These guidelines have been produced to guide clinical decision making for general practitioners (GPs). They are not strict protocols. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline.


Urinary retention secondary to Balanitis requires immediate referral to the nearest Emergency Department.


  • Balanitis is an inflammation and infection of the glans and foreskin.
  • This can be a result of poor hygiene or associated with other causes including urine trapping, irritation from soaps or forcible retraction of the foreskin.
  • A non-retractable foreskin is a normal condition in early childhood with the foreskin naturally separating from the glands and becoming retractile by 5 years of age.

Pre-referral investigations

Physical examination.

Pre-referral management

  • Balanitis may require antibiotic therapy – see Balanitis - ED guideline for antibiotic choice.
  • Salt baths may be beneficial.
  • Education around hygiene and necessity to abstain from forcibly retracting the foreskin.

When to refer

  • A specialist referral is not required for simple balanitis.
  • Recurrent balanitis should be referred via Central Referrals Service pathway. 
  • Refer to the nearest Emergency Department if the patient is in urinary retention. 

How to refer

Essential information to include in your referral

  • Patient demographics including next of kin and contact details.
  • Number of episodes of balanitis, frequency and treatments trialled.

Useful resources

Reviewer/Team: Mr Gera, HoD General Surgery, PCH Last reviewed: Sep 2021

Next review date: Sep 2024
Endorsed by:
Fast track approval Date:  Sep 2021

This document can be made available in alternative formats on request for a person with a disability.

Referring service