Phimosis and topical steroids: new clinical findings

Abstract

Phimosis has been defined as unretractable foreskin without adherences and/or a circular band of tight prepuce preventing full retraction. The aim of this study is to evaluate the efficacy (response rate) of topical steroids for the treatment of tight phimosis at different age stages. After using the same medication with different dosage schemes, a retrospective analysis was carried out to assess the efficacy of topical steroids in the treatment of tight phimosis. Patients were divided into three groups: group A (betamethasone scheme A), group B (betamethasone scheme B) and group C (control group). Remission of phimosis, with a complete exposure and without a narrowing behind the glans, was considered a complete response to treatment. The outcomes were then related to dosage scheme and patient's age. The dosage for group A was more effective than the dosage for groups B and C (control group). Phimosis resolved in 90% (group A), 72% (group B) and 56% (group C) of cases. A successful treatment was closely related to the age of patients at the beginning of steroid application. The results showed that treatment with topical steroids, which in general gives good results, proved to be much more successful in patients aged between 4 and 8 years, suggesting the efficacy of an early beginning of the treatment.

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

“…The reported recurrence rates of phimosis treated with topical steroid were variant, ranging from 4.0% to 34% in different studies. 12 , 14 , 20 , 21 In the present study, the recurrence rate was 7.6% and 12.9% at 8 weeks and 6 months after treatment, respectively. The long‐term follow‐up showed that the majority (58.7%) of recurrence occurred within 2 months, with 41.3% (57/138) recurrence after 6 months.…”

“…The reported recurrence rates of phimosis treated with topical steroid were variant, ranging from 4.0% to 34% in different studies 12,14,20,21 . In the present study, the recurrence rate was 7.6% and 12.9% at 8 weeks and 6 months after treatment, respectively.…”

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

“…The reported recurrence rates of phimosis treated with topical steroid were variant, ranging from 4.0% to 34% in different studies. 12 , 14 , 20 , 21 In the present study, the recurrence rate was 7.6% and 12.9% at 8 weeks and 6 months after treatment, respectively. The long‐term follow‐up showed that the majority (58.7%) of recurrence occurred within 2 months, with 41.3% (57/138) recurrence after 6 months.…”

“…The reported recurrence rates of phimosis treated with topical steroid were variant, ranging from 4.0% to 34% in different studies 12,14,20,21 . In the present study, the recurrence rate was 7.6% and 12.9% at 8 weeks and 6 months after treatment, respectively.…”

Role of topical steroid in primary treatment of childhood phimosis

“…The percentage of treatment failure in our series is compatible with that of Zampieri et al at 4.0% and Golubovic et al at 5%. 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).…”

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

“…This was mainly due to the ongoing process of pathologic phimosis. 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].…”

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

“…The reported recurrence rates of phimosis treated with topical steroid were variant, ranging from 4.0% to 34% in different studies. 12 , 14 , 20 , 21 In the present study, the recurrence rate was 7.6% and 12.9% at 8 weeks and 6 months after treatment, respectively. The long‐term follow‐up showed that the majority (58.7%) of recurrence occurred within 2 months, with 41.3% (57/138) recurrence after 6 months.…”

“…The reported recurrence rates of phimosis treated with topical steroid were variant, ranging from 4.0% to 34% in different studies 12,14,20,21 . In the present study, the recurrence rate was 7.6% and 12.9% at 8 weeks and 6 months after treatment, respectively.…”

Role of topical steroid in primary treatment of childhood phimosis

“…The percentage of treatment failure in our series is compatible with that of Zampieri et al at 4.0% and Golubovic et al at 5%. 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).…”

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

“…This was mainly due to the ongoing process of pathologic phimosis. 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].…”

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

“…The reported recurrence rates of phimosis treated with topical steroid were variant, ranging from 4.0% to 34% in different studies. 12 , 14 , 20 , 21 In the present study, the recurrence rate was 7.6% and 12.9% at 8 weeks and 6 months after treatment, respectively. The long‐term follow‐up showed that the majority (58.7%) of recurrence occurred within 2 months, with 41.3% (57/138) recurrence after 6 months.…”

“…The reported recurrence rates of phimosis treated with topical steroid were variant, ranging from 4.0% to 34% in different studies 12,14,20,21 . In the present study, the recurrence rate was 7.6% and 12.9% at 8 weeks and 6 months after treatment, respectively.…”

Role of topical steroid in primary treatment of childhood phimosis

“…The percentage of treatment failure in our series is compatible with that of Zampieri et al at 4.0% and Golubovic et al at 5%. 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).…”

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

“…This was mainly due to the ongoing process of pathologic phimosis. 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].…”