Document Detail


Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial.
MedLine Citation:
PMID:  18157674     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Ciro Esposito; Antonella Centonze; Francesca Alicchio; Antonio Savanelli; Alessandro Settimi
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-12-19
Journal Detail:
Title:  World journal of urology     Volume:  26     ISSN:  0724-4983     ISO Abbreviation:  World J Urol     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-16     Completed Date:  2008-10-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8307716     Medline TA:  World J Urol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  187-90     Citation Subset:  IM    
Affiliation:
Department of Experimental and Clinical Medicine, Magna Graecia University, Campus SVenuta, Viale Europa 11, 88100 Catanzaro, Italy. ciroesp2@unicz.it
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Adolescent
Child
Child, Preschool
Circumcision, Male / methods*
Dose-Response Relationship, Drug
Humans
Male
Phimosis / drug therapy*,  surgery*
Prospective Studies
Steroids / administration & dosage,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Steroids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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