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Local steroid therapy as the first‐line treatment for boys with symptomatic phimosis – a long‐term prospective study
Author(s) -
Reddy Srinath,
Jain Viral,
Dubey Manish,
Deshpande Pankaj,
Singal Arbinder K
Publication year - 2012
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2011.02534.x
Subject(s) - medicine , foreskin , betamethasone , surgery , prospective cohort study , corticosteroid , pediatrics , genetics , biology , cell culture
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.