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 .
High incidence of balanitis xerotica obliterans in boys with phimosis: prospective 10-year study.
This prospect i ve study was design ed to address the incidence and clinical and histologic characteristics of balanitis xerotica obliterans in a large r and om pediatric population with phimosis . We investigated 1178 boys who presented consecutively with phimosis between 1991 and 2001 . All patients who underwent complete circumcision and surgical specimens  were typed histologically as early , intermediate , or late forms of this disorder or as nonspecific chronic inflammation . Patients with balanitis xerotica obliterans were controlled at 1 , 6 , and 12 months postoperatively , then yearly . Balanitis xerotica obliterans was found in 471 of the 1178 patients ( 40 % ) , with the highest incidence in boys aged 9 to 11 years ( 76 % ) . Secondary phimosis occurred in 93 % of boys with balanitis xerotica obliterans and in 32 % of those without the disorder . In six instances of balanitis xerotica obliterans , meatotomy and in one meatoplasty was performed , as well as circumcision . On histologic evaluation , we found 19 % had early , 60 % intermediate , and 21 % late form of balanitis xerotica obliterans . Glanular lesions disappeared completely within 6 months in 229 out of 231 patients . Our data strongly suggest that the true incidence of childhood balanitis xerotica obliterans is higher than previously assumed . Its incidence peaks in the 9 to 11 years age group , in whom secondary phimosis was almost exclusively caused by balanitis xerotica obliterans
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 .