Outcome and recurrence in treatment of phimosis using topical betamethasone in children in Hong Kong.
OBJECTIVE
To study the efficacy of treating phimosis with topical steroid, and its long-term outcome and side effects. We also looked into the effect of daily retraction and cleansing of prepuce on preventing recurrence of phimsosis.


METHODS
This prospective study comprised 138 boys who were prescribed 0.05% betamethasone ointment (Diprocel) during 1 August 2001-31 July 2004. Five boys were excluded because of non-compliance. Of the remaining 133 boys, 108 were followed-up and assessed. Age ranged from 0.03 to 12.9 years (mean=3.38, SD=2.79). The number of treatment course received, short-term and long-term outcome, side effects and the effect of daily foreskin retraction were studied.


RESULTS
The success rate of first treatment course was 81.5%, and 60.2% of boys remained free from phimosis upon latest assessment. The follow-up period ranged from 0.4 to 4.4 years (mean=2.45, SD=0.90). There were no side effects noted. We found a significant and linear relationship between daily foreskin retraction and sustained resolution of phimosis.


CONCLUSIONS
Topical steroid is an effective and safe treatment for phimosis, especially when combined with a good hygiene practice of the foreskin with daily cleansing and retraction. A trial of topical steroid treatment should be offered upon considering circumcision.
Ku
Wai-Hung
WH
Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital, Hong Kong SAR, China. kuwh2002@yahoo.com.hk
Chiu
Becky S-K
BS
Huen
Kwai-Fun
KF
D001623:Betamethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006723:Hong Kong; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010688:Phimosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology
D005938:Glucocorticoids; D001623:Betamethasone