Efficacy of topical steroid treatment in children with severe phimosis in China: A long-term single centre prospective study.

Abstract

AimTo evaluate the efficacy of topical steroid (0.1% mometasone furoate) therapy and factors affecting long‐term outcome of paediatric severe phimosis in China.MethodsA total of 1550 patients with severe phimosis classified by Kikiros system were prospectively enrolled in the study from January 2016 to February 2020. They were prescribed with 0.1% mometasone furoate twice a day for 4 weeks. Patients were re‐evaluated at the end of weeks 2, 4, 8 and 6 months follow‐up.ResultsA total of 1499 patients completed the treatment, 71.1% responded at the end of week 4. The long‐term success rate was 66.0% over a mean follow‐up of 26.9 months. The success rate of grade 4 phimosis was significantly higher than that of grade 5 at 4, 8 weeks and 6 months (P = 0.005, P < 0.001 and P < 0.001, respectively). Patients with balanoposthitis had a poorer outcome compared with patients without symptoms and patients symptoms by prepuce ballooning or urinary tract infections (P < 0.001). Initial grade of 5 phimosis and symptom with balanoposthitis were independent risk factors for recurrence. All patients had no systemic side effects, 23 cases developed local erythema or burning sensation.ConclusionTopical steroid (0.1% mometasone furoate) is an effective treatment for severe phimosis in children. The recurrence was related to the grade or symptoms of severe phimosis.