Foreskin Analysis of Circumcised Boys With and Without Previous Topical Corticosteroid

Borges, Luis Gustavo Sabino; Perez-Bóscollo, Adriana Cartafina; Rocha, Laura Penna; Silva, Renata Calciolari Rossi; Guimarães, Camila Souza de Oliveira; Castro, Eumênia Costa da Cunha; Corrêa, Rosana Rosa Miranda

doi:10.3109/15513815.2012.659381

Cited by 9 publications

(8 citation statements)

References 21 publications

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“…Because patients with complications are prone to developing a pathologic process, their foreskin tissue would have more collagen fiber and inflammatory cells, which is the main microscopic finding in late inflammatory tissue [16]. The same result was shown in a study analyzing the foreskin collected from 40 patients who underwent circumcision [17]. In that study, the percentage of collagen fibers was significantly higher in the groups of patients with clinical complications diagnosed before surgery.…”

Section: Discussionmentioning

confidence: 56%

Effect of Topical Steroid (0.05% Clobetasol Propionate) Treatment in Children With Severe Phimosis

Lee

2013

Korean J Urol

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PurposeWe report our experience with the use of a topical steroid, 0.05% clobetasol propionate, for the treatment of phimosis with clinical complications.Materials and MethodsThis was a retrospective analysis of the clinical outcomes of all patients presenting with phimosis to a single institution during the time period from October 2008 to May 2012. A total of 88 patients who had a Kikiros retractability grade of 4 or 5 and phimosis-associated clinical complications, such as ballooning of the prepuce, balanoposthitis, or a history of urinary tract infection (UTI), were instructed to apply 0.05% clobetasol propionate cream to the slightly retracted foreskin and to massage gently while retracting the foreskin. The efficacy of treatment was evaluated at 4 weeks from the initiation of therapy.ResultsA total of 60 of the 88 patients (68.2%) showed a complete response (i.e., full retraction of the foreskin) to the therapy. The phimotic ring disappeared in 25 of the 88 patients (28.4%) after treatment. Patients who had a history of balanoposthitis, smegma, ballooning of the prepuce, or UTI showed significantly poorer improvement in preputial retraction (p<0.001, p<0.001, p<0.001, and p=0.02, respectively) and phimotic ring disappearance (p<0.001, p=0.001, p<0.001, and p=0.001, respectively) after treatment. No significant local or systemic side effects were associated with the administration of topical steroids.ConclusionsTopical application of 0.05% clobetasol propionate cream and skin stretching is a safe, simple, and effective procedure with no significant side effects for severe phimosis in prepubertal boys.

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Section: Discussionmentioning

confidence: 56%

Effect of Topical Steroid (0.05% Clobetasol Propionate) Treatment in Children With Severe Phimosis

Lee

2013

Korean J Urol

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“…The present study showed that phimosis patients with a history of balanoposthitis had the lowest success rate (48.6%), compared to those with phimosis alone, ballooning of the prepuce and a history of UTI (76.3%, 73.1% and 69.3% respectively). Sabino et al 10 . and Zampieri et al 14 .…”

Section: Discussionmentioning

confidence: 98%

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

Zhou

Jiang

Yang

et al. 2021

J Paediatrics Child Health

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Aim: To evaluate the efficacy of topical steroid (0.1% mometasone furoate) therapy and factors affecting long-term outcome of paediatric severe phimosis in China. Methods: A total of 1550 patients with severe phimosis classified by Kikiros system were prospectively enrolled in the study from January 2016 to February 2020. They were prescribed with 0.1% mometasone furoate twice a day for 4 weeks. Patients were re-evaluated at the end of weeks 2, 4, 8 and 6 months follow-up. Results: A total of 1499 patients completed the treatment, 71.1% responded at the end of week 4. The long-term success rate was 66.0% over a mean follow-up of 26.9 months. The success rate of grade 4 phimosis was significantly higher than that of grade 5 at 4, 8 weeks and 6 months (P = 0.005, P < 0.001 and P < 0.001, respectively). Patients with balanoposthitis had a poorer outcome compared with patients without symptoms and patients symptoms by prepuce ballooning or urinary tract infections (P < 0.001). Initial grade of 5 phimosis and symptom with balanoposthitis were independent risk factors for recurrence. All patients had no systemic side effects, 23 cases developed local erythema or burning sensation. Conclusion: Topical steroid (0.1% mometasone furoate) is an effective treatment for severe phimosis in children. The recurrence was related to the grade or symptoms of severe phimosis.

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“…This finding is of fundamental importance. Although authors have not reported significant differences in the total amount of collagen fibres in the preputial area in patients who have undergone cortisone treatment compared with those who have not undergone medical therapy, the presence of a lower amount of collagen fibres in the distal portion of the prepuce has been demonstrated associated with reduction in their diameter (Sabino Borges et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…paediatric, phimosis, treatment proliferation, collagen depletion and scarring) (Chan & Wong, 2016;Sabino Borges et al, 2012;Zampieri et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Histology and immunohistochemical evaluation of phimotic prepuce: The role of steroid therapy

et al. 2021

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Phimosis is a clinical condition characterised by a narrowing of the foreskin and the presence of adhesions between the glans and the foreskin, which determine the inability to discover the glans. It can be a condition both physiological (congenital), present in almost all subjects at birth, and pathological (acquired), due to poor hygiene, recurrent infections (balanitis, posthitis and balanoposthitis), BXO (Balanitis Xerotica Obliterans), repeated catheterisation procedures or incomplete circumcision with altered scarring of the preputial flaps not removed correctly (Fahmy, 2017). According to Kikiros et al., phimosis can be classified into 5 clinical degrees (Kikiros et al., 1993); it is believed that, at birth, 95%-96% of children present physiological phimosis, and of these, 90% between 3 and 4 years of age meet spontaneous resolution, while in 16-year-old boys only 1% present a nonretractile foreskin: it is therefore highlighted that there is spontaneous resolution of phimosis. The incidence of pathological phimosis is instead 0.4 cases/1,000 patients per year, and 0.6% of males within 15 years of age are affected (Fahmy, 2017) (Favorito

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Foreskin Analysis of Circumcised Boys With and Without Previous Topical Corticosteroid

Cited by 9 publications

References 21 publications

Effect of Topical Steroid (0.05% Clobetasol Propionate) Treatment in Children With Severe Phimosis

Effect of Topical Steroid (0.05% Clobetasol Propionate) Treatment in Children With Severe Phimosis

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

Histology and immunohistochemical evaluation of phimotic prepuce: The role of steroid therapy

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