Urologie pro praxi 2/2016

Inflammation of the external genitalia in children: balanitis, epididymitis, orchitis

Diagnosing and treating balanitis is straightforward. Most balanitides resolve following antiseptic penile baths and local administration of an antibiotic ointment; the need for systemic antibiotics is rare. An inflammatory condition of the epididymis or testis has to be distinguished from other common causes of the acute scrotum: torsion of testicular and epididymal appendages or torsion of the spermatic cord. Antibiotic treatment of epididymitis is indicated in patients with pyuria, those with an established developmental defect of the urinary tract, and in adolescents. Voiding cystourethrography should only be performed when a developmental anomaly is suspected on ultrasound or when pyuria is detected. Mumps orchitis is the most common complication of mumps in adolescents. It is managed with non-steroidal anti-inflammatory drugs, resting regimen, and cooling of the external genitalia. When a complicating bacterial infection is suspected, the administration of antibiotics is necessary. Treatment with corticosteroids fails to reduce the risk of testicular atrophy and that of developing a pathological semen analysis.

Keywords: balanitis, epididymitis, mumps orchitis, children.