Outcome and recurrence in treatment of phimosis using topical betamethasone in children in Hong Kong

Abstract

Topical steroid is an effective and safe treatment for phimosis, especially when combined with a good hygiene practice of the foreskin with daily cleansing and retraction. A trial of topical steroid treatment should be offered upon considering circumcision.

Local steroid therapy as the first‐line treatment for boys with symptomatic phimosis – a long‐term prospective study

“…Most commonly used and effective steroid for phimosis has been betamethasone dipropionate in concentrations ranging from 0.025 to 0.1% (5,6,8–20). Other steroids such as hydrocortisone (6), triamcinolone acetonide (21), clobetasol propionate (7,22,23), mometasone (24) and fluticasone propionate (25) have also shown good success rates.…”

“…Ku et al. (17) followed up patients for a mean of 2.45 years, and an actual physical examination was performed to give a reliable assessment of outcome. They reported a lower sustained success rate of 60.2% of the children.…”

Role of topical steroid in primary treatment of childhood phimosis

“…In the series of WaiHung et al, there was significant difference on the first treatment outcome (four weeks) between boys <3 years (92.6%) and >3 years (70.4%) of age. 15 Orsola et al also reported 82% patients to have responded to the treatment within 4 weeks. 5 It appears that the response varies with the age group of the patient and decreases as the age of the patient increases.…”

“…13,14 The failure rate is much lower than Wai-Hung et al series results (14.8%). 15 Majority of patients (82.4%) responded within 4 weeks to topical steroid (0.05% betamethasone ointment). Significantly highest number of patients who responded within 4 weeks were <5 years old.…”

Análise do nível do cortisol salivar em crianças portadoras de fimose e tratadas com corticóide tópico

“…Várias drogas, classificadas como corticóides de alta, média e baixa potência, foram testadas, aplicadas duas vezes ao dia, por um período de quatro a oito semanas (Wright, 1994;Golubovic, Milanovic et al, 1996;Chu, Chen et al, 1999;Monsour, Rabinovitch et al, 1999;Lund, Wai et al, 2000;Orsola, Caffaratti et al, 2000;Elmore, Baker et al, 2002;Ashfield, Nickel et al, 2003;Ku, Chiu et al, 2007;Pileggi Fde e Vicente, 2007;Zampieri, Corroppolo et al, 2007;Esposito, Centonze et al, 2008;Palmer e Palmer, 2008). Em 1993, Jorgensen e Svensson, ao tratar balanite xerótica obliterante, com propionato de clobetasol tópico, a 0,05%, em cinqüenta e quatro crianças, obtiveram cura, em 70% dos casos.…”