OUTCOME OF TOPICAL STEROID IN TREATMENT OF PHIMOSIS

Abstract

BACKGROUND:Topical steroid is effective alternative to circumcision in boys with phimosis. We evaluated theeffectiveness of topical steroid therapy as primary treatment in patients with phimosis.MATERIAL AND METHODSThe study was conducted from January 2010 to Jan 2013 in institute of kidney diseases Hayat abadmedical complex Peshawar. A total of 38 male children who had a Kikiros retractability grade of 4 or 5phimosis were included in the study. Topical steroids (0.05% clobetasol propionate cream) were appliedtwice a day. The outcome was defined as successful if the prepuce was retractable with completeexposure of the glans after 4 to 6 weeks of treatment and there was no recurrence at 6-month follow up.RESULTS: A total of 38 male children with mean age of 2.11±1.78 years (range, 3 months to 12 years)were allocated to treatment with topical steroid cream. Three patients were excluded for lost to followup. A successful result (i.e., full retraction of the foreskin), after 4 or 6 weeks treatment with topicalcream was achieved in a total of 29 (82.85%) patients. The remaining 6 patients (17.14%) showed noresponse. Three had circumcision. No significant local or systemic side effects were noted with theadministration of the topical steroidCONCLUSION: Treatment with topical application of 0.05% clobetasol propionate cream and skinstretching for 4-6 weeks is a safe, simple, and effective procedure with no significant side effects forsevere phimosis in boys.KEY WORDS: phimosis, topical steroids, circumcision