Balanitis xerotica obliterans in children and its incidence under the age of 5 years

Objective: To analyse the incidence of BXO among paediatric circumcisions for preputial pathology, in particular in children under the age of 5 years. Methods: Retrospective review revealed 1769 paediatric circumcisions performed between 1997 and 2008 at our institution. Data were collected on patient's age, date when sample received by pathology department and histological findings for all the foreskin samples received and examined during the study period. Epidemiological data were obtained from the Office for National Statistics, UK. Results: A total of 346 foreskin samples were received and BXO was found in 182 (52.6%). There were 31 children under the age of 5 years circumcised for preputial pathology. BXO was reported in 6 (19.3%) and chronic inflammation in 16 (51.6%) of these patients. The foreskin was reported normal in 2 (6.5%) and the remaining 7 (22.6%) patients had preputial cysts or other pathology. Epidemiological population data analysis revealed the incidence of BXO per year to be 3.01 cases/1000 boys under 15 years of age and 0.322 cases/1000 boys under 5 years. Conclusion: The incidence of BXO in boys noted in our study is higher than previously reported. BXO can result in significant complications and should be considered in children even under 5 years. (C) 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.