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Highly potent and moderately potent topical steroids are effective in treating phimosis: a prospective randomized
Stephen Shei Dei Yang1, Yao Chou Tsai, Chia Chang Wu
1Department of Urology, En Chu Kong Hospital, Taipei Medical University, Taiwan.
Insights
Both highly potent and moderately potent topical steroids effectively treat pediatric phimosis. A less potent steroid is recommended first to minimize potential side effects.
Area of Science:
- Pediatric Urology
- Dermatology
- Pharmacology
Background:
- Phimosis is a common condition in pediatric patients.
- Topical steroids are a non-invasive treatment option for phimosis.
- Comparing the efficacy of different potencies of topical steroids is important for clinical decision-making.
Purpose of the Study:
- To compare the effectiveness of highly potent (betamethasone valerate) and moderately potent (clobetasone butyrate) topical steroids in treating pediatric phimosis.
- To evaluate treatment outcomes based on changes in foreskin retractibility.
Main Methods:
- A prospective randomized study involving 70 boys aged 1-12 years with phimosis.
- Participants received either betamethasone valerate 0.06% or clobetasone butyrate 0.05% applied topically twice daily for 4-8 weeks.
- Foreskin retractibility was graded, with improvement defined as a score increase of over 2 points.
Main Results:
- Response rates were comparable: 81.3% for betamethasone valerate and 77.4% for clobetasone butyrate (p = 0.63).
- Both steroid groups showed significant improvement in retractibility scores.
- No adverse effects were reported in either treatment group.
Conclusions:
- Highly potent and moderately potent topical steroids demonstrate similar effectiveness in treating pediatric phimosis.
- Consideration of less potent steroids as a first-line treatment may reduce the risk of potential adverse effects.
Purpose:
We report a prospective randomized study comparing the effects of highly potent and moderately potent topical steroids in treating pediatric phimosis.
Materials And Methods:
A total of 70 boys 1 to 12 years old with phimosis were randomly assigned to receive topical application of either betamethasone valerate 0.06% (a highly potent steroid) or clobetasone butyrate 0.05% (a moderately potent steroid). Parents of the boys were instructed to retract the foreskin gently without causing pain, and to apply the topical steroids over the stenotic opening of the prepuce twice daily for 4 weeks, then for another 4 weeks if no improvement was achieved. Retractibility of the prepuce was graded from 0 to 5. Response to treatment was arbitrarily defined as improvement in the retractibility score of more than 2 points.
Results:
Mean treatment and followup periods were 4.3 and 19.1 weeks, respectively. The response rates in boys treated with betamethasone valerate and clobetasone butyrate were 81.3% and 77.4%, respectively (p = 0.63). Mean retractibility score decreased from 3.9 +/- 1.0 to 1.7 +/- 1.1, and 4.2 +/- 1.0 to 1.9 +/- 1.0 in the betamethasone and clobetasone groups, respectively. Both steroids were effective in all age groups. Pretreatment retractibility score did not affect treatment outcomes. No adverse effect was encountered.
Conclusions:
Highly potent and moderately potent topical steroids are of comparable effectiveness in treating phimosis. A less potent steroid may be considered first to decrease the risk of the potential adverse effects.
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