Xerotica

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It is described in medical literature as a chronic inflammatory condition of unknown aetiology that affects the foreskin , glans and the external urethral meatus and urethra in severe cases. Most patients present with phimosis with varying degrees of difficulty or inability to retract the foreskin [2]. The phimosis is usually progressive in nature with the presence of initially a white sclerotic ring in the distal prepuce Figure 1 that becomes more apparent on retraction of the foreskin and at later stages complete inability to retract with fissuring and haemorrhagic blistering during sexual activity [2,3]. Obstructive symptoms, dysuria, poor urinary stream and urinary retention should also raise the suspicion of possible involvement of the external urethral meatus [2,4].
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The surgical treatment of Balanitis Xerotica Obliterans

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The surgical treatment of Balanitis Xerotica Obliterans

This common penile disease can involve the prepuce, the glans Fig. BXO was regarded as an exclusively adult disease until a case was documented in a 7-year-old boy in [ 1 ]. Further reports of prepubertal BXO followed during the s and currently it is recognized as a common cause of acquired phimosis and meatal stenosis in schoolboys, and has even been identified in the first year of life unpublished communication. It remains speculation as to whether this represents a genuine change in prevalence and behaviour of this disease, or merely greater clinical awareness and recognition. The aetiology of BXO remains obscure.
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Balanitis Xerotica Obliterans BXO is a chronic, often progressive disease, which can lead to phimosis and urethral stenosis, affecting both urinary and sexual function. Steroid creams are usually the first-line treatment but have a limited role and surgical intervention is frequently necessary. Conservative surgical procedures circumcision are often preferred in the first instance with the premise that recurrence of disease will require a more definitive reconstruction. The aim was to look at their management in the past and subsequent management by us. We also looked at whether early referral of progressive and recurrent BXO patients to reconstructive surgery could have prevented unnecessary delay in resolving symptoms at an earlier stage.
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