What is BXO?
In 1928, Stuhmer of Germany first explained the disease called Balinitis Xerotica Obliterans or BXO. BXO is also known as LSA or Lichen Sclerosus et Athropicus. The origin of the disease was not known. However, it is known to affect both male and female. The term LSA is used when the disease develops in females. On the other hand, the same term (LSA) is also used when the disease appears in males but not in the genital organs. BXO is customarily used when the disease affects the sexual organ of a male.
BXO is considered as uncommon disease and is reported to affect 6 out of 1000 males. The disease is known to affect males of all ages. Traditionally, the best treatment known for BXO is only through circumcision. However, modern medicine has offered several options for treatment. The detailed description of BXO was only provided in 1941 by Laymon and Freeman.
As described by Laymon and Freeman, the disease is characterized by hardened tissue forming a ring. At the tip of the male genital’s foreskin appears a whitish coloration. What happens with the foreskin is that its retraction is thwarted due to the hardened tissue. For differential diagnosis, immunophenotyping is effective. On the other hand, if distinct diagnosis is needed, histologic test of cutaneous biopsy is necessary.
If the biopsy result confirms that the reason for the non-retraction of the foreskin is not due to BXO, conservative treatment is recommended. However, if the biopsy result tells that BXO is present, modes of treatment may be difficult to decide.
BXO is not a simple disease but rather serious that needs immediate medical attention. If taken for granted, BXO may cause stricture of the urethra thus resulting to urine retention. Urine retention may cause some other serious disease such as infection of the urinary tract. On the other hand, there are no reports of malignant tumors developing from BXO. Since BXO is a serious disorder of the male genitalia, an individual must be given urgent medical consideration.
Treatment of BXO may be dealt with conventional or conservative type of medication. Circumcision is the conventional medical treatment applied to relieve BXO. Conventional medical treatment believes that the prepuce have no significant use for an individual. However, there are studies showing that the prepuce has special value and function. Through conservative treatment, surgical methods meant to cure BXO are now under the prerogative of doctors. Conservative treatment has been proven to cure BXO without removing the prepuce.
Several successes in the treatment of BXO have already been on records. The use of corticosteroids has been proven effective in the treatment of the disease. Moreover, the application of topical testosterone propionate ointment (Pasieczny) has been reported to be effective. Clobetasol propionate has also been reported to cure BXO. Antibiotics were recommended by Shelley and associates and are also proven to be effective. In addition, Dewan gave an account that during the early stage, the male genitalia disorder can also be effectively treated by topical steroid ointment. However, Depasquale and associates maintained that circumcision is still necessary but clobetasol cream or mometasone is still recommended.