THE CIRCUMCISION REFERENCE LIBRARY
Klyver H, Mortensen SO, Klarskov OP, Christiansen P.
Amtssygehuset i Glostrup, urologisk sektion D1 og borneafdeling L.
ABSTRACT: The current treatment of phimosis in Denmark is surgical. Reports of success rates of 70-80% with topical steroids have prompted us to carry out the present study.
METHODS: Parents of boys, who were referred because of phimosis, volunteered to participate in an open trial of topical clobetasol 0.05%, along with gentle mobilisation of the foreskin once daily for 4-6 weeks. Fifty-five boys completed the treatment. The results were recorded at clinical follow-up four and six weeks later, and a long-term follow-up was done by questionnaire sent after 9-11 months.
RESULTS: At six weeks of treatment, 42 had a fully retractable foreskin, 11 a partially retractable foreskin, and two had unchanged phimosis. Ten patients had a circumcision or plasty. At long- term follow-up, 12 had a symptomatic recurrence. Four of these were given surgical treatment and eight had a repeat topical treatment, which was effective in six. The overall effect was independent of the degree of phimosis. Four patients with obvious scarified foreskin failed. Twelve patients had agglutinations, which became apparent after the treatment for phimosis. We recorded no systemic and very few local side effects. The patients and parents found the treatment convenient and satisfactory.
CONCLUSION: Topical clobetasol 0.05% once a day for 4-6 weeks can be recommended as primary treatment in phimosis in boys without scarification of the foreskin. The treatment may be repeated as necessary.
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