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 .
Topical steroid treatment of phimosis in boys.
PURPOSE We evaluate whether steroid application alone or retraction and hygiene are responsible for successful results in boys treated with topical steroids for phimosis . MATERIAL S AND METHODS A prospect i ve study was performed , which included a control group of 42 patients with phimosis seen at our outpatient department from January to June 1997 . During that time we trained the parent to retract and clean the foreskin only . From July 1997 to June 1998 topical steroid cream was prescribed in addition to retraction and hygiene in 276 boys with phimosis . All cases were divided into 3 subgroups of asymptomatic , symptomatic and buried penis . RESULTS The response rate was greater than 95 % in patients who received topical steroid treatment in addition to improved hygiene . Only 13 boys ( less than 5 % ) had no response to steroid treatment . Of the control patients 23 ( 55 % ) had no response to gentle retraction and personal hygiene . There was a significant difference ( p<0.001 ) in response rate between the study and control groups . However , the subgroup with a buried penis responded poorly to  steroid , retraction and hygiene treatment .  There was significant difference ( p<0.001 ) in response rate between the buried penis and other steroid groups but no significant difference ( p>0.05 ) in the control group . CONCLUSIONS Phimosis is a physiological condition in neonates due to natural adhesion between the foreskin and the glans . Chronic infection due to poor hygiene is responsible for most cases of childhood phimosis . Circumcision is the traditional treatment of choice for phimosis or unretractable foreskin , although it is not always desired by parents or surgeons . Topical steroid cream is an easy , safe and nonsurgical alternative for phimosis . However , boys with a buried penis are not good c and i date s for steroid treatment
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 .