Medication
For longer strictures, the recommended treatment is a urethroplasty (open urethral reconstruction). The most complex strictures associated with BXO are pan-urethral strictures, which involve the entire anterior urethra and can measure over 22 cm in length.
Self-care
A suggested treatment protocol If the condition, as observed clinically, is limited to the foreskin, then circumcision is curative and provides... If there is associated glans discoloration, but with no scarring, ulceration or fusion to the foreskin, simple... Potent topical steroid creams may be ...
Nutrition
Rarely, BXO can be hereditary. Platelet rich plasma injection and circumcision are the primary treatment methods employed at Pollock Clinics, as well as other options, including topical steroids as appropriate. Please contact us to schedule a consultation for lichen sclerosus treatment. No referral is needed. What is Male Genital Lichen Sclerosus?
What is the initial approach to BXO treatment?
Nov 11, 2019 · Successful treatment of BXO with topical tacrolimus has been reported. Etretinate therapy has been used, but it is no longer available; acitretin is …
Where can I get treatment for BXO for men?
Balanitis xerotica obliterans (BXO) is a scarcely known disease, wrongly considered rare. With a high degree of suspicion and histologic examination, the condition will prove to be much more frequent than one generally believes. ... Treatment of BXO depends on the anatomic location of the lesions and their extent and severity, together with the ...
How is lichen sclerosus (BXO) treated?
Oct 19, 2015 · The following treatment measures may be considered for Balanitis Xerotica Obliterans: Application of topical steroid creams and lotions, topical tacrolimus or pimecrolimus Surgery to remove scar tissue In case of urethral stricture, urethroplasty surgical procedure can be performed that can help the individual to urinate better
What is the best treatment for urethroplasty with BXO?
Penile lichen sclerosus is a progressive, sclerosing, inflammatory dermatosis of the glans penis and foreskin which is of uncertain aetiology. Recent studies have shown a link between lichen sclerosus and squamous cell carcinoma of the penis. In this review, we discuss the clinical presentation, pathology and current approach to treatment of ...
Can BXO be treated?
Can BXO be cured? No treatment is likely to reverse the changes of BXO completely, but the symptoms and signs of the disease can usually be well controlled with a steroid application.
Is BXO a lifelong condition?
Background: Balanitis Xerotica Obliterans (BXO) is a chronic, often progressive disease, which can lead to phimosis and urethral stenosis, affecting both urinary and sexual function.
How long does it take for BXO to go away?
Balanitis generally is not a serious condition and can be treated with antibiotic creams and pills. Most occurrences of balanitis clear up within three to five days of starting treatment. Left untreated, however, it can become more painful or cause other health problems.
How do you treat BXO at home?
What can I do to help relieve symptoms of balanitis?Bathe often: Wash every day. ... Avoid harsh soaps: Try not to use strong soap or lotions that can irritate your skin.Stay dry: After urinating, dry the area under the foreskin so urine doesn't become trapped under the foreskin.More items...•4 Nov 2019
What does BXO look like?
What does BXO look like? On the main areas of the foreskin, the spots of BXO look like small ivory-coloured slightly raised areas, which can join up to form white patches.
What causes BXO?
The etiology of BXO is uncertain; however, autoimmune disease, local trauma, and genetic and infective causes have been proposed. BXO occurs most commonly on the prepuce and glans penis.12 Oct 2018
Is BXO cancerous?
However, a number of authors have noted that tissue affected by BXO may become cancerous,2-10 though others express uncertainty. There are indications that BXO may be more common than is currently thought. A history of phimosis is also associated with a dramatically increased risk of penile cancer.13 Jun 2005
Can amoxicillin treat balanitis?
If a bacterial infection is the cause of your balanitis, you will be prescribed a seven-day course of oral antibiotics (antibiotic tablets or capsules). An antibiotic called amoxicillin is usually recommended.
What are the side effects of BXO?
One of the side effects associated with BXO is the development of urethral strictures. Below are retrograde urethrograms (RUGs) of 2 patients diagnosed with Lichen Sclerosus after very early detection of the disease. The first patient had a Lichen Sclerosus case that caused a stricture that only involved the very distal urethra.
What is BXO stricture?
BXO stricture extending into the penile urethra. This next example is of a patient who had an extensive history of slow urination and mild penile skin changes. Although he had areas of the urethra that were completely normal in size, the majority of the penile urethra was extremely narrow.
Why is BXO recurrence high?
In the past, it was reported that using penile skin as a tissue to augment the narrow urethra could lead to a high rate of BXO recurrence. It was suggested that because the disease involves penile skin, the recurrence may be due to the disease progressing into the penile skin.
How long is a BXO?
The most complex strictures associated with BXO are pan-urethral strictures, which involve the entire anterior urethra and can measure over 22 cm in length.
Can BXO surgery be done without skin?
This revision surgery adds width where needed without having to remove any skin. When BXO is associated with urethral stricture disease, it is best to avoid observation or dilation to treat the stricture. The best treatment depends on the length of the stricture.
Can BXO be treated with topical steroid cream?
A comprehensive plan is best formulated by a urologist with expertise in male urethral and penile disorders. While some of the skin changes respond favorably to topical steroid cream (such as Temovate 0.05%), no topical cream can provide a cure for any associated strictures.
Can a steroid cream cure strictures?
While some of the skin changes respond favorably to topical steroid cream (such as Temovate 0.05%), no topical cream can provide a cure for any associated strictures.
Symptoms of BXO or Lichen Sclerosus
Men and boys with penile lichen sclerosus may have phimosis, an inability to retract the foreskin. The foreskin may harden and become inflexible, and the same can occur with the skin of the glans.
Causes of Lichen Sclerosus or BXO
Lichen sclerosus is poorly recognised; reported figures likely underestimate the prevalence of this disease.
Risks of Penile Lichen Sclerosus
Men with penile lichen sclerosus or BXO are at higher risk of developing penile cancer. In addition, the progression of the disease may result in urethral strictures, inability to urinate, and bladder and kidney damage.
How PRP Treatment Works
Platelet rich plasma injection is a simple and near painless procedure which uses platelet rich plasma (PRP) drawn from your own blood to treat penile lichen sclerosus. The injection of platelet-rich plasma appears to stimulate regeneration of blood vessels, nerves and tissues.
The Lichen Sclerosus PRP Procedure
The platelet rich plasma injection is created from the patient’s own blood.
What to Expect During Your Visit
When you arrive, our staff will take you to an examination room to draw your blood.
How does platelet-rich plasma (PRP) therapy work?
Platelet-rich plasma (PRP) therapy is an innovative and promising treatment that represents a major advance in regenerative medicine.
What is the treatment for BXO?
Surgical treatment which may include circumcision and reconstructive surgery with skin grafts or flaps is sometimes necessary. Meatotomy, urethral dilation, and urethroplasty are sometimes necessary for the treatment of BXO. For many patients, surgical treatment is the only effective option available to them.
What is BXO in medical terms?
What is Balanitis Xerotica Obliterans (BXO)? Balanitis Xerotica Obliterans (abbreviated BXO) is disease-causing fibrosis and severe scarring of the foreskin, glans penis, and urethral meatus, which can lead to phimosis and urethral strictures. Lichen sclerosus of the penis or genitalia is another name for BXO.
How to contact BXO?
If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5545. We have excellent reviews from patients and their partners. Information for out-of-state and international patients.
What is the first line of treatment for tight phimosis?
Corticosteroid creams (such as 0.05% betamethasone) are usually the first-line treatment but are often ineffective, providing partial or temporary improvement in symptoms. Sometimes, the presence of BXO is not evident especially in men with tight phimosis until they are undergoing circumcision. Surgical treatment which may include circumcision ...
Can BXO cause bladder cancer?
Men with BXO are at higher risk of developing penile cancer. In addition, disease progression can lead to urethral strictures, inability to urinate, and damage to the bladder and kidneys. Circumcision is a treatment option for patients with lichen sclerosus of the penis (balanitis xerotica obliterans). It is not necessarily curative as the disease ...
Can BXO cause phimosis?
It is suspected the chronic infection and inflammation causes B XO. BXO is more commonly seen in patients with severe phimosis, whether BXO is a cause or a result of severe phimosis is not known. In a small number of men, precancerous changes or penile cancer may co-exist with BXO (lichen sclerosus).
Does balanitis xerotica obliterans heal?
Recovery after circumcision in patients with balanitis xerotica obliterans tends to be more prolonged than in patients who undergo elective circumcision for aesthetic reasons as surgical dissection tends to be more involved. Most patients heal well and are satisfied with their choice of treatment.
Is etretinate used for BXO?
Etretinate therapy has been used, but it is no longer available; acitretin is the current equivalent. Carbon dioxide laser treatment has been used. [ 37] An interesting report notes the successful use of intralesional adalimumab, a medication for psoriasis among other things, for BXO.
Does topical steroid help BXO?
Studies have shown that applying a potent topical steroid improves BXO in the histologically early and intermediate stages of disease and may inhibit further worsening in the late stages. Kiss [ 35] questioned the utility of topical steroid-based creams for the treatment of clinical BXO.
Can steroids be used for BXO?
Topical and intralesional steroids have been used. Topical steroids can offer a reliable option only in the management of mild BXO limited to the prepuce in boys with minimal scar formation. Patients and their families must have realistic expectations with regard to the success of such treatments.
How to treat BXO?
Treatment of BXO depends on the anatomic location of the lesions and their extent and severity, together with the rapidity of progression of the disease process. The treatment may vary from topical corticosteroids, laser vaporization in early cases to meatoplasty and urethroplasty in extensive cases. Topical pharmacotherapy is useful in the early ...
Why is biopsy important for BXO?
Early diagnosis and treatment of BXO are very important in preventing the urological complications of the diseases such as urethral stricture.
What are the indications for surgical treatment of a urethra?
Meatal stenosis, phimosis, scar adhesions, fissures, erosions of glans and prepuce and involvement of the urethra are indications for surgical treatment. Surgery seems to be the only treatment that can relieve the symptoms of advanced disease.
Is BXO rare?
Balanitis xerotica obliterans (BXO) is a scarcely known disease, wrongly considered rare. With a high degree of suspicion and histologic examination, the condition will prove to be much more frequent than one generally believes. The etiology of the condition is unknown at present.
Is BXO a secondary phimosis?
The etiology of the condition is unknown at present. Many cases of BXO occurring after circumcision may be cases of secondary phimosis due to BXO not being recognized at the time of surgery. Most of the cases of BXO are seen in the third to fifth decades of life, even though they may occur at the extremes of age.
What is the treatment for BXO?
The following treatment measures may be considered for Balanitis Xerotica Obliterans: Application of topical steroid creams and lotions, topical tacrolimus. Surgery to remove scar tissue.
How to treat BXO?
Circumcision may be considered after retraction of the foreskin, usually when individuals present with severe signs and symptoms. Providing reassurance and helping with anxiety feelings. Abstinence from sex, until the condition heals completely.
What are the diagnostic methods for Balanitis Xerotica Obliterans?
The following are the diagnostic methods that may be helpful for Balanitis Xerotica Obliterans: A thorough physical examination and a complete medical history is very important. Blood tests to rule out infections. Tests and examinations as required for underlying conditions or infections.
What are the symptoms of Xerotica Obliterans?
The signs and symptoms of Balanitis Xerotica Obliterans include itching and pain during urination and sex, leading to complications such as urination difficulties. Balanitis Xerotica Obliterans is observed in middle-aged men. An early diagnosis and treatment of BXO is very important to prevent irreversible damage to the penis.
What is circumcision in Xerotica?
Circumcision is the surgical removal of skin around the tip of the penis, which is also known as the foreskin or prepuce.
Can Xerotica cause pooling of urine?
The complications due to Balanitis Xerotica Obliterans may include: Difficulty in urination can cause pooling of the urine within the urethra with the potential risk of urethral stone formation. This can make urination even more difficult or painful.
What is the treatment for balanitis?
Treatment often includes antifungal creams, antibiotics, improved personal hygiene and, in some cases, circumcision.
What are the symptoms of balanoposthitis?
Signs of balanoposthitis include itching, irritation, and swollen foreskin and glans. Balanoposthitis occurs more often in males who have diabetes or a tight foreskin. Balanitis xerotica obliterans (BXO): Also called lichen sclerosus, BXO occurs when skin on the glans hardens and turns white.
What is the procedure to remove the foreskin covering the penis?
Diabetes management: If you have diabetes, your provider will show you how to manage the condition. Circumcision: If you have recurring symptoms of balanitis, your provider may recommend circumcision. Circumcision is a surgical procedure in which a provider removes the foreskin covering the penis.
