Effect of Topical Steroid on Non-retractile Prepubertal Foreskin by a Prospective, Randomized, Double-blind Study

Lund, Lars H.; Wai, K. H.; Mui, L. M.; Yeung, Chung Kwong

doi:10.1080/003655900750042013

Cited by 43 publications

(28 citation statements)

References 9 publications

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“…The clinical treatment of the phimosis with topic corticosteroids is well accepted by the parents, since it is a simple procedure, presents low costs and risks, no side effects and a good compliance to the treatment when the guardians of the patients are well oriented (14,15). In our studies we did not have reports of signifi cant side effects and all fi fty-three patients submitted to clinical treatment completed the six weeks of treatment.…”

Section: Discussionmentioning

confidence: 63%

“…The success rate of the phimosis topic treatment with corticosteroids is signifi cant, with satisfactory results (67%-95%) (8)(9)(10)14,15). The success rate of the topical treatment of the phimosis is lower when smaller concentrations of betamethasone are used (21).…”

Section: Discussionmentioning

confidence: 94%

“…The most common used topical treatments were betamethasone, clobetasol, diclofenac sodium, mometasone furoate 0.05% and triamcinolone acetate (10,12,13). Recent randomized prospective studies have confi rmed that topical use of corticosteroids as treatment for phimosis is superior to placebo (14,15).…”

Section: Introductionmentioning

confidence: 99%

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Structural analysis of the phimotic prepuce in patients with failed topical treatment compared with untreated phimosis

et al. 2012

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Objectives: To evaluate histological alterations in prepuce of patients with phimosis submitted to topic treatment with betamethasone in association with hyaluronidase. Materials and Methods:We studied sixty patients (mean age 4.5), presenting true phimosis and treated with a topical treatment with betamethasone cream (0.2%) + hyaluronidase. The parents of seven of these patients opted for circumcision (control group). The other fi fty-three patients were submitted to clinical treatment. The samples were stained with Weigert's resorcin-fuchsin (analysis of the elastic fi bers) and Picro-Sirius Red, for analysis of the collagen. The volumetric density of the elastic fi bers was determined by stereological methods. Results: Only eight (15%) of the fi fty-three patients submitted to topical treatment presented failure, being indicated for circumcision (histological analysis). We observed an increase of the collagen type III of the patients submitted to topical treatment. The quantifi cation showed a reduction of the volumetric density of the prepuce's elastic fi bers of the patients submitted to the cream treatment, when compared to the control group (p = 0.056). The volumetric density of the elastic fi bers of the prepuce at the group not submitted to topical treatment showed an average of 14.60% (11.06 to 21.64%); in the group submitted to the cream treatment, the volumetric density of the elastic fi bers of the prepuce showed an average of 10.34% (3.45 to 17.9%). Conclusion:The topical treatment of phimosis with betamethasone 0.2% + hyaluronidase had a success rate of 85%. Patients with failure of the topical treatment with steroid had histological alterations in the prepuce.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 94%

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Structural analysis of the phimotic prepuce in patients with failed topical treatment compared with untreated phimosis

et al. 2012

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“…2 Another randomized controlled study by Lund et al in 2000 quoted a success rate of 74%. 13 Various other studies been done. All together they show success rates varying between 67% to 90% with a mean of around 85%.…”

Section: Discussionmentioning

confidence: 99%

“…Another option which has been evaluated is local steroid cream therapy, which loosens the tight foreskin. [9][10][11][12][13][14] This is applied for a period of six weeks and has shown good response.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Neosporin hydrocortisone cream versus preputial dilatation in children with phimosis: a comparative study

Ainippully¹,

Preeth²,

Somnath³

2017

Int Surg J

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Background: Physiological phimosis, a common complaint in the pediatric surgery outpatient department presenting as non-retractile foreskin is due to adhesions between the inner layer of the prepuce with glans penis or due to tight tip of the prepuce. These patients are managed with circumcision, preputial dilatation. In this study, we compare different outcomes measures in children treated with dilatation and those with application of Neosporin-hydrocortisone ointment.Methods: This prospective comparative study was conducted in the department of pediatric surgery outpatient department between 2015 and 2017. We followed up 50 patients who underwent only dilatation and other 66 patients who were advised to apply only hydrocortisone impregnated antibiotic cream twice daily over a period of six weeks. We recorded basic demographic features, parent anxiety, parental compliance, parent satisfaction, complete response and persistence of phimosis at the end of the treatment. All statistical tests were done using R statistical software.Results: Of the 116 children recruited to the study, 50(43%) belonged in the dilatation group and rest (66%) to the Neosporin-hydrocortisone (NH) group. The median age of the patients was 36 with inter-quartile range (23-48) months. Baseline characteristics were comparable across the groups. At the end of six weeks, there was statistically significant difference between the two groups with regard to all outcome measures namely parent compliance, parent satisfaction, symptom resolution with the NH group showing a better result (P value<0.0001). Moreover, Phimosis persisted in 18 (36%) of the patients treated with dilatation compared to 4 (6%) in Neosporin hydrocortisone ointment group which was statistically significant.Conclusions: Present study shows that local application of Neosporin-hydrocortisone ointment is a better alternative to using the painful preputial dilatation in children with phimosis.

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Topical corticosteroids for treating phimosis in boys

Moreno

Corbalán

Peñaloza

et al. 2014

Cochrane Database of Systematic Reviews

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Effect of Topical Steroid on Non-retractile Prepubertal Foreskin by a Prospective, Randomized, Double-blind Study

Abstract: when treatment is necessary, application of topical steroid as a first line of treatment may avoid surgery in almost 90% of cases.

Cited by 43 publications

References 9 publications

Structural analysis of the phimotic prepuce in patients with failed topical treatment compared with untreated phimosis

Structural analysis of the phimotic prepuce in patients with failed topical treatment compared with untreated phimosis

Efficacy of Neosporin hydrocortisone cream versus preputial dilatation in children with phimosis: a comparative study

Topical corticosteroids for treating phimosis in boys

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