What is balanitis xeroderma obliterans

I am just writing to let you know that I thought the service you offer is excellent. I am impressed by high standards of professionalism displayed throughout my stay here Thornhill Circumcision Centre.

Good team and God bless. Very good manner, put me at ease through out the procedure, would definitely recommend. Excellent service Dr Khan and I will recommend to anyone who needs this services. Thank you. Thank you for your help and constant check ups.

I am so pleased thank you so much. The doctor was extremely informative and explained everything and the reason behind it. Dr Khan was very informative and listened to our concerns. So happy with the result. Baby Circumcision. Child Circumcision. Adult Circumcision. Partial Circumcision. Balanitis Xerotica Obliterans. Penoscrotal web.

Urology Services. Circumcision Blog. About Dr Khan. Contact Us. Who gets the BXO BXO is a disease that can affect uncircumcised males ranging from young boys to adolescents, men and older adults. What are the symptoms of BXO? What does BXO look like?

How will BXO be diagnosed? Can the BXO be cured? How can BXO be treated? What can YOu do? Circumcision with frenuloplasty in adults and children with BXO 3. Assessment and advice for the option of treatment like steroid cream, circumcision or further operations 2. Consultation before the circumcision 3.

Circumcision with glue because glue circumcision is better than stitches 4. Aftercare advice following the circumcision 5. To send the biopsy to confirm the diagnosis and exclude any malignancy 6. The underlying benefit of performing a circumcision is to remove the urine exposed warm, moist environment provided by the foreskin aiding the development of BXO. Circumcision is recommended when BXO is restricted to the foreskin with or without the involvement of the external urethral meatus.

In the presence of a urethral stricture, surgical procedures vary depending on the location of the stricture, the length and previous treatments. Therefore, urethral dilatation, urethrotomy and urethroplasty are all recognised treatments for the management of this disease [17,18].

Long-term monitoring of the foreskin is required in patients managed conservatively as progressive phimosis and adhesions between the inner prepuce and the glans may lead to a less favourable cosmetic result following circumcision. Patients need to be educated with regards to BXO once diagnosis is confirmed and following circumcision, monitoring of the penile shaft skin and urethral meatus is required [19].

Good cosmetic and functional outcomes are dependent on the severity and the extent of the disease. Early diagnosis in primary care will enable timely conservative management under specialist dermatologist teams [20]. Arch F Dermat u Syph ; Phimosis in boys. Br J Urol ; 52 2 The treatment of balanitis xerotica obliterans.

BJU Int ; 86 4 Balanitis xerotica obliterans in children. Balanitis xerotica obliterans: epidemiologic distribution in an equal access health care system. South Med J ; 96 1 Lichen sclerosus et atrophicus.

A histological, immunohistochemical and electron microscopic study. Arch Dermatol Res ; 8 Composition of the inflammatory infiltrate in pediatric penile lichen sclerosus et atrophicus balanitis xerotica obliterans : a prospective, comparative immunophenotyping study. Pediatric Pathology ; 14 2 Male Genital Lichen Sclerosus. Indian Journal of Dermatology ; 60 2 Lichen sclerosus associated with urinary contamina-tion.

Eur J Dermatol ; 26 1 Al-Niaimi F, Lyon C. Peristomal lichen sclerosus: the role of occlusion and urine exposure? Br J Dermatol ; 3 Association of autoimmune diseases with lichen sclerosus in male and female patients. Acta Derm Venereol ; 93 Detection of human papillomavirus types in balanitis xerotica obliterans and other penile conditions. Nasca MR. Innocenzi D, Micali G. Lichen sclerosis is not an infection so there is no risk that it will spread to other people.

The condition is chronic and progressive, which means that it is a long term condition that will gradually get worse if it is left untreated. Lichen sclerosis causes inflammation that can make the penis sore and red. The opening of the urethra may become narrowed or blocked and an ulcer can eventually form. The skin of the glans and foreskin can be permanently changed or scarred. At this moment in time we recommend circumcision to be performed.

There is some debate that foreskins can be left intact with injection of steroids or the use of topical steroids. This has currently not been proven and due to the ongoing risks associated with this condition, we would recommend a formal circumcision to ensure this is BXO through histology and guarantee the situation has treated properly. Since BXO is a progressive and painful condition, it is usually best to tackle it swiftly with surgery rather than to wait to see if other, less reliable treatments might help.

Circumcision is the main component of balanitis xerotica obliterans treatment, but it is also vital to follow the post-surgical treatment plan to reduce the risk of further problems.

Medication can prevent the urethra from becoming narrower after the operation. In some cases, further surgery may be required to ensure that the urethra is able to function properly. We prescribe a small amount chloramphenicol cream to be used for a number of days to allow the tissues to settle down. At around 5 days after surgery, a course of hydrocortisone cream is used twice a day for 6 weeks to stop the meatus from narrowing.

It is our experience that this may help make a significant difference to the insistence of meatal stenosis in this population. Your child will then attend a follow-up review to ensure that their opening is nice and wide and they are voiding without any difficulties.

BXO if left for the long term can be extremely severe and cause a huge amount of pain. Prolonged BXO can also allow the opening of the penis to narrow and this can require the need for further surgery and dilatation. There is also an association with penile cancer in later life if undiagnosed. Balanitis xerotica obliterans surgery is usually very effective, especially when circumcision is combined with post-operative medication.

However, there is a small chance that the remaining skin will still be affected by lichen sclerosis. Balanitis xerotica obliterans is a chronic inflammatory process of the foreskin and is also known as lichen sclerosis.

Inflammation occurs when the immune system is active. It can result in redness, swelling, pain and other symptoms. Lichen sclerosis is a chronic inflammatory condition. When it affects the skin on the penis, it is known as balanitis xerotica obliterans. Lichen sclerosis can affect other parts of the skin too.

Sometimes the skin can become quite inflamed or on some occasions it can be quite thin and very pale or even quite thick. The condition is slightly more common in boys who have autoimmune disorders or atopic conditions such as asthma and eczema, but it still only affects a small proportion of these boys. If your son has symptoms of BXO then it is important to see a doctor as the condition can get worse if it is left untreated.