title: Effect of topical steroid on non-retractile prepubertal foreskin by a prospective, randomized, double-blind study.
abstract: OBJECTIVE
  The present study, conducted in Hong Kong, aimed to evaluate the effect of topical steroid in non-retractile prepubertal foreskin by a prospective, randomized, double-blind design.
  
  
  METHODS
  137 boys with non-retractile foreskin were randomized to betamethasone (n = 66) or placebo (n = 71 ) for 4 weeks with application of the cream twice daily. Non-responders to treatment were offered steroid treatment for a further 4 weeks.
  
  
  RESULTS
  The mean pretreatment grade of the foreskin in the steroid and control groups was 5.08 +/- 0.66 and 4.97 +/- 0.70, respectively. At the 4-week follow-up, 49 of the former (74%) had a retractile foreskin (grade less than or equal to 3, mean 2.38 +/- 1.41). In contrast, only 31 of the control group (44%) had a retractile foreskin (less than or equal to 3, mean 3.55 +/- 1.55) (p < 0.001). Only 14 boys were circumcised because 43 of the remaining 57 boys had a retractile foreskin after 4 weeks of treatment.
  
  
  CONCLUSIONS
  when treatment is necessary, application of topical steroid as a first line of treatment may avoid surgery in almost 90% of cases.
authors.affiliation: Division of Paediatric Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T.
authors.forename: L
authors.initials: L
authors.lastname: Lund
authors.forename: K H
authors.initials: KH
authors.lastname: Wai
authors.forename: L M
authors.initials: LM
authors.lastname: Mui
authors.forename: C K
authors.initials: CK
authors.lastname: Yeung
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001623:Betamethasone / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005938:Glucocorticoids; D006801:Humans; D008297:Male; D010688:Phimosis / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D001623:Betamethasone