Conservative treatment of phimosis in children using a topical steroid

Orsola, Anna; Caffaratti, Jorge; Garat, J.M.

doi:10.1016/s0090-4295(00)00576-8

Cited by 82 publications

(83 citation statements)

References 16 publications

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“…Although in the last decades many authors have advocated the use of topical steroids as an alternative treatment of phimosis (1)(2)(3), with success rate ranging from 67 to 90% (4,5), circumcision is still the "gold standard" treatment for phimosis, and although not always performed for …”

Section: Introductionmentioning

confidence: 99%

A prospective evaluation of plastibell® circumcision in older children

et al. 2013

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Introduction and Objective:Circumcision is one of the oldest surgical procedures and one of the most frequently performed worldwide. It can be done by many different techniques. This prospective series presents the results of Plastibell® circumcision in children older than 2 years of age, evaluating surgical duration, immediate and late complications, time for plastic device separation and factors associated with it. Materials and Methods: We prospectively analyzed 119 children submitted to Plastic Device Circumcision with Plastibell® by only one surgeon from December 2009 to June 2011. In all cases the surgery was done under general anesthesia associated with dorsal penile nerve block. Before surgery length of the penis and latero-lateral diameter of the glans were measured. Surgical duration, time of Plastibell® separation and use of analgesic medication in the post-operative period were evaluated. Patients were followed on days 15, 45, 90 and 120 after surgery. Results: Age at surgery varied from 2 to 12.5 (5.9 ± 2.9) years old. Mean surgical time was 3.7 ± 2.0 minutes (1.9 to 9 minutes). Time for plastic device separation ranged from 6 to 26 days (mean: 16 ± 4.2 days), being 14.8 days for children younger than 5 years of age and 17.4 days for those older than 5 years of age (p < 0.0001). The diameter of the Plastibell® does not interfered in separations time (p = 0,484). Late complications occurred in 32 (26.8%) subjects, being the great majority of low clinical significance, especially prepucial adherences, edema of the mucosa and discrete hypertrophy of the scar, all resolving with clinical treatment. One patient still using diaper had meatus stenosis and in one case the Plastibell® device stayed between the glans and the prepuce and needed to be removed manually. Conclusions: Circumcision using a plastic device is a safe, quick and an easy technique with low complications, that when occur are of low clinical importance and of easy resolution. The mean time for the device to fall is shorter in children under 6 years of age and it is not influenced by the diameter of the device.

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Section: Introductionmentioning

confidence: 99%

A prospective evaluation of plastibell® circumcision in older children

et al. 2013

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“…[3]. Some centers, in an early stage of BXO, have also tried topical application of steroids like clobetasol dipropionate or betamethasone valereate and claim gratifying results to the tune of 70-90% [4,5,6]. In our series, it was noticed that incidence of circumcision carried out in pediatric age group was 2.3 per 1000 population.…”

Section: Discussionmentioning

confidence: 64%

Circumcision : A Time to Rethink

Nagar

Chauhan

Saxena

2004

Medical Journal Armed Forces India

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“…17 Their use in physiological phimosis was first described by Kikiros et al 18 Subsequent studies showed the response rate for resolution of phimosis to be 68.2% to 95%. 16,[19][20][21][22] Moreno et al 23 subsequently performed a meta-analysis and reviewed 12 randomised controlled trials on the use of different topical steroid formulations, and again confirmed the significant benefit of corticosteroids in the complete or partial clinical resolution of phimosis (risk ratio=2.45; 95% confidence interval, 1.84-3.26).…”

Section: Topical Steroidsmentioning

confidence: 94%