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 .
The response of balanitis xerotica obliterans to local steroid application compared with placebo in children.
PURPOSE We evaluated the clinical effectiveness of topical steroid application for balanitis xerotica obliterans in children and analyzed the association of any clinical response with histological findings . MATERIAL S AND METHODS Our double-blind , placebo controlled , r and omized study included 40 boys in whom balanitis xerotica obliterans was diagnosed clinical ly by cicatricial phimosis . The severity of phimosis was grade d into 4 groups . Patients were r and omized to receive the topical application of 0.05 % mometasone furoate or placebo . After 5 weeks phimosis severity was reevaluated and all patients underwent circumcision . Surgical specimens were histologically typed as an early , intermediate or late form of balanitis xerotica obliterans . RESULTS Seven patients were withdrawn from the study . In the steroid group 7 boys had clinical improvement and 10 had no change . Histological study showed an early , intermediate and late form of balanitis xerotica obliterans in 5 , 5 and 7 cases , respectively . Of cases with clinical improvement 5 were the early and 2 the intermediate type . In the placebo group 5 cases worsened clinical ly and 11 did not change . Histological evaluation revealed an early , intermediate and late form of balanitis xerotica obliterans in 3 , 7 and 6 boys , respectively . Of the 5 cases with histological worsening , disease was the early , intermediate and late type in 2 , 2 and 1 , respectively . CONCLUSIONS Applying a potent topical steroid affects improvement in balanitis xerotica obliterans in the histologically early and intermediate stages of disease , and may inhibit further worsening in the late stage
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 .