[Treatment of phimosis with locally applied 0.05% clobetasol propionate. Prospective study with 108 children].
OBJECTIVE
This study was designed to evaluate the efficacy of topical application of corticosteroid cream in the treatment of phimosis in children and to compare the results obtained with those reported in the literature.


METHODS
In the context of a prospective study conducted between January 1997 and November 2001, 108 children with a mean age of 5.9 years, presenting with true phimosis preventing retraction of the foreskin, were treated by twice-daily application of 0.05% clobetasol propionate cream for 10 days. The results were evaluated at one month and then every six months by a urologist in the outpatients department. A second course of treatment identical to the first was proposed in the case of failure or partial efficacy.


RESULTS
96 children were evaluated with a mean follow-up of 14 months (range: 6 to 24 months). Seventy nine children (82%) are cured after a first course of treatment. In the remaining 17 children, 2 were treated by circumcision and 15 received a second course of treatment resulting in cure in another 9 cases. The final cure rate was therefore 92%. Among the six failures, 4 children were circumcised, corresponding to a total of 6 circumcisions out of this series of 96 cases of phimosis (6%). No local or systemic adverse effects related to steroid therapy were observed and no recurrence of phimosis was observed during the study.


CONCLUSIONS
This study confirms the efficacy and safety of local steroid therapy in the treatment of phimosis in children. Surgical treatment of phimosis should therefore be reserved for failures of medical treatment and has now become much less frequent.
Iken
Ali
A
Service d'Urologie, Hôpital Ambroise Paré, 9, avenue Charles de Gaulle, 92100 Boulogne.
Ben Mouelli
Sami
S
Fontaine
Eric
E
Quenneville
Vincent
V
Thomas
Laurent
L
Beurton
Daniel
D
D000287:Administration, Topical; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D002990:Clobetasol / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D005500:Follow-Up Studies; D005938:Glucocorticoids; D006801:Humans; D008297:Male; D010688:Phimosis / Q000188:drug therapy*; D011446:Prospective Studies
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D002990:Clobetasol