Topical steroid in the treatment of phimosis in children: a Meta-analysis

Abstract

Objective To evaluate the efficacy of topical steroid in the treatment of phimosis in children by systematic reviews. Methods The Embase, PubMed, Cochrane Library, CBM, Wanfang and Wiper databases were searched by computer, and the clinical study of topical steroid treatment on phimosis in children was collected. The retrieval time was established until April 2018. The bias risks of literature screening, data extraction and evaluation for inclusion in the study were performed independently by two evaluators. Meta-analysis was performed by RevMan 5.3 software. Results Included in 9 studies, with a total of 1326 children, of which 804 children were treated with topical steroid therapy. Five hundred and twenty-two patients received placebo treatment or only manipulative.Meta-analysis showed that the effective rate of phimosis in children by topical steroids treatment was significantly different from that of the control group [OR=5.98, 95%CI: 3.73-9.59, P<0.00001]. In the subgroup analysis, the topical steroids treatment group had a significant difference compared with the placebo control group [OR=5.01, 95%CI: 3.56-7.04, P<0.00001]. The curative effect of betamethasone group was also significantly different from that of placebo group[OR=3.65, 95%CI: 2.26-5.88, P<0.00001]. Conclusions Compared with placebo or manual therapy, topical steroids is effective in the treatment of phimosis in children. Although there are still controversies between different types and doses of topical steroids, they can be used in the treatment of phimosis before circumcision. Key words: Phimosis; Child; Gonadal Steroid Hormones