title: Local steroid therapy as the first-line treatment for boys with symptomatic phimosis - a long-term prospective study.
abstract: OBJECTIVE
  Phimosis is a common paediatric urological disorder and often necessitates circumcision. We prospectively evaluated local steroid therapy (LST) as the first choice therapy for such children.
  
  
  METHODS
  Two hundred and sixty symptomatic boys up to 15 years of age (mean 34 months) with phimosis were started on betamethasone dipropionate (0.05%) application on gently stretched prepuce twice a day. Follow-up visits were arranged at the end of weeks 1, 2 and 4 and 6 months. Grade of phimosis was objectively graded.
  
  
  RESULTS
  Ninety one percent of the boys showed a successful outcome at the end of 4 weeks; 72% responded in first week, further 16% responded in week 2, and only 2.6% achieved alleviation of phimosis on further application of LST beyond 2 weeks. Fourty two (17.8%) boys had a recurrence of phimosis on a long-term follow-up (mean - 25.4 months, range 6-48 months); thus, the long-term success rate was 77%, while 60 (23%) boys underwent surgery.
  
  
  CONCLUSIONS
  Local steroid therapy is safe and successful in alleviating symptomatic tight foreskin in a large majority of children. The response can be seen as early as 1 week; most of the children respond by week 2 and continuing therapy further may not be very effective.
authors: Department of Pediatrics, MGM University of Health Sciences, Navi Mumbai, India.
authors: Srinath
authors: S
authors: Reddy
authors: Viral
authors: V
authors: Jain
authors: Manish
authors: M
authors: Dubey
authors: Pankaj
authors: P
authors: Deshpande
authors: Arbinder K
authors: AK
authors: Singal
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D001623:Betamethasone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D010688:Phimosis / Q000188:drug therapy* / Q000601:surgery; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone