Topical corticosteroids offer an effective alternative for treating phimosis in boys .
Although sub optimal reporting among the included studies meant that the size of the effect remains uncertain , corticosteroids appear to be a safe , less invasive first-line treatment option before undertaking surgery to correct phimosis in boys
BACKGROUND Until recently , phimosis has been treated surgically by circumcision or prepuceplasty ; however , recent reports of non-invasive treatment using topical corticosteroids applied for four to eight weeks have been favourable .
The efficacy and safety of topical corticosteroids for treating phimosis in boys has not been previously systematic ally review ed .
OBJECTIVES We aim ed to 1 ) compare the effectiveness of the use of topical corticosteroid ointment applied to the distal stenotic portion of the prepuce in the resolution of phimosis in boys compared with the use of placebo or no treatment , and 2 ) determine the rate of partial resolution ( improvement ) of phimosis , rate of re-stenosis after initial resolution or improvement of phimosis , and the rate of adverse events of topical corticosteroid treatment in boys with phimosis .
An 18-month follow-up study after randomized treatment of phimosis in boys with topical steroid versus placebo
Objective To evaluate the treatment of  phimosis  using topical steroid . Material and methods This was a follow-up study after a prospect i ve , r and omized , double-blind study . A total of 137 boys with phimosis were r and omly assigned to either betamethasone treatment or placebo for 4 weeks , with application of the cream twice daily . Non-responders to treatment were offered steroid treatment for a further 4 weeks . All patients were invited to a follow-up examination after 18 months . Results The mean pre-treatment phimosis grade s in the steroid and control groups were 5.08±0.66 and 4.97±0.70 , respectively . At the 4-week follow-up , 49 boys ( 74 % ) in the steroid group were cured , compared to only 31 ( 44 % ) in the control group . Fourteen boys were circumcised after another 4 weeks of treatment ; 43 of the remaining 57 boys ( 17 in the steroid group ; 40 in the control group ) had been cured . After a total of 92 boys took part in the 18-month follow-up study : 79 had been cured and 13 had suffered a relapse . Twenty-six patients did not took part in the follow-up investigation . No side-effects were noted . Conclusions When treatment is necessary for phimosis , we recommend application of topical steroid as first-line treatment because surgery can then be avoided in 85 % of cases . This first r and omized , double-blind , follow-up study shows that the treatment effect persists for at least 18 months
Topical corticosteroids offer an effective alternative for treating phimosis in boys .
Although sub optimal reporting among the included studies meant that the size of the effect remains uncertain , corticosteroids appear to be a safe , less invasive first-line treatment option before undertaking surgery to correct phimosis in boys
BACKGROUND Until recently , phimosis has been treated surgically by circumcision or prepuceplasty ; however , recent reports of non-invasive treatment using topical corticosteroids applied for four to eight weeks have been favourable .
The efficacy and safety of topical corticosteroids for treating phimosis in boys has not been previously systematic ally review ed .
OBJECTIVES We aim ed to 1 ) compare the effectiveness of the use of topical corticosteroid ointment applied to the distal stenotic portion of the prepuce in the resolution of phimosis in boys compared with the use of placebo or no treatment , and 2 ) determine the rate of partial resolution ( improvement ) of phimosis , rate of re-stenosis after initial resolution or improvement of phimosis , and the rate of adverse events of topical corticosteroid treatment in boys with phimosis .