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TOPICAL STEROID TREATMENT OF PHIMOSIS IN BOYS

1999; Lippincott Williams & Wilkins; Volume: 162; Issue: 3 Part 1 Linguagem: Inglês

10.1097/00005392-199909010-00078

1527-3792

Chih-Chun Chu, Ke-Chi Chen, Guan‐Yeu Diau,

Urologic and reproductive health conditions

No AccessJournal of UrologyPediatric Urology1 Sep 1999TOPICAL STEROID TREATMENT OF PHIMOSIS IN BOYS CHIH-CHUN CHU, KE-CHI CHEN, and GUAN-YEU DIAU CHIH-CHUN CHUCHIH-CHUN CHU More articles by this author , KE-CHI CHENKE-CHI CHEN More articles by this author , and GUAN-YEU DIAUGUAN-YEU DIAU More articles by this author View All Author Informationhttps://doi.org/10.1097/00005392-199909010-00078AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate whether steroid application alone or retraction and hygiene are responsible for successful results in boys treated with topical steroids for phimosis. Materials and Methods: A prospective study was performed, which included a control group of 42 patients with phimosis seen at our outpatient department from January to June 1997. During that time we trained the parent to retract and clean the foreskin only. From July 1997 to June 1998 topical steroid cream was prescribed in addition to retraction and hygiene in 276 boys with phimosis. All cases were divided into 3 subgroups of asymptomatic, symptomatic and buried penis. Results: The response rate was greater than 95% in patients who received topical steroid treatment in addition to improved hygiene. Only 13 boys (less than 5%) had no response to steroid treatment. Of the control patients 23 (55%) had no response to gentle retraction and personal hygiene. There was a significant difference (p <0.001) in response rate between the study and control groups. However, the subgroup with a buried penis responded poorly to steroid, retraction and hygiene treatment. There was significant difference (p 0.05) in the control group. Conclusions: Phimosis is a physiological condition in neonates due to natural adhesion between the foreskin and the glans. Chronic infection due to poor hygiene is responsible for most cases of childhood phimosis. Circumcision is the traditional treatment of choice for phimosis or unretractable foreskin, although it is not always desired by parents or surgeons. Topical steroid cream is an easy, safe and nonsurgical alternative for phimosis. However, boys with a buried penis are not good candidates for steroid treatment. References 1 : The fate of the foreskin. A study of circumcision. Brit. Med. J.1949; 2: 1433. Crossref, Medline, Google Scholar 2 : Topical clobetasol propionate compared with placebo in the treatment of unretractable foreskin. Eur. J. Surg.1996; 162: 969. Medline, Google Scholar 3 : Phimosis-ett overvarderat problem?. Lakartidningen1993; 90: 4107. Google Scholar 4 : Penile hygiene in school-boys. Med. Officer1964; 112: 171. Google Scholar 5 : Carcinoma of the penis and the anti-circumcision crusade. J. Urol.1973; 110: 79. Link, Google Scholar 6 : Herpes genitalis and circumcision. Brit. J. Ven. Dis.1975; 51: 274. 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Link, Google Scholar From the Department of Surgery, Division of Pediatric Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byPileggi F, Martinelli C, Tazima M, Daneluzzi J and Vicente Y (2010) Is Suppression of Hypothalamic-Pituitary-Adrenal Axis Significant During Clinical Treatment of Phimosis?Journal of Urology, VOL. 183, NO. 6, (2327-2331), Online publication date: 1-Jun-2010.Letendre J, Barrieras D, Franc-Guimond J, Abdo A and Houle A (2009) Topical Triamcinolone for Persistent PhimosisJournal of Urology, VOL. 182, NO. 4S, (1759-1764), Online publication date: 1-Oct-2009.Schoen E, Colby C and To T (2018) Re: Cost Analysis of Neonatal Circumcision in a Large Health Maintenance OrganizationJournal of Urology, VOL. 176, NO. 5, (2315-2319), Online publication date: 1-Nov-2006.YANG S, TSAI Y, WU C, LIU S and WANG C (2018) HIGHLY POTENT AND MODERATELY POTENT TOPICAL STEROIDS ARE EFFECTIVE IN TREATING PHIMOSIS: A PROSPECTIVE RANDOMIZED STUDYJournal of Urology, VOL. 173, NO. 4, (1361-1363), Online publication date: 1-Apr-2005.ASHFIELD J, NICKEL K, SIEMENS D, MacNEILY A and NICKEL J (2018) Treatment of Phimosis With Topical Steroids in 194 ChildrenJournal of Urology, VOL. 169, NO. 3, (1106-1108), Online publication date: 1-Mar-2003.Elmore J, Baker L and Snodgrass W (2018) Topical Steroid Therapy as an Alternative to Circumcision for Phimosis in Boys Younger Than 3 YearsJournal of Urology, VOL. 168, NO. 4 Part 2, (1746-1747), Online publication date: 1-Oct-2002. Volume 162Issue 3 Part 1September 1999Page: 861-863 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information CHIH-CHUN CHU More articles by this author KE-CHI CHEN More articles by this author GUAN-YEU DIAU More articles by this author Expand All Advertisement PDF downloadLoading ...