Histology and immunohistochemical evaluation of phimotic prepuce: The role of steroid therapy

Abstract

Phimosis is a clinical condition characterised by a narrowing of the foreskin and the presence of adhesions between the glans and the foreskin, which determine the inability to discover the glans. It can be a condition both physiological (congenital), present in almost all subjects at birth, and pathological (acquired), due to poor hygiene, recurrent infections (balanitis, posthitis and balanoposthitis), BXO (Balanitis Xerotica Obliterans), repeated catheterisation procedures or incomplete circumcision with altered scarring of the preputial flaps not removed correctly (Fahmy, 2017). According to Kikiros et al., phimosis can be classified into 5 clinical degrees (Kikiros et al., 1993); it is believed that, at birth, 95%-96% of children present physiological phimosis, and of these, 90% between 3 and 4 years of age meet spontaneous resolution, while in 16-year-old boys only 1% present a nonretractile foreskin: it is therefore highlighted that there is spontaneous resolution of phimosis. The incidence of pathological phimosis is instead 0.4 cases/1,000 patients per year, and 0.6% of males within 15 years of age are affected (Fahmy, 2017) (Favorito