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

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

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.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Betamethasone / analogs & derivatives*
  • Betamethasone / therapeutic use
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Glucocorticoids / therapeutic use*
  • Humans
  • Infant
  • Male
  • Phimosis / drug therapy*
  • Phimosis / surgery
  • Prospective Studies
  • Treatment Outcome

Substances

  • Glucocorticoids
  • betamethasone-17,21-dipropionate
  • Betamethasone