Conclusions Compared to the placebo or manual reduction method , the topical steroid therapy is more effective in the treatment of phimosis in children .
Although there is still controversy in the different type and dosage of steroid , this could be used against phimosis before circumcision
Abstract Purpose We evaluated a systematic review on the therapeutic efficacy of topical steroids in children with phimosis to provide data for the clinical options of pediatric phimosis .
Topical triamcinolone for persistent phimosis.
PURPOSE Between 2 % and 5 % of uncircumcised boys have persistent or pathological phimosis . Traditional treatment is usually circumcision . Recently medical treatment with topical corticosteroids has become more popular . We evaluated the efficacy of the topical steroid triamcinolone compared to foreskin retraction with an emollient cream and verified the long-term success rate of these treatments . MATERIAL S AND METHODS We performed a double-blind , r and omized , placebo controlled study to compare 2-month twice daily treatment with emollient cream ( placebo group 1 ) vs 0.1 % triamcinolone ( experimental group 2 ) . Boys between ages 3 and 12 years with persistent or pathological phimosis were included in analysis . Study EXCLUSION criteria were previous treatment with topical corticosteroid , untreated balanitis and any known medical condition with immune system impairment . Patients were seen 2 , 4 and 12 months after treatment initiation . Success was defined as complete , easy foreskin retraction at 4 and 12 months . Statistical analysis was done using Fisher 's exact test . RESULTS We enrolled 63 patients , of whom 43 completed the study . Despite multiple attempts 20 patients had incomplete followup and were excluded from study . Placebo group 1 included 25 patients and triamcinolone group 2 included 21 . In group 1 the success rate was significantly lower than in group 2 ( 9 patients or 39 % vs 16 or 76 % , p = 0.0086 ) . At 2 months 5 and 16 nonresponders in groups 2 and 1 , respectively , were treated in nonblinded fashion with topical triamcinolone . In this subgroup 1 of 3 group 2 patients and 6 of 13 in group 1 achieved complete , easy retraction . Two and 1 patients were lost to followup in groups 1 and 2 , respectively . Circumcision was required in only 5 patients ( 11.6 % ) , including 4 ( 17.4 % ) initially in group 1 . No complications were noted in either group . CONCLUSIONS Triamcinolone is a highly effective and safe short-term treatment for persistent physiological or pathological phimosis . However , at long-term followup recurrence is frequent and not rare with triamcinolone and it may require re-treatment or circumcision
Conclusions Compared to the placebo or manual reduction method , the topical steroid therapy is more effective in the treatment of phimosis in children .
Although there is still controversy in the different type and dosage of steroid , this could be used against phimosis before circumcision
Abstract Purpose We evaluated a systematic review on the therapeutic efficacy of topical steroids in children with phimosis to provide data for the clinical options of pediatric phimosis .