title: Is steroids therapy effective in treating phimosis? A meta-analysis.
abstract: OBJECTIVE
  We evaluated a systematic review on the therapeutic efficacy of topical steroids in children with phimosis to provide data for the clinical options of pediatric phimosis.
  
  
  METHODS
  We searched the related original studies on topical steroid therapy in pediatric phimosis before August 2014. Two reviewers independently performed the study selection, data extraction, risk of bias and reporting quality assessment with confirmation by cross-checking. The quality of eligible studies was appraised with the 'Cochrane handbook.' The meta-analysis was performed by REVMAN 5.2 software.
  
  
  RESULTS
  Eleven studies were included with 1669 patients among which 1093 received topical steroids and 576 cases treated with placebo or only manual reduction. Significant difference of the treatment efficacy was detected among the three methods [OR 7.46, 95 % CI (4.42, 12.58), p < 0.00001]. In subgroup analysis, significant difference of the treatment efficacy was also detected whether with placebo or manual reduction only [respectively, OR 5.04, 95 % CI (3.19, 7.95), p < 0.00001; OR 16.28, 95 % CI (6.06, 43.69), p < 0.00001].
  
  
  CONCLUSIONS
  Compared to the placebo or manual reduction method, the topical steroid therapy is more effective in the treatment of phimosis in children. Although there is still controversy in the different type and dosage of steroid, this could be used against phimosis before circumcision.
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Jiaming
authors.initials: J
authors.lastname: Liu
authors.affiliation: The Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China. dr.jinyang@163.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Yang
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yuntian
authors.initials: Y
authors.lastname: Chen
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Sihang
authors.initials: S
authors.lastname: Cheng
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Xia
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Tuo
authors.initials: T
authors.lastname: Deng
mesh_terms: D000287:Administration, Topical; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010688:Phimosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids
keywords: Meta-analysis; Pediatric phimosis; Phimosis; Topical steroids