Clinical and Laboratory ObservationPhimosis: Stretching Methods with or without Application of Topical Steroids?
Section snippets
Methods
Between January 2003 and September 2004, 247 boys (4 to 14 years, mean 7.6) were included, after parental consent, in this consecutive and prospective open study on patients referred for surgical treatment of phimosis. Phimosis was graded according to the following 3-grade scale: Grade 1: The foreskin is fully unretractable, with the penis either flaccid or erect. Grade 2: There is partial or total exposure of the glans with a lacerated foreskin. Grade 3: There is a phimotic ring, unnoticeable
Results
Two hundred forty-seven patients adhered to our protocol (52 grade 1, 77 grade 2, and 118 grade 3). At 10 days after the end of the treatment cycle, 191(77.3%) patients reported complete resolution of phimosis with only one cycle; 56 (22.7%) patients needed a second treatment cycle, and 24 of these patients were invited to start a third cycle. Surgery was performed in only 10 patients (4%): 4 circumcisions and 6 preputial plasty.
The success rate in each group is shown in the Table as a function
Discussion
There are 2 possible mechanisms by which steroid cream may help resolve phimosis. First, there is an anti-inflammatory and immunosuppressive effect. Corticosteroids not only inhibit the early phenomenon of inflammation (edema, fibrin deposition, capillary dilation, migration of leukocytes into the inflamed area and phagocytic activity) but also its later manifestations (proliferation of capillaries and fibroblasts, depletion of collagen and cicatrization).
A second effect is skin thinning.
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Cited by (24)
Urology Mythbusters: are topical corticosteroids effective for treating postcircumcision penile adhesions?
2020, Journal of Pediatric UrologyRandomized open-label trial comparing topical prescription triamcinolone to over-the-counter hydrocortisone for the treatment of phimosis
2019, Journal of Pediatric UrologyCitation Excerpt :Several randomized placebo-controlled trials have shown 68–96% efficacy of various corticosteroids [5]. Multiple clinical studies have demonstrated that phimosis treatment is most successful when the corticosteroid cream is applied with gentle stretching or traction of the foreskin [6,7]. To the study authors' knowledge, there are no studies directly comparing prescription triamcinolone 0.1% cream with over-the-counter hydrocortisone 1% cream.
Management of Phimosis and Balanoposthitis in a Pet Chinchilla (Chinchilla lanigera)
2016, Journal of Exotic Pet MedicineCitation Excerpt :Therefore, bacterial infections of the prepuce, which might be subclinical, should be considered in cases of hyporexia and reduced activity, and a thorough examination of the prepuce and entire glans penis should be performed in any male chinchilla, regardless of the presenting complaint.10,14,15 In both humans and small animals, prognosis for phimosis is reported as good to excellent.5-7,16 The recommended treatment for dogs and cats diagnosed with phimosis is surgical correction, in contrast to humans where the primary treatment includes topical steroid application and gentle extrusion of the penis.3,5-8
Topical triamcinolone for persistent phimosis
2009, Journal of UrologyCitation Excerpt :Topical steroid cream should be considered as first line treatment in boys presenting with phimosis because of its safety and good success rate. As in other studies of topical steroid in phimosis, 6–22 we found no adverse effect. However, a rare adverse systemic reaction was reported for a long-term high dose of topical steroid. 26
Male circumcision - see the harm to get a balanced picture
2007, Journal of Men's Health and Gender