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Acta Paediatr. 2012 Mar;101(3):e130-3. doi: 10.1111/j.1651-2227.2011.02534.x. Epub 2011 Dec 9.

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

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  • 1Department of Pediatrics, MGM University of Health Sciences, Navi Mumbai, India.

Abstract

AIM:

Phimosis is a common paediatric urological disorder and often necessitates circumcision. We prospectively evaluated local steroid therapy (LST) as the first choice therapy for such children.

METHODS:

Two hundred and sixty symptomatic boys up to 15 years of age (mean 34 months) with phimosis were started on betamethasone dipropionate (0.05%) application on gently stretched prepuce twice a day. Follow-up visits were arranged at the end of weeks 1, 2 and 4 and 6 months. Grade of phimosis was objectively graded.

RESULTS:

Ninety one percent of the boys showed a successful outcome at the end of 4 weeks; 72% responded in first week, further 16% responded in week 2, and only 2.6% achieved alleviation of phimosis on further application of LST beyond 2 weeks. Fourty two (17.8%) boys had a recurrence of phimosis on a long-term follow-up (mean - 25.4 months, range 6-48 months); thus, the long-term success rate was 77%, while 60 (23%) boys underwent surgery.

CONCLUSION:

Local steroid therapy is safe and successful in alleviating symptomatic tight foreskin in a large majority of children. The response can be seen as early as 1 week; most of the children respond by week 2 and continuing therapy further may not be very effective.

© 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

PMID:
22103624
[PubMed - indexed for MEDLINE]
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