Effect of Topical Steroid (0.05% Clobetasol Propionate) Treatment in Children With Severe Phimosis

Abstract

PurposeWe report our experience with the use of a topical steroid, 0.05% clobetasol propionate, for the treatment of phimosis with clinical complications.Materials and MethodsThis 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.ResultsA 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.ConclusionsTopical 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.

Effectiveness of dexamethasone and hyaluronidase + valerate of bethasone associated with prepucial massage in the treatment of child phimosis

“…As to the time required to reach grade 0, on average 47% of patients in both groups required 1 month. A study by Lee and Lee found that 68.2% of the boys achieved success in the same time period [7].…”

“…Clinical treatment, based on the use of topical corticosteroids for phimosis, poses no risk to patients and there is no signi icant side-effect or systemic effect. However, it is extremely important to perform the preputial massage, since there is no ef icacy in the treatment without it [4,7]. After the period of drug therapy, the need to continue the massage and maintain good local hygiene is stressed, in order to avoid relapses [5].…”

Treating umbilical granuloma with topical clobetasol propionate cream at home is as effective as treating it with topical silver nitrate in the clinic

“…Clobetasol propionate cream (0.05%) may be used in children for local treatment of stoma granulomas and phimosis . Application to a small nonvascularised area is considered safe .…”

Common urological problems in children: prepuce, phimosis, and buried penis

“…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).…”