title: Phimosis: stretching methods with or without application of topical steroids?
abstract: Phimosis has been defined as unretractable foreskin without adherences or a circular band of tight prepuce preventing full retraction. We suggested a new treatment protocol combining betamethasone with stretching exercises to reduce the number of patients requiring surgery for phimosis. Between January 2003 and September 2004, 247 boys aged 4 to 14 years (mean 7.6) were included in this consecutive, prospective, open study. Patients were treated with 0.05% betamethasone cream applied to the distal aspect of the prepuce twice daily for the first 15 days, then once daily for 15 more days. Preputial gymnastics started 1 week after topical application of betamethasone. Ninety-six percent of patients receiving 1 or more cycles of betamethasone showed complete resolution of phimosis. There was a significant difference (P < .001) in response rate between the study and control groups. Only 10 boys in the study group had no response to steroid and stretching. Treatment with topical steroids, combined with stretching exercises, is a suitable alternative to surgical correction (preputial plasty/circumcision).
authors.affiliation: Department of Surgical Sciences, Pediatric Surgical Unit, University of Verona, Verona, Italy- Policlinico G.B.Rossi, piazzale Scuro n. 1-Verona. zampius@libero.it
authors.forename: Nicola
authors.initials: N
authors.lastname: Zampieri
authors.forename: Michele
authors.initials: M
authors.lastname: Corroppolo
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Camoglio
authors.forename: Luca
authors.initials: L
authors.lastname: Giacomello
authors.forename: Alberto
authors.initials: A
authors.lastname: Ottolenghi
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001623:Betamethasone / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D010688:Phimosis / Q000628:therapy*; D026741:Physical Therapy Modalities; D011446:Prospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D001623:Betamethasone