DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20204942

A study on effectiveness of topical steroid therapy in boys with phimosis in the age group of 5 to 10 years

S. Selva Kumar, S. Santha Kumar, S. Alph Shirley

Abstract


Background: Phimosis defined as the inability to retract the prepuce over the glans of penis is a common condition affecting boys. Objective was to study the effectiveness of topical steroid therapy (0.05% clobetasol propionate cream) in boys with phimosis in the age group of 5 to 10 years.  

Methods: This retrospective observational study was conducted at the Department of Pediatrics and Department of Surgery at Arunai Medical College and Hospital, Thiruvannamalai, Tamilnadu, India among 74 boys in the age group of 5 to 10 years with phimosis. The effect of twice daily application of 0.05% clobetasol propionate cream for six weeks on phimosis was studied.  

Results: out of the 74 boys, 25 (33.78%) were in the age group of 5 to 6 years, 20 (27.02%) in the age group of 7 to 8 years and 29 (39.19%) in the age group of 9 to 10 years. As per Kikiros et al system of grading of retraction of foreskin, majority of the boys 30 (40.54%) were grade 4, followed by grade 2 (24 boys, 32.43%), grade 3 (14 boys, 18.93%) and grade 5 (6 boys, 8.1%). Out of the 74 boys with phimosis, 53 boys (71.62%) had associated complications. After 6 weeks of topical steroid therapy, 39 (52.71%) boys showed complete response, 24 (32.43%) boys showed partial response and 11 (14.86%) boys showed no response to the treatment regimen. There was no significant correlation between age of boys and grade of phimosis with treatment response. Significant correlation was noted between history of urinary tract infection and treatment response. None of the other complications showed significant correlation with treatment response. None of the boys had any side effects to topical steroid therapy.  

Conclusions: Topical steroid application can be tried as an effective treatment modality in boys with phimosis in the age group of 5 to 10 years.


Keywords


Children phimosis, Topical steroid phimosis, Clobetasol propionate phimosis

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References


Kikiros CS, Beasley SW, Woodward AA. The response of phimosis to local steroid application. Pediat Surg Int. 1993;8(4):329-32.

Griffiths DM, Atwell JD, Freeman NV. A prospective survey of the indications and morbidity of circumcision in children. Eur Urol. 1985;11(3):184-7.

Rickwood AM, Walker J. Is phimosis overdiagnosed in boys and are too many circumcisions performed in consequence?. Ann Roy Colle Surge Engl. 1989;71(5):275.

Shankar KR, Rickwood AM. The incidence of phimosis in boys. Brit J Urol Int. 1999;84(1):101-2.

Shahid SK. Phimosis in children. ISRN urol. 2012;2012.

Lee CH, Lee SD. Effect of topical steroid (0.05% clobetasol propionate) treatment in children with severe phimosis. Korea J Urol. 2013;54(9):624-30.

Ashfield JE, Nickel KR, Siemens DR, MacNEILY AE, Nickel JC. Treatment of phimosis with topical steroids in 194 children. J Urol. 2003;169(3):1106-8.

Orsola A, Caffaratti J, Garat JM. Conservative treatment of phimosis in children using a topical steroid. Urol. 2000;56(2):307-10.

CHU CC, Chen KC, DIAU GY. Topical steroid treatment of phimosis in boys. J Urol. 1999;162(3 Part 1):861-3.

Makhija D, Shah H, Tiwari C, Dwiwedi P, Gandhi S. Outcome of topical steroid application in children with non-retractile prepuce. Dev Period Med. 2018;22(1):71-4.

Wright JE. The treatment of childhood phimosis with topical steroid. Australian and New Zealand. J Surg. 1994;64(5):327-8.

Monsour MA, Rabinovitch HH, Dean GE. Medical management of phimosis in children: our experience with topical steroids. J Urol. 1999;162(3):1162-4.

Jørgensen ET, Svensson A. The treatment of phimosis in boys, with a potent topical steroid (clobetasol propionate 0.05%) cream. Acta dermato-venereol. 1993;73(1):55-6.

Ng WT, Fan N, Wong CK, Leung SL, Yuen KS, Sze YS, et al. Treatment of childhood phimosis with a moderately potent topical steroid. ANZ J Surg. 2001;71(9):541-3.

Webster TM, Leonard MP. Topical steroid therapy for phimosis. Canad J Urol. 2002;9(2):1492.

Golubovic Z, Milanovic D, Vukadinovic V, Rakic I, Perovic S. The conservative treatment of phimosis in boys. Brit J Urol. 1996;78(5):786-8.

Elmore JM, Baker LA, Snodgrass WT. Topical steroid therapy as an alternative to circumcision for phimosis in boys younger than 3 years. J Urol. 2002;168(4):1746-7.