Local steroid therapy as the first-line treatment for boys with symptomatic phimosis – a long-term prospective study
Article first published online: 9 DEC 2011
© 2011 The Author(s)/Acta Pædiatrica © 2011 Foundation Acta Pædiatrica
Volume 101, Issue 3, pages e130–e133, March 2012
How to Cite
Reddy, S., Jain, V., Dubey, M., Deshpande, P. and Singal, A. K. (2012), Local steroid therapy as the first-line treatment for boys with symptomatic phimosis – a long-term prospective study. Acta Paediatrica, 101: e130–e133. doi: 10.1111/j.1651-2227.2011.02534.x
- Issue published online: 25 JAN 2012
- Article first published online: 9 DEC 2011
- Accepted manuscript online: 21 NOV 2011 09:54AM EST
- Received 24 August 2011; revised 2 November 2011; accepted 17 November 2011.
- Topical steroids
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.