📃 Paper Title: A conservative treatment of phimosis in boys
🧍 Author: PH ter Meulen
🕒 Year: 2001
📚 Journal: European Urology
🌎 Country: The Netherlands
ㅤContext to the study:
Can you tell me about a study that established the role of 0.05% clobetasol propionate cream as first-line treatment for phimosis in boys?
ㅤ✅ Take-home message of study:
Twice daily application of 0.05% clobetasol propionate cream for one month allowed the majority of boys referred for a circumcision to treat phimosis to avoid surgery and should therefore be considered as first-line treatment.
ㅤ Non-comparative prospective longitudinal cohort study
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Study participants:
94 consecutive boys (mean age 5.5 years, range 2-12 years) referred to secondary care for surgical treatment of phimosis were instead managed with twice daily application of 0.05% clobetasol propionate cream for one month, with instructions to manually retract the foreskin daily from 2 weeks of treatment.
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Key study outcomes:
After mean follow up of 11 months treatment with circumcision was required in only 24 boys (26.4%) and local anaesthetic division of adhesions in 13 (14.3%).
Three were lost to follow up (3.3%). Forty seven boys (50.0%) did not require further treatment after one month, and 7 (7.4%) had resolution of persistent adhesions/recurrence after a further month of treatment.
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Study Limitations:
As a non-comparative study it is not clear what the observed outcome would have been had the patients received no intervention.
Boys with signs of infection of the prepuce or with a 'so-called physiologically unretractable prepuce' were excluded and the results are therefore not generalisable to these groups.
Relatively short followup to check for recurrence and future need for circumcision
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