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 .
Highly potent and moderately potent topical steroids are effective in treating phimosis: a prospective randomized study.
PURPOSE We report a prospect i ve r and omized study comparing the effects of highly potent and moderately potent topical steroids in treating pediatric phimosis . MATERIAL S AND METHODS A total of 70 boys 1 to 12 years old with phimosis were r and omly assigned to receive topical application of either betamethasone valerate 0.06 % ( a highly potent steroid ) or clobetasone butyrate 0.05 % ( a moderately potent steroid ) . Parents of the boys were instructed to retract the foreskin gently without causing pain , and to apply the topical steroids over the stenotic opening of the prepuce twice daily for 4 weeks , then for another 4 weeks if no improvement was achieved . Retractibility of the prepuce was grade d from 0 to 5 . Response to treatment was arbitrarily defined as improvement in the retractibility score of more than 2 points . RESULTS Mean treatment and followup periods were 4.3 and 19.1 weeks , respectively . The response rates in boys treated with betamethasone valerate and clobetasone butyrate were 81.3 % and 77.4 % , respectively ( p = 0.63 ) . Mean retractibility score decreased from 3.9 + /- 1.0 to 1.7 + /- 1.1 , and 4.2 + /- 1.0 to 1.9 + /- 1.0 in the betamethasone and clobetasone groups , respectively . Both steroids were effective in all age groups . Pretreatment retractibility score did not affect treatment outcomes . No adverse effect was encountered . CONCLUSIONS Highly potent and moderately potent topical steroids are of comparable effectiveness in treating phimosis . A less potent steroid may be considered first to decrease the risk of the potential adverse effects
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 .