Publication:

Evaluating the role of topical steroids as a primary intervention for treatment of phimosis in pediatric age group

Background Phimosis is the inability to completely retract the prepuce, a common cause of anxiety to parents of young boys. It is usually physiological and gradually improves with age. Phimosis is considered a problem when there is fibrotic foreskin and its adherence to the glans making it impossible to expose the glans.

Methods Study was conducted on 82 patients that presented to the surgical Outpatient Department (OPD) at Smt. SCL Hospital, NHL Medical College, Ahmedabad for a period of 2 years between September 2011 to September 2013. Case selection was done by detailed history, clinical examination and followed up regularly at 1 week, 2 week and 1 month in necessary individuals. The treatment consisted of applying a topical steroid (betamethasone 0.05% cream) three times a day.

Results 85% of patients had physiologic phimosis and along with Frenulum Breve the count rose to 91%. Only 9% presented with pathological or acquired phimosis. 51 out of 53 patients who completed the course (96%) achieved success with conservative line of treatment. Only 2 failures were seen (4%). 72.5% of patients responded successfully within 2 weeks of treatment. 27.5% of patients took 1 month of therapy to be successful.

Conclusions The study has shown that a majority (96%) of boys with phimosis can be successfully treated conservatively. Hence, topical steroids might be used as a first-line therapy for phimosis, as a feasible pre-surgery alternative. Surgical interventions should be reserved for recalcitrant phimosis that do not respond to medical administration.