the cause can be idiopathic (Morris & Krieger, 2017). The most common causative agents are yeast, especially Candida albicans (Morris & Krieger, 2017; Porche, 2007). The genital area and prepuce provide an optimal medium for overgrowth of normal organisms found on the glans penis (Morris & Krieger, 2017). Other causative microbial agents include Group B and Group A beta-hemolytic streptococci, Neisseria gonorrhoeae, Chlamydia species, human papilloma virus, Gardnerella vaginalis, Treponema pallidum, Trichomoniasis, and the Borrelia species (Leber & Tirumani, 2017). Irritant causes include poor hygiene, retained soap or accumulation of smegma under the foreskin, or inadequate aeration and drying (Porche, 2007). Balanoposthitis may also be associated with contact dermatitis and/or obesity (Morris & Krieger, 2017).