[Balanitis xerotica obliterans with phimosis in elderly patients presenting with difficulty in urination].

Eight elderly patients (average age 76.1±4.3 years) with balanitis xerotica obliterans (BXO) accompanied by phimosis presented with difficulty in urination. Preoperative average international prostate symptom score, average maximum urinary flow rate, and average volume of residual urine were 20.7±6.3 points (n＝8), 5.1±3.6 ml/s (n＝5), and 85.4±77.3 ml (n＝8), respectively. Some of the patient's complaints, such as severe dribbling of urine, urinary stream division, and ballooning of the foreskin, were not included in the items of the major questionnaire on urination. Dorsal incision and circumcision was performed in all patients, and all were pathologically diagnosed with BXO. Meatoplasty was performed in one patient with a meatal stenosis. No coexistence of penile cancer was observed. Statistically significant improvements were observed in subjective and objective findings after treatment. In conclusion, BXO with phimosis in elderly patients should be considered as a cause of lower urinary tract symptoms.

Erythematous penile lesion.

Previous efforts to diagnose the cause of this patient's rash had been unsuccessful. A biopsy confirmed our suspicions.

Review of 120 biopsies performed on the balanopreputial sac. from zoon's balanitis to the concept of a wider spectrum of inflammatory non-cicatricial balanoposthitis.

BACKGROUND: Long-lasting erythematous lesions involving the balanopreputial sac may be clinically difficult to classify, and biopsies may be performed in order to clarify the nature of the disease. However, our previous experience led us to consider several cases as histopathologically unclassifiable. OBJECTIVE: To establish the causes of such unsatisfactory findings. METHODS: We reviewed 120 balanopreputial sac biopsies performed at the surgical unit of our institute from January 1999 to December 2002 examining also the patients' clinical records. RESULTS: We found that a small group of previously unclassified cases showed common clinical and histopathological features. Clinically, all patients were uncircumcised and had long-lasting asymptomatic erythematous plaques on the balanopreputial sac with no erythroplastic or lichenoid features and no correlation with sexual intercourse. Histologically, all specimens showed a thinned and spongiotic epithelium, a band-like infiltrate of lymphocytes and histiocytes with a variable number of plasma cells in the upper part of the chorion and further signs of acute, subacute or chronic inflammation. CONCLUSIONS: In our view, these cases fall within a spectrum of inflammatory non-cicatricial disorders, ranging from almost pure lymphohistiocytic forms to forms which fulfil all criteria to be classified as balanitis circumscripta plasmacellularis of Zoon. We propose to classify these cases histologically as inflammatory non-cicatricial balanoposthitis and clinically as idiopathic inflammatory non-cicatricial balanoposthitis.

Plasma cell balanitis treated with a copper vapour laser.

A 48-year-old, uncircumcised man presented with plasma cell balanitis, which is a chronic, erosive dermatitis at the glans penis and the inner surface of the prepuce, which is normally treated by circumcision. He was treated with three sessions of copper vapour laser over a period of three months and apart from a minor relapse after seven months he has to our knowledge been well.

Balanitis circunscrita plasmocelular (Balanitis de Zoon) / Circunscribed plasmocelular balanitis (Zoo's Balanitis)

Se informa de dos casos de balanitis circunscrita plasmocelular. Esta es una entidad poco común y de manejo difícil, que carcterísticamente afecta a varones no ciruncidados y que puede ser confundida con otras enfermedades de localización genital, particularmente con la eritroplasia de Queyrat. El diagnóstico se basa en el cuadro clínico y su correlación con la histopatología, en la que sobresalen los cambios vasculares y la presencia de numerosas células plasmáticas. Se intenta llamar la atención hacia esta enfermedad ya que parece ser poco conocida en nuestro medio .