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Abstract
Purpose
We evaluated the effect of a topical steroid (0.05% clobetasol propionate [DermovateⓇ]) on phimosis.
Materials and Methods
Between May 2005 and May 2007, 30 boys with phimosis were assigned to receive topical application of DermovateⓇ. Of the 30 boys, 19 boys had concealed penises. The parents of the boys were instructed to retract the foreskin gently without causing pain, and to apply the topical steroid 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 1–6. Response to treatment was arbitrarily defined as improvement in the retractibility score (complete response, score 5 and 6; partial response, score 3 and 4; no response, score 1 and 2). The effect of treatment was studied with respect to the duration of treatment, age, and an associated concealed penis.
Results
The pretreatment grade in all patients was a retractibility score of 1. The mean age of the patients was 48.5±27.6 months (range, 7–108 months). The complete response rates in boys treated for 4 and 8 weeks were 50% and 73.3%, respectively. In boys younger than 3 years of age (n=12) and older than 3 years of age (n=18), the complete response rates were 75% and 72.2%, respectively (p=0.866). In boys with or without an associated concealed penis (n=19 and n=11, respectively), the complete response rates were 63.1% and 90.9%, respectively (p=0.199). No adverse effect was encountered in all patients.
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Table 1.
The grade of prepuce retractability
Table 2.
Treatment outcome based on the duration of treatment
| Treatment duration (weeks) | Treatment outcome | Total | |
|---|---|---|---|
| Complete response | No Response | ||
| 4 | 15 (50) | 15 (50) | 30 |
| 8 | 7 (70) | 3 (30) | 10∗ |
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