World Journal of Urology

, Volume 26, Issue 2, pp 187–190

Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial

Authors

    • Department of Experimental and Clinical Medicine, Chair of Pediatric SurgeryMagna Graecia University
  • Antonella Centonze
    • Department of Experimental and Clinical Medicine, Chair of Pediatric SurgeryMagna Graecia University
  • Francesca Alicchio
    • Department of PediatricsFederico II University
  • Antonio Savanelli
    • Department of PediatricsFederico II University
  • Alessandro Settimi
    • Department of PediatricsFederico II University
Original Article

DOI: 10.1007/s00345-007-0231-2

Cite this article as:
Esposito, C., Centonze, A., Alicchio, F. et al. World J Urol (2008) 26: 187. doi:10.1007/s00345-007-0231-2

Abstract

Objectives

Topical steroids have been advocated as an effective alternative treatment to circumcision in boys with phimosis. We evaluated the effectiveness of topical steroid therapy compared to a placebo neutral cream in 240 patients with phimosis.

Methods

A prospective study was carried out over a 24-months period, on an out-patient basis on two groups of patients with phimosis. One-hundred twenty patients applied a steroid cream twice a day for 4 weeks, and another group of 120 pts used a placebo cream twice a day for 4 weeks. Patients were assigned to either group by a computer-generated random choice.

Results

All patients in our series completed the two treatment periods without interruption. At a median follow-up of 20 months (6–30 months) therapeutic success was obtained in 43.75% (99/240) of cases, independently of the protocol. In particular, therapeutic success was obtained in 65.8% (79/120) of cases in the steroids group and in 16.6% (20/120) of cases in the placebo group, the difference being statistically significant (P < 0.0001, Mann–Withney test).

Conclusion

Our study shows that topical steroids represent a good alternative to surgery in case of phimosis. Steroid therapy using monometasone furoate 0.1% in our series gave better results that placebo with an overall efficacy of 65.8%. In patients where a phimotic ring persist after steroid therapy, circumcision is mandatory.

Keywords

PhimosisSteroidsCircumcisionChildren

Copyright information

© Springer-Verlag 2007