Treatment of Balanoposthitis in Lichen Sclerosus of the Glans Penis and Prepuce

This protocol addresses balanoposthitis occurring in the context of lichen sclerosus affecting the glans penis and prepuce — a condition also known as balanitis xerotica obliterans (BXO). Management in this setting is distinct from routine balanoposthitis and requires a targeted clinical approach.

Clinical Scenario Lichen sclerosus of the glans penis and prepuce is an inflammatory scarring skin condition. Although an autoimmune pathogenesis has been postulated, it may be related to chronic occluded contact with urine in uncircumcised individuals. This underlying condition directly shapes the treatment strategy.

Treatment Approach (partial overview) The management protocol in this scenario involves surgical intervention — circumcision is a key component, with additional procedures considered depending on anatomical complications present.

The complete structured regimen — including the full procedural sequence, decision criteria, and management of associated complications — is available in the full protocol.

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References

DOI: 10.1111/jdv.18954

An inflammatory scarring skin condition: although an autoimmune pathogenesis has been postulated, it may be due to chronic occluded contact with urine in the uncircumcised.

Circumcision is indicated for (a) failed topical medical treatment or (b) persistent requirement for daily topical treatment (2,D).

Surgery may be indicated to address symptoms secondary to persistent phimosis or meatal stenosis, and urethral disease (2,B). This may include circumcision, meatotomy, glans-resurfacing, urethroplasty and bariatric surgery.

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