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[Treatment of phimosis with betamethasone ointment in children]
K S Lee1, T Koizumi, H Nakatsuji
1Department of Urology, Takamatsu Red Cross Hospital.
Insights
Betamethasone ointment effectively treats childhood phimosis, with the 0.12% concentration showing the highest success rate. This safe and easy treatment is recommended for pediatric phimosis.
Area of Science:
- Pediatric Urology
- Dermatology
- Pharmacology
Context:
- Phimosis is a common condition in children, often requiring medical intervention.
- Topical corticosteroids are increasingly used for non-surgical management of phimosis.
Purpose:
- To evaluate the efficacy of betamethasone ointment in treating childhood phimosis.
- To determine the optimal concentration of betamethasone for effective treatment.
Summary:
- A study involving 69 children with severe phimosis assessed betamethasone ointment at 0.12%, 0.05%, and 0.025% concentrations over 4 weeks.
- The 0.12% betamethasone ointment achieved the highest success rate (96.8%), significantly outperforming lower concentrations (82.8% and 55.6%).
- The overall success rate was 85.5%, with no observed adverse effects and a low recurrence rate of 4.3%.
Impact:
- Betamethasone ointment is a highly effective, safe, and easily administered first-line treatment for childhood phimosis.
- The findings support the use of 0.12% betamethasone ointment as the preferred concentration for managing pediatric phimosis.
- This non-invasive approach avoids surgical intervention and associated risks for children with phimosis.
Objective:
We evaluated the efficacy of betamethasone ointment in the treatment of childhood phimosis and determined the most effective concentration of betamethasone.
Material And Methods:
Between August 1996 and May 2000, 69 patients (median age 3.0, range 0-12) presented to our department with severe phimosis (grade 4, Tsugaya's classification), and were enrolled in this study and treated with betamethasone ointment for 4 weeks. The ointment was applied on the narrowed preputial skin twice a day by parents. During the first week, parents were asked not to retract the foreskin. After this period, parents were encouraged to retract the foreskin gently and without intense tension. The concentration of betamethasone were 0.12%, 0.05% and 0.025%. If the patients become to be able to retract foreskin satisfactory, we consider the state as complete response. If he become to be able to retract to allow partial exposure of the glans, we consider the state as partial response. We compared the efficacy among each of the concentrations, and at 3 months after the end of the treatment, we also assessed the adverse effects and recurrence.
Results:
The overall success rate was 85.5%. Success rates with 0.12%, 0.05% and 0.025% ointment were 96.8%, 82.8% and 55.6%, respectively (p = 0.0001). The 0.12% ointment was most effective. Recurrence was observed in 3 patients (4.3%). No adverse effects were observed in any of the patients.
Conclusions:
Treatment with betamethasone ointment is very effective, easy and safe. We recommend betamethasone ointment as the first treatment of choice for childhood phimosis.