Balanitis code according to ICD 10 in children. What is acute balanitis and balanoposthitis in men and why are they dangerous? Treatment of gangrenous balanoposthitis

Balanoposthitis is an inflammatory process affecting the foreskin and glans penis. Experts distinguish between 2 pathological conditions - balanitis and posthitis. However, in clinical practice, in the vast majority of cases, they are present simultaneously (contact of the inner layer of the foreskin with the head promotes the spread of inflammation to these adjacent structures), and therefore are combined into one diagnosis.

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Origin of the disease

This disease is inflammatory in nature. It occurs when two factors are present simultaneously:

presence of a pathogen;
favorable conditions for the development of the disease.

Pathogens

Infectious agents that are the direct cause of the development of the pathological process in most clinical cases are:

staphylococci;
streptococci;
gardnerella;
fungi of the genus Candida.

Often, increased proliferation of pathogenic bacteria is facilitated by non-compliance with hygiene rules.

Contributing Factors

Inflammation does not occur on its own. Conditions favorable for the development of the inflammatory process are created in the body in the following cases:

Phimosis (pathological narrowing of the foreskin).
Mechanical injuries (abrasions, abrasions, reaction to irritation).
STD.
Skin pathologies that entail a violation of the integrity of the skin of the genital organ (psoriasis, contact dermatitis, lichen).
Skin hypersensitivity, which occurs when the body is prone to allergies.
Immunodeficiency states of any origin (after a course of chemotherapy, diabetes mellitus, HIV infection).

Classifications

According to the international classification, balanoposthitis, which has ICD-10 code N48. 1, classified as a group of diseases of the male genital organs (N48).

There are several classifications of balanoposthitis:

Each of the forms has its own typical characteristics (course, symptoms).

Clinical manifestations

The clinical picture of balanoposthitis has both manifestations common to all forms and characteristic of each form of the disease.

The main symptoms suggestive of the disease:

Feeling of discomfort, itching and burning in the area of the head of the penis.
Swelling and hyperemia of the skin.
Accumulation of discharge in the preputial space.
Painful sensations during sexual intercourse (dyspareunia).
In some cases - erosive and ulcerative changes.

Flow option	Clinical picture
Simple balanoposthitis	Hyperemia and swelling of a diffuse nature. Maceration of the skin with further development of foci of erosive lesions with purulent discharge. Subjectively, the patient feels itching and burning
Erosive balanoposthitis	Severe swelling, especially in certain areas. After swelling of the epithelium, painful erosions are formed, which are large in size, have a bright red tint and a zone of maceration in the periphery. Complications such as phimosis may develop. Regional lymphadenitis often occurs
Gangrenous balanoposthitis	Characterized by the presence of general symptoms in the form of weakness and febrile syndrome. The head and foreskin are sharply swollen and hyperemic, against this background deep painful, slowly healing ulcers develop, which are purulent-necrotic in nature. A typical complication is phimosis. Possible perforation of the foreskin

Diagnostics

To make a diagnosis of balanoposthitis, it is necessary to conduct the following examination:

Type of study	Diagnostic value
General blood analysis	Shows the presence of an inflammatory process in the body. Based on changes in the leukocyte formula, one can make an assumption about the nature of inflammation
Biochemical blood test	Registers the concentration of protein in the blood, reflects the state of the functions of internal organs
Bacteriological examination of urethral discharge and erosive-ulcerative elements	In this way, the infectious agent that caused the inflammatory process is isolated
Blood testing for the presence of HIV or antibodies to it	Is required. Carried out using polymerase chain reaction (PCR) or enzyme-linked immunosorbent assay (ELISA) techniques

In all cases of balanoposthitis, it is necessary to exclude syphilitic infection (using serological tests).

Treatment with folk remedies can be used as an auxiliary therapy, but you should not rely on it as the main method of treatment.

The main symptoms of acute balanoposthitis: sharp pain localized on the glans penis, burning sensation, swelling of the glans and foreskin, itching, redness. Inflammation can affect both the entire head and its individual sections.

Forms

The main forms of acute balanoposthitis according to the severity of the lesion:

Simple balanoposthitis - causes redness, swelling, burning and itching of the glans penis and foreskin. In some cases, patients develop a purulent or grayish coating with an unpleasant odor and erosion on the head of the penis.
Erosive balanoposthitis - unlike simple balanoposthitis, this form is characterized by deep inflammation. The patient develops swollen, inflamed white growths that lead to skin tears. Multiple erosions occur on the head of the genital organ, which can be covered with pus. Due to the inflammatory process, it is impossible to open the head of the penis. The inflammatory process may involve the inguinal lymph nodes and lymphatic vessels of the penis.
Gangrenous balanoposthitis is the most severe and most dangerous form of inflammation. The patient experiences an increase in body temperature to 39 degrees, symptoms of intoxication, increased sweating, lack of appetite, low blood pressure and high pulse. Due to severe swelling and redness, deep bleeding wounds with purulent discharge appear on the genital organ.

Despite such painful and pathological symptoms, acute balanoposthitis can be treated normally. There is no single treatment regimen for the disease, so treatment depends on the stage of balanoposthitis and the characteristics of the patient’s body. As a rule, the acute form is infectious in nature and appears due to streptococcal or staphylococcal microorganisms. The danger of this form of balanoposthitis is that in advanced cases, surgical intervention, that is, circumcision, is possible.

Simple balanoposthitis

Simple balanoposthitis is the primary form of an infectious and inflammatory disease. Primary balanoposthitis appears due to the action of decaying smegma on the skin of the foreskin and head of the penis. The main symptoms of this form of balanoposthitis are itching, burning, redness of the head of the genital organ, swelling of the foreskin, bloody wounds and small ulcers, possibly an increase in the amount of discharge and the appearance of an unpleasant odor. In advanced cases, simple balanoposthitis progresses to more serious stages, causing fever, purulent discharge and other painful symptoms.

At the first symptoms of the disease, you must seek medical help. The urologist diagnoses simple balanoposthitis and prescribes a treatment regimen. As a rule, treatment is not complicated and consists of washing the genital organ with special solutions and lubrication with anti-inflammatory drugs.

Erosive balanoposthitis

Erosive balanoposthitis is an inflammatory process that occurs on the head of the penis.

With the erosive form of balanoposthitis, the patient develops areas of dead epithelium with white bumps on the penis, which peel off and turn into erosive areas. Without timely treatment, this form of the disease can lead to phimosis and damage to the inguinal lymph nodes. In addition, without treatment, the erosive form can turn into the gangrenous form of balanoposthitis.

Gangrenous balanoposthitis

Gangrenous balanoposthitis, as a rule, develops against the background of a feverish state and general weakness of the body. The patient develops deep purulent ulcers and dead areas of the epithelium, swelling and redness of the foreskin and head of the penis, as well as pain. Gangrenous balanoposthitis causes phimosis and the formation of through ulcers of the foreskin, which heal very slowly.

Diagnosis of balanoposthitis causes pain and discomfort, but is a complex of methods. The urologist identifies the cause of the disease and possible concomitant diseases. Diagnostic tests allow you to determine the causative agent of the disease and conduct an examination of the genitourinary organs.

Treatment of acute balanoposthitis

Treatment of erosive balanoposthitis

Treatment of erosive balanoposthitis depends on the stage of the disease at which the patient sought medical help. So, in the initial stages, the entire treatment process may consist of lotions and medicinal baths. But if erosive spots appear, the patient is prescribed antibiotics. In case of pathological narrowing of the foreskin, the urologist performs surgical excision. If the disease is detected in a timely manner, then treatment does not take much time, and balanoposthitis itself does not leave consequences.

Treatment of erosive balanoposthitis is recommended by washing with potassium permanganate solutions. After the therapeutic bath, a thin layer of cotton wool or gauze soaked in Lapis solution is applied to the affected organ. You can use a powder made from antibacterial drying powders - Dermatol, Xeroform. If the erosive form is complicated by phimosis, then solutions of potassium permanganate and silver nitrate are used to wash the cavity of the preputial sac, 2-3 times a day.

An uncomplicated form of erosive balanoposthitis is treated with rinsing and baths with potassium permanganate. The use of disinfectant drying ointments is mandatory. If erosive balanoposthitis has a complex form, then the urologist prescribes antibiotics to the patient and rinsing the penis with hydrogen peroxide. In extreme cases, the urologist refers the patient to excision of the foreskin. Timely treatment of erosive balanoposthitis leaves no consequences and does not cause complications.

Treatment of gangrenous balanoposthitis

Treatment of gangrenous balanoposthitis depends on the cause that caused it, the stage of the disease and the individual characteristics of the patient’s body. Modern techniques allow you to quickly and effectively cure balanoposthitis. Treatment of the gangrenous form is mandatory, since balanoposthitis can lead to narrowing of the foreskin, inguinal lymphadenitis, gangrene of the penis and scar complications. Patients are prescribed antimicrobial drugs, creams and ointments. If the disease is diagnosed at an early stage, then treatment consists of using medicinal baths and washing the glans penis.

It is important to know!

Among many inflammatory diseases, balanitis occupies a special place. Firstly, this is a disease that affects only the strong half of humanity. Secondly, the source of inflammation is localized in the area of the head of the genital organ, which greatly increases the problem in the eyes of men.

Balanoposthitis- inflammation of the skin of the glans and inner layer of the foreskin of the penis.

Code according to the international classification of diseases ICD-10:

N48.1

Causes

Etiology: more often a banal infection (staphylococci, streptococci, fusospiripillosis symbiosis, yeast fungi); Often infection occurs through sexual contact. The development of balanoposthitis is favored by general diseases that weaken the natural resistance of the skin to xaprophytic flora (diabetes mellitus, anemia, hypovitaminosis, allergic diseases), local predisposing factors (narrowness of the foreskin, purulent discharge from the urethra, lack of hygienic care).

Symptoms (signs)

Clinical picture. There are simple, erosive and gangrenous balanoposthitis. Simple balanoposthitis is characterized by diffuse redness, swelling and maceration of the skin of the head and inner layer of the foreskin, followed by the formation of superficial isolated and confluent erosions of various sizes and shapes with purulent discharge, surrounded by scraps of macerated epithelium. Subjectively - mild burning and itching. Erosive balanoposthitis is characterized by the formation of white swollen areas of dead epithelium, and then large, sharply demarcated bright red painful erosions with a rim of maceration along the periphery. The process may be complicated by phimosis. Painful regional lymphangitis and inguinal lymphadenitis are often observed. After regression of simple and erosive balanoposthitis, no traces remain. Gangrenous balanoposthitis is accompanied by fever and general weakness. Deep painful purulent-necrotic ulcers of various sizes appear against the background of severe swelling and redness of the head and foreskin. As a rule, phimosis develops; Possible perforation of the foreskin. Ulcers heal slowly. In all cases of balanoposthitis, it is necessary to exclude syphilis (tests for Treponema pallidum, serological tests, confrontation).

Treatment

Treatment. For simple and erosive balanoposthitis, local disinfectant and anti-inflammatory therapy is sufficient (warm baths with potassium permanganate, ointments - 1% decamine, Lorinden - S, Hyoxyzon, Dermozolon, 10% xeroform, powders - dermatol, xeroform). For gangrenous balanoposthitis, phimosis and lymphadenitis, oral antibiotics are additionally prescribed.

Prevention.

Treatment general and local disorders favoring the development of balanoposthitis. Personal hygiene is necessary.

Diagnosis code according to ICD-10. N48.1

The diagnosis of balanoposthitis according to the International Statistical Classification, Tenth Revision (ICD-10), adopted by Russia in 1999, belongs to class 14 of diseases.

If you decipher the digital and alphabetic ICD 10 codes used for designations in medical documents, then balanoposthitis refers to urology. In the ICD 10 registry, balanoposthitis is registered under code N48.1

Urology is the clinical discipline concerned with the urinary organs. Therefore, in case of inflammation of the glans penis and its foreskin, men should consult a urologist. After all, they are the ones who diagnose and treat diseases of the penis.

In order not to make a mistake in diagnosis, it is first necessary to distinguish the symptoms from other diseases that are similar in clinical picture.

Preventing disease is the wisest decision. So what should be done to prevent balanoposthitis:

Stop promiscuity. If this is contrary to your principles, then during intimacy you must use barrier contraception.
The best prevention of diseases of the genital area will be an annual scheduled examination by a urologist, and of the sexual partner by a gynecologist.
Personal hygiene using neutral detergents that cannot cause allergies is the main principle of preventive measures.
Do not overuse antibiotics and hormonal drugs.
Control and prevention of increased blood glucose levels.

Incubation period of balanoposthitis
Men who have promiscuous sexual intercourse without barrier contraception or in the event of a condom breaking during sex with a casual...

Purulent balanoposthitis in a child

Purulent balanoposthitis in a child develops due to inflammatory damage to the head and foreskin of the penis. The peculiarity of purulent balanoposthitis in comparison with other forms of inflammation is that the disease affects the inner layer of the foreskin and can be a complication of phimosis. Complete narrowing of the foreskin causes stagnation of urine and smegma, which become infected and suppurate.

The first symptom of purulent balanoposthitis is itching, burning, swelling and redness of the head of the penis. The child feels pain when trying to urinate, and purulent discharge appears with a very unpleasant odor. The main causes of the disease are staphylococcal and streptococcal microorganisms, yeast fungi. The type of treatment depends on the type of pathogen. Therefore, the urologist conducts diagnostics to obtain complete information about the causes and pathogens of purulent balanoposthitis.

Purulent inflammation can be provoked by various types of allergic reactions, narrowness of the foreskin, and failure to comply with personal hygiene rules. The main method of treating purulent balanoposthitis in a child is circular excision of the foreskin, that is, circumcision. In particularly severe cases, the child undergoes skin grafting, which is aimed at expanding the ring of the foreskin.

Balanoposthitis in a newborn

Balanoposthitis occurs very often in a newborn. The inflammatory process causes swelling of the head of the penis, causing restless behavior and pain in the baby. The appearance of the disease is associated with harmful microorganisms that are found in the intestines or on the skin of the newborn (Proteus, E. coli, staphylococci, Candida yeast).

The foreskin of a newborn is very different from the foreskin of an adult male. This is due to the fact that after birth for some time, the head and foreskin of the child are a single system, that is, the head cannot be opened, since it is completely attached to the penis. As the baby grows, this fold of skin moves away. All this suggests that newborns are born with phimosis. Therefore, the first cause of balanoposthitis in a baby is the parents’ attempts to open the head on their own. This leads to tears in the skin and infection. Balanoposthitis can occur due to infrequent diaper changes and bathing the baby in baths with foam and other irritants.

The main symptom of inflammation is swelling and redness, and in some cases, blue discoloration of the glans penis. Sometimes the child develops rashes. The baby turns from calm to capricious and fussy. Also, parents may notice that when changing a diaper, diaper rash appears in the folds of the baby’s skin, which does not disappear after using special creams and powders. Another symptom of balanoposthitis in a newborn is damage to the oral mucosa. It seems as if there are small clots of milk left in the mouth. Stomatitis can also cause inflammation of the genital organs in a newborn.

Treatment of balanoposthitis in a newborn is carried out under the supervision of a pediatrician with strict adherence to all rules and requirements. As a rule, the therapy is conservative; the baby’s penis is washed with herbal infusions, decoctions and disinfectants. It is mandatory to maintain genital hygiene in order to prevent relapses of the disease.

Balanoposthitis in infants

Balanoposthitis in infants is not uncommon, since boys under five years of age are susceptible to infectious and inflammatory diseases of the genital organs. Balanoposthitis can appear due to phimosis, poor hygiene of the preputial sac and other infectious lesions. The disease causes redness of the foreskin and head of the genital organ, small ulcers and erosion of the epithelium.

A short frenulum of the penis in combination with phimosis can also provoke the appearance of balanoposthitis. Due to the impossibility of completely exposing the head of the penis, inflammatory diseases and even tumors develop. As the child grows, a short frenulum will create discomfort, and in adulthood it will cause problems during sexual intercourse and with erection. Abnormalities of this kind in infants cause balanoposthitis, and therefore require not only medical therapy to eliminate inflammation, but also surgical intervention.

Balanoposthitis in boys

Balanoposthitis in boys is a disease of the genital organs that occurs due to the action of yeast fungi, streptococcal and staphylococcal microorganisms. In medical practice, there are two forms of balanoposthitis: primary and secondary. Primary occurs due to infection, and secondary, as one of the symptoms of chronic diseases. Inflammation requires immediate treatment, since without appropriate therapy, the disease causes complications and negative consequences, and can also become recurrent or chronic.

Symptoms of balanoposthitis in boys are accompanied by swelling and hyperemia of the glans and foreskin of the penis, causing severe itching and burning in the groin area. The child becomes restless, experiences pain when urinating and trying to open the head of the penis, and sometimes the body temperature rises. If balanoposthitis is not treated in time, the disease will lead to cicatricial phimosis and infection of the genitourinary system, which will have a very negative impact on the functioning of the reproductive system of the future man.

Acute balanoposthitis in children

Acute balanoposthitis in children, as a rule, begins suddenly, that is, for no apparent reason at first glance. A previously healthy child experiences pain in the penis area and when trying to urinate. Swelling and hyperemia appear on the foreskin. The child develops yellow or white purulent discharge. Acute balanoposthitis in children causes fever, anxiety and general weakness.

Despite such striking symptoms, treatment of the acute form of balanoposthitis does not present any difficulties. The duration of relief of the inflammatory process takes 2-3 days. As a rule, the child is prescribed baths with chamomile decoction or furatsilin. In treatment, ointments with a drying and bactericidal effect are used. It is important to follow the rules of hygiene to prevent the occurrence of the disease in the future.