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Lichen sclerosus of the male genitalia
Article published in Urologia Polska 2008/61/1.

authors

Igor Michajłowski, Marcin Matuszewski, Jerzy Michajłowski, Michał Sobjanek, Adam Włodarkiewicz, Kazimierz Krajka
Oddział Dermatochirurgii, Katedra i Klinika Dermatologii, Wenerologii i Alergologii Akademii Medycznej w Gdańsku
Katedra i Klinika Urologii Akademii Medycznej w Gdańsku

keywords

penis, lichen sclerosus, phimosis, circumcision, diagnostics, treatment

summary

Balanitis Xerotica Obliterans (BXO) is currently regarded as a synomin of chronic lichen sclerosus affecting male genital organs, that if untreated may lead to cirrhosis of glans and prepuce. Ethiology is still unclear. Immunologic, genetic and infectious factors are taken
into consideration.. The BXO lesions can be localized on the prepuce, glans, around urethral orifice, inside the urethra or more rarely on the penile shaft or scrotum. Patients complain of difficulties in retracting prepuce or of impaired urine flow. Treatment initially
consists of topical corticosteroids, antibiotics or tacrolimus (calcineurin inhibotor). If BXO is causing phimosis, then the most popular management is circumcision with wide excision of preputial layers, especially the inner one. When the glans is invaded, the defect after removing the lesion, is may be covered with for example buccal mucosa often covered with buccal mucosa. The most challenging problem occurs if BXO affects urethra. Calibration is an option, but it very seldom gives a long-lasting effect. So usually meato- or urethro-plasty with two stages is necessary. That is why in authors opinion treatment of BXO should be performed in centers with adequate experience in urethral surgery.

references

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correspondence

Igor Michajłowski
Klinika Dermatologii, Wenerologii i Alergologii AM
ul. Dębinki 7
80-211 Gdańsk
tel. 0 513 35 00 82
igor.mich@amg.gda.pl