Differences in preputial-colonizing bacteria between balanoposthitis and physiological phimosis

Redundant prepuce and phimosis are known risk factors for balanoposthitis. It is usually caused by retrograde infection and is related to the preputial bacterial flora. We investigated differences in the preputial bacterial flora between patients with balanoposthitis and physiological phimosis. Fifty-six male children were included in the study. Fifteen patients presented to the emergency room or outpatient department with balanoposthitis. Forty-one patients with physiological phimosis received a circumcision. Preputial swab cultures were done. Differences in age, body weight, and preputial flora between these two groups of patients were compared. Patients with balanoposthitis in this study were significantly younger. Common uropathogens were predominant in patients with balanoposthitis, whereas in patients with physiological phimosis, the main isolates were enteric flora other than common uropathogens. Patients with a body weight higher than the 50th percentile of the normal growth curve had a lower risk of balanoposthitis (odds ratio = 0.212). The preputial bacterial flora in patients with physiological phimosis may change from enteric flora to common uropathogens which are predominant in patients with balanoposthitis. Furthermore, patients at a younger age and with a lighter body weight also had increased susceptibility to balanoposthitis.