An 18-month follow-up study after randomized treatment of phimosis in boys with topical steroid versus placebo.
OBJECTIVE
To evaluate the treatment of phimosis using topical steroid.


METHODS
This was a follow-up study after a prospective, randomized, double-blind study. A total of 137 boys with phimosis were randomly assigned to either betamethasone treatment or placebo for 4 weeks, with application of the cream twice daily. Non-responders to treatment were offered steroid treatment for a further 4 weeks. All patients were invited to a follow-up examination after 18 months.


RESULTS
The mean pre-treatment phimosis grades in the steroid and control groups were 5.08+/-0.66 and 4.97+/-0.70, respectively. At the 4-week follow-up, 49 boys (74%) in the steroid group were cured, compared to only 31 (44%) in the control group. Fourteen boys were circumcised after another 4 weeks of treatment; 43 of the remaining 57 boys (17 in the steroid group; 40 in the control group) had been cured. After a total of 92 boys took part in the 18-month follow-up study: 79 had been cured and 13 had suffered a relapse. Twenty-six patients did not took part in the follow-up investigation. No side-effects were noted.


CONCLUSIONS
When treatment is necessary for phimosis, we recommend application of topical steroid as first-line treatment because surgery can then be avoided in 85% of cases. This first randomized, double-blind, follow-up study shows that the treatment effect persists for at least 18 months.
Lund
L
L
Department of Urology, Viborg Hospital, Viborg, Denmark. Dr.LL@Dadlnet.dk
Wai
K H
KH
Mui
L M
LM
Yeung
C K
CK
D000287:Administration, Topical; D001623:Betamethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D004311:Double-Blind Method; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010688:Phimosis / Q000188:drug therapy*; D011446:Prospective Studies; D013997:Time Factors
D005938:Glucocorticoids; D001623:Betamethasone