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 treatment for phimosis: time span and other factors behind treatment effectiveness.
OBJECTIVE To study the factors that may influence the effectiveness of 0.2 % betamethasone/hyaluronidase cream in the treatment of phimosis . METHODS We treated 427 patients ( 3 - 10 years old , mean 6.33 ) in a prospect i ve , r and omized , blind study , with 214 patients on a 4-week and 213 patients on an 8-week course . All patients were seen once monthly at least for 6 months after the end of treatment . The penis was photographed to allow objective evaluation of treatment response . The therapeutic response was grade d as total success when there was complete exposure of the glans ; partial success when there was exposure of half of the glans , impeded by balanopreputial adherence or ring fibrosis at the prepuce ; and therapeutic failure when patients had no or less than 50 % glans exposure . RESULTS After treatment 92.1 % of patients showed total or partial success , but during follow up ( mean 9.36 months , range 6 - 13 ) 29.5 % failed to maintain this ( 22.6 % and 37.6 % for 8- and 4-week treatment , respectively ) . During treatment , 13.6 % presented side effects or complications : prepuce ardor ( 6.1 % ) , hyperemia ( 4.6 % ) , paraphimosis ( 0.0098 % ) . Intervention or interruption of treatment was unnecessary . The two groups were statistically similar in all parameters , but time of treatment=8 weeks , previous urethral meatal exposure and no previous balanoposthitis increased the chance of total success . Surgery was indicated for failure or relapse in 181 patients ( 42.38 % ) . CONCLUSION Treatment with topical 0.2 % betamethasone/hyaluronidase cream for 8 weeks is effective and safe , especially if the urethral meatus is exposed and there is no previous balanoposthitis . Rescue treatment is not recommended , as the results were not encouraging
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 .