Phimosis: Stretching Methods with or without Application of Topical Steroids?

Zampieri, Nicola; Corroppolo, Michele; Camoglio, Francesco Saverio; Giacomello, Luca; Ottolenghi, A.

doi:10.1016/j.jpeds.2005.07.017

Cited by 27 publications

(17 citation statements)

References 12 publications

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“…In the period 2001-2003, patients with phimosis treated with topical steroids received betamethasone 0.05% once a day for 30 days (group B), while in the period 2003-2005 patients received betamethasone 0.05% twice a day for 15 days, and then once a day for the following 15 days (group A) [15].…”

Section: Methodsmentioning

confidence: 99%

Phimosis and topical steroids: new clinical findings

Zampieri¹,

Corroppolo²,

Zuin³

et al. 2007

Pediatr Surg Int

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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.

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Section: Methodsmentioning

confidence: 99%

Phimosis and topical steroids: new clinical findings

Zampieri¹,

Corroppolo²,

Zuin³

et al. 2007

Pediatr Surg Int

Self Cite

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“…Topical steroid creams can be used, but have to be applied frequently for over a month, are not completely successful, can lead to iatrogenic Cushing's syndrome, adrenal suppression, delayed growth, skin atrophy, and do not confer the additional benefits that circumcision provides. (93)(94)(95) Paraphimosis An inability to return the prepuce after retraction is also cured by circumcision. Paraphimosis can result in partial or complete ''Accidents'' The prepuce can become entrapped in zippers, leading to swelling and scarring.…”

Section: Balanoposthitismentioning

confidence: 99%

Why circumcision is a biomedical imperative for the 21^stcentury

Morris

2007

BioEssays

101

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Circumcision of males represents a surgical “vaccine“ against a wide variety of infections, adverse medical conditions and potentially fatal diseases over their lifetime, and also protects their sexual partners. In experienced hands, this common, inexpensive procedure is very safe, can be pain‐free and can be performed at any age. The benefits vastly outweigh risks. The enormous public health benefits include protection from urinary tract infections, sexually transmitted HIV, HPV, syphilis and chancroid, penile and prostate cancer, phimosis, thrush, and inflammatory dermatoses. In women circumcision of the male partner provides substantial protection from cervical cancer and chlamydia. Circumcision has socio‐sexual benefits and reduces sexual problems with age. It has no adverse effect on penile sensitivity, function, or sensation during sexual arousal. Most women prefer the circumcised penis for appearance, hygiene and sex. Given the convincing epidemiological evidence and biological support, routine circumcision should be highly recommended by all health professionals. BioEssays 29:1147–1158, 2007. © 2007 Wiley Periodicals, Inc.

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“…17 Their use in physiological phimosis was first described by Kikiros et al 18 Subsequent studies showed the response rate for resolution of phimosis to be 68.2% to 95%. 16,[19][20][21][22] Moreno et al 23 subsequently performed a meta-analysis and reviewed 12 randomised controlled trials on the use of different topical steroid formulations, and again confirmed the significant benefit of corticosteroids in the complete or partial clinical resolution of phimosis (risk ratio=2.45; 95% confidence interval, 1.84-3.26).…”

Section: Topical Steroidsmentioning

confidence: 94%

“…[13][14][15] Simple stretching of the prepuce alone has been shown to be effective in achieving complete resolution of physiological phimosis. 16 After 3 months of prepuce stretching, 76% of patients reported resolution of phimosis. 16 …”

Section: Prepuce Hygiene and Retractionmentioning

confidence: 99%