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