Role of topical steroid in primary treatment of childhood phimosis

Abstract

Background: Circumcision has been the traditional treatment for phimosis, but with some controversies due to complications. The current study was undertaken to evaluate the effectiveness of topical steroid therapy as primary treatment for childhood phimosis. Methods: A prospective observational study was conducted and a total of 100 patients (age-3 to 12 years) of phimosis were enrolled. The management consisted of topical application of 0.05% betamethasone Ointment for 4 weeks. Those with partial response were advised additional 2 weeks of therapy. Failure to treatment cases were subsequently subjected to circumcision. Results: Total 100 patients were enrolled in the study. Out of 100 patients, 9 were excluded because of noncompliance and remaining 91 patients were studied and followed up. 85 cases out of 91 (93.4%) were declared a 'success'; while remaining 6 (6.6%) were declared 'failure' and were subjected to circumcision. Of the 85 successfully treated; majority (70, 82.3%) responded within 4 weeks of treatment and 15 (17.6%) responded in 6 weeks. The highest number of patients who responded to treatment within 4 weeks were < 5 years of age (54, 93.1%) (p<0.05). Conclusions: Topical steroid (0.05% betamethasone ointment) is an effective, safe, conservative and non-surgical method of primary treatment of childhood Phimosis, especially when combined with good hygiene practices of foreskin with daily retraction and cleansing.

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

“…Changole et al . 11 reported poorer outcomes in boys above 5 years of age as compared to younger age group. Ku et al .…”

“…This study found that the long‐term outcome deteriorated with increasing age, with the lowest success rate (56.6%) in the 8‐ to 12‐year age group. Changole et al 11 . reported poorer outcomes in boys above 5 years of age as compared to younger age group.…”

“…Reddy et al 8 concluded that continuing therapy for longer duration may not be very effective. However, Changole et al 11 reported that 17.6% of patients responded between 4 and 6 weeks. Nascimento et al 18 recommended to extend the treatment period to 8 weeks, since the results at 8 weeks (54.8%) were significantly better than at 4 weeks (31.3%), which was consistent with Zavras et al study.…”

“…However, Changole et al . 11 reported that 17.6% of patients responded between 4 and 6 weeks. Nascimento et al .…”

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

“…Continuation of treatment to four weeks results in drug accumulation, increased elasticity of the foreskin and the skin, and improved efficiency. Changole et al ( 13 ) reported that 17.6% of phimosis cases had a remarkable effect in the late stage of treatment. Reddy et al ( 14 ) found that 8.6% of grade 4 and 5 patients responded to continuous therapy for four weeks.…”