OBJECTIVES: Topical steroids have been advocated as an effective alternative treatment to circumcision in boys with phimosis. We evaluated the effectiveness of topical steroid therapy compared to a placebo neutral cream in 240 patients with phimosis. METHODS: A prospective study was carried out over a 24-months period, on an out-patient basis on two groups of patients with phimosis. One-hundred twenty patients applied a steroid cream twice a day for 4 weeks, and another group of 120 pts used a placebo cream twice a day for 4 weeks. Patients were assigned to either group by a computer-generated random choice. RESULTS: All patients in our series completed the two treatment periods without interruption. At a median follow-up of 20 months (6-30 months) therapeutic success was obtained in 43.75% (99/240) of cases, independently of the protocol. In particular, therapeutic success was obtained in 65.8% (79/120) of cases in the steroids group and in 16.6% (20/120) of cases in the placebo group, the difference being statistically significant (P < 0.0001, Mann-Withney test). CONCLUSION: Our study shows that topical steroids represent a good alternative to surgery in case of phimosis. Steroid therapy using monometasone furoate 0.1% in our series gave better results that placebo with an overall efficacy of 65.8%. In patients where a phimotic ring persist after steroid therapy, circumcision is mandatory.

Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial / Esposito, Ciro; Centonze, A.; Alicchio, Francesca; Savanelli, Antonio; Settimi, Alessandro. - In: WORLD JOURNAL OF UROLOGY. - ISSN 0724-4983. - ELETTRONICO. - Apr;26:(2)(2008), pp. 187-190.

Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial

ESPOSITO, CIRO;ALICCHIO, FRANCESCA;SAVANELLI, ANTONIO;SETTIMI, ALESSANDRO
2008

Abstract

OBJECTIVES: Topical steroids have been advocated as an effective alternative treatment to circumcision in boys with phimosis. We evaluated the effectiveness of topical steroid therapy compared to a placebo neutral cream in 240 patients with phimosis. METHODS: A prospective study was carried out over a 24-months period, on an out-patient basis on two groups of patients with phimosis. One-hundred twenty patients applied a steroid cream twice a day for 4 weeks, and another group of 120 pts used a placebo cream twice a day for 4 weeks. Patients were assigned to either group by a computer-generated random choice. RESULTS: All patients in our series completed the two treatment periods without interruption. At a median follow-up of 20 months (6-30 months) therapeutic success was obtained in 43.75% (99/240) of cases, independently of the protocol. In particular, therapeutic success was obtained in 65.8% (79/120) of cases in the steroids group and in 16.6% (20/120) of cases in the placebo group, the difference being statistically significant (P < 0.0001, Mann-Withney test). CONCLUSION: Our study shows that topical steroids represent a good alternative to surgery in case of phimosis. Steroid therapy using monometasone furoate 0.1% in our series gave better results that placebo with an overall efficacy of 65.8%. In patients where a phimotic ring persist after steroid therapy, circumcision is mandatory.
2008
Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial / Esposito, Ciro; Centonze, A.; Alicchio, Francesca; Savanelli, Antonio; Settimi, Alessandro. - In: WORLD JOURNAL OF UROLOGY. - ISSN 0724-4983. - ELETTRONICO. - Apr;26:(2)(2008), pp. 187-190.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/350906
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