Termokoterle Yapılan Sünnet Sonrası Gelişen Fimozisin Tedavisinde Topikal Steroid Kremin Etkinliği

Abstract

Objective : In our country, thermocautery device is used extensively for circumcision performed under local anesthesia for fast and safe circumcision. One of the complications that may occur after circumcision with thermocautery is pathological phimosis. However, there aren’t studies in the literature regarding the medical treatment of pathological phimosis after circumcision with thermocautery. We aimed to investigate the effectiveness of topical corticosteroid application in the treatment of pathological phimosis developed after circumcision with thermocautery. Material&Methods: Data of 68 patients (aged: 1-8 years) who developed phimosis secondary to circumcisions performed by one surgeon between the years 2009 and 2018 were analysed retrospectively from a computerised database. Cases of phimosis developed after circumcisions performed using thermocautery and scalpel were analysed in two separate groups, and the effectiveness of topical steroid treatment was evaluated. Results : In the thermocautery group, 32 patients who developed Grade 5 phimosis didn’t respond to steroid therapy, while only three of 16 (18.75%) cases with Grade 4 phimosis responded partially to topical steroid treatment. All these 48 cases were treated with surgery. In the scalpel group, no therapeutic response was elicited in four cases who developed Grade 5 phimosis. However, four out of eight (50%) patients with Grade 4 and six out of eight (75%) patients with Grade 3 phimosis responded to steroid therapy, and full retraction of the foreskin was achieved. In the scalpel group, ten cases underwent surgical revision. Conclusion : Topical steroid creams may be partially beneficial in cases of pathological phimosis after circumcision. However, they do not show efficacy in cases of high-grade phimosis after thermocautery use.