Efficacy of topical steroid treatment in children with severe phimosis in China: A long‐term single centre prospective study

Zhou, Guanglun; Jiang, Man; Yang, Zhilin; Xu, Wei; Li, Shoulin

doi:10.1111/jpc.15628

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…7 Another prospective study carried out in China in 2021 among 1499 patients, long-term success rate of steroid therapy was 66.0% over a mean follow-up of 26.9 months with 65.7% of patients responding favorably to treatment by the end of 2 weeks. 8 The different modalities of treatment for phimosis apart from topical steroids include circumcision, manual retraction therapy, dorsal slit with transverse closure, preputioplasty, frenulotomy and meatoplasty among others. 4 Scarred foreskin appearance, which is present in the spectrum of pathological phimosis, usually warrants circumcision.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Medical Management of Phimosis in Pediatric Patients: A Descriptive Cross Sectional Study

Bajracharya,

Thapa,

Oli

et al. 2024

Nep. Med. Coll. J.

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Phimosis is considered virtually universal in newborn males. Circumcision is mostly done for unresolved phimosis. There is a stream of evidence that suggests steroid cream application is effective in these children prior to any surgical decision. A cross-sectional descriptive study from October 2021 to November 2022, was designed to include all cases of phimosis in male children up to 15 years of age. Caregivers of the patients were counseled and advised for management with hydrocortisone 1.0% ointment twice a daily and follow up in 2 weeks. The resolution rates were noted in 2 weeks and 4 weeks and unresolved children were counseled for either continuation of medical management or circumcision. Electronic registry was used to enroll all the cases and note the outcomes. A total of 146 boys were evaluated. Median age of presentation was 4 years, 113 children (77.4%) were successfully treated with medical therapy and only 33 children (22.6%) had failed medical therapy requiring circumcision. A total of 66 children (58.4%) required only 1 followup for resolution of phimosis. By contrast, 47 children (41.6%) required more than 1 follow-up for resolution. Topical steroid in treatment of phimosis is a very safe, effective, inexpensive and easy approach that attenuates the need for surgical intervention. The response rate is very high and adverse effects are minimal. In the developing world, medical therapy can thus be more feasible of an option as compared to surgery.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Medical Management of Phimosis in Pediatric Patients: A Descriptive Cross Sectional Study

Bajracharya,

Thapa,

Oli

et al. 2024

Nep. Med. Coll. J.

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“…Corticosteroid therapy has been introduced by Kikiros and colleagues ( 2 ) in the early 1990s as a conservative alternative treatment for phimosis. Such treatment is performed by the patient over a period of 4 to 8 weeks with application of the cream on the tip of the foreskin opening with gentle and progressive stretching of the prepuce over the glans, with an aim to stimulate the growth of the foreskin and its expansion over time ( 14 , 15 ). This form of phimosis treatment has been extensively studied and applied over the past three decades and has been effective in 71.1–91.1% of cases with a recurrence rate of up to 29.5% ( 10 , 14 - 17 ).…”

Section: Discussionmentioning

confidence: 99%

Novoglan device for treatment of adult phimosis: Novoglan-01 open-label clinical trial on safety, efficacy and tolerability

Chung¹,

Polikarpov²,

Mazure³

et al. 2023

Transl Androl Urol

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Background At present, the only definitive treatment for adult phimosis is circumcision, which is a surgical removal of the prepuce. Novoglan is a novel device that could offer patients with phimosis an alternative to surgery. It is based on application of custom-moulded balloons for gradual skin remodelling and prepuce dilatation. This open-label clinical trial aimed to investigate the safety, efficacy and tolerability of the Novoglan treatment. Methods A prospective trial was conducted on 20 patients with adult phimosis recruited at Macquarie University Hospital and Princess Alexandra Hospital. After eligibility screening and enrolment, patients were provided with the Novoglan product and training. The treatment involved twice daily 10-minute applications for a duration of 4–8 weeks with patient’s degree of phimosis assessed before and at 6–8 weeks after the initiation of the treatment. Participants were also asked to complete questionnaires aimed to assess the safety and tolerability of the Novoglan treatment. Results The treatment was successful with improved foreskin retraction in 90% of patients and all patients achieving full foreskin retraction after the treatment. Ninety-five percent of patients reported reduced level of anxiety, and over 60% of patients reported reduced pain/discomfort during sexual activity or in general. Similarly, 95% of patients were moderately-to-very satisfied with the treatment and would recommend Novoglan to others. No adverse events were observed and only 15% of participants reported minor side effects. Conclusions The Novoglan-01 trial demonstrated high safety, efficacy and tolerability of the Novoglan treatment for adult phimosis and its high potential as a conservative alternative to circumcision or steroid cream treatment. Trial Registration The Novoglan-01 study has been registered with the Australia and New Zealand Clinical Trial Registry under the reference ACTRN 1262 10009 24853, dated 15 July 2021.

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“…Second, success was defined as downgrading of phimosis to grade 0–1, while downgrading of phimosis to grade 2–3 was not considered successful because this may have occurred due to self-remission of phimosis. Third, all the included patients were symptomatic, especially those with a history of recurrent balanoposthitis, which might affect the therapeutic effect ( 11 ). Finally, the efficacy of topical steroid treatment was evaluated at 3 months and the recurrence rate of phimosis was 5.4%; by contrast, previous studies did not perform follow up or followed up patients for only 4–8 weeks ( 4 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

“…Further, friction between patients' clothing and the penis might easily wipe the cream away from the outer prepuce, which would reduce the curative effect of grade 5 phimosis. Moreover, the worse outcome of patients with grade 5 phimosis may be due to more severe scarring in these patients compared to those with grade 4 phimosis ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

The efficacy of topical 0.1% mometasone furoate for treating symptomatic severe phimosis: A comparison of two treatment regimens

et al. 2022

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BackgroundTwice daily 0.1% mometasone furoate is an effective treatment for phimosis in children. However, mometasone furoate has an important therapeutic advantage because it is effective in once-daily applications. This study was to compare the efficacy of two different topical 0.1% mometasone furoate regimens for the treatment of symptomatic severe phimosis in pediatric patients.MethodsA total of 1,689 patients with symptomatic severe phimosis classified by the Kikiros system were prospectively enrolled in the study from March 2018 to February 2021. A total of 855 patients received 0.1% mometasone furoate twice-daily (BID group) and 834 patients received 0.1% mometasone furoate once-daily (QD group) for 4 weeks.ResultsA total of 1,595 boys completed the treatment (798 and 797 in the BID and QD groups, respectively). The success rate of the BID group was higher than that of the QD group at the end of week 2 (44.8% vs. 33.3%, P < 0.05), while there was no difference in the success rate at 4 weeks and 3 months between the two groups (70.7% vs. 69.7%, and 66.8% vs. 64.9%, respectively) (P > 0.05). In both treatment groups, the success rate of grade 5 phimosis was lower than that of grade 4 at 2 weeks, 4 weeks, and 3 months. A total of 83 patients experienced recurrence of phimosis. Only fifteen patients had local mild adverse drug reactions.ConclusionTopical application of 0.1% mometasone furoate once-daily or twice-daily for 4 weeks had comparable efficacy in children with symptomatic severe phimosis. A once a day regimen may be more suitable for children. Topical steroid application is more effective in children with low-grade phimosis than those with high-grade phimosis.

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Efficacy of topical steroid treatment in children with severe phimosis in China: A long‐term single centre prospective study

Cited by 4 publications

References 26 publications

Evaluation of Medical Management of Phimosis in Pediatric Patients: A Descriptive Cross Sectional Study

Evaluation of Medical Management of Phimosis in Pediatric Patients: A Descriptive Cross Sectional Study

Novoglan device for treatment of adult phimosis: Novoglan-01 open-label clinical trial on safety, efficacy and tolerability

The efficacy of topical 0.1% mometasone furoate for treating symptomatic severe phimosis: A comparison of two treatment regimens

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