title: Effect of topical steroid (0.05% clobetasol propionate) treatment in children with severe phimosis.
abstract: OBJECTIVE
  We report our experience with the use of a topical steroid, 0.05% clobetasol propionate, for the treatment of phimosis with clinical complications.
  
  
  METHODS
  This was a retrospective analysis of the clinical outcomes of all patients presenting with phimosis to a single institution during the time period from October 2008 to May 2012. A total of 88 patients who had a Kikiros retractability grade of 4 or 5 and phimosis-associated clinical complications, such as ballooning of the prepuce, balanoposthitis, or a history of urinary tract infection (UTI), were instructed to apply 0.05% clobetasol propionate cream to the slightly retracted foreskin and to massage gently while retracting the foreskin. The efficacy of treatment was evaluated at 4 weeks from the initiation of therapy.
  
  
  RESULTS
  A total of 60 of the 88 patients (68.2%) showed a complete response (i.e., full retraction of the foreskin) to the therapy. The phimotic ring disappeared in 25 of the 88 patients (28.4%) after treatment. Patients who had a history of balanoposthitis, smegma, ballooning of the prepuce, or UTI showed significantly poorer improvement in preputial retraction (p<0.001, p<0.001, p<0.001, and p=0.02, respectively) and phimotic ring disappearance (p<0.001, p=0.001, p<0.001, and p=0.001, respectively) after treatment. No significant local or systemic side effects were associated with the administration of topical steroids.
  
  
  CONCLUSIONS
  Topical application of 0.05% clobetasol propionate cream and skin stretching is a safe, simple, and effective procedure with no significant side effects for severe phimosis in prepubertal boys.
authors.affiliation: Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.
authors.forename: Chan Ho
authors.initials: CH
authors.lastname: Lee
authors.forename: Sang Don
authors.initials: SD
authors.lastname: Lee
keywords: Circumcision; Phimosis; Steroids
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