Dr. Anoop Kumar singh


Introduction: Physiological phimosis, a common complaint in the surgery outpatient department presenting as non-retractile foreskin is due to adhesions between the inner layer of the prepuce with glans penis or due to tight tip of the prepuce. These patients are managed with circumcision, preputial dilatation and topical application of steroid. In this study, we compare different outcomes measures in children treated with dilatation along with Betamethasone ointment.

Methods: This prospective  study was conducted in the department of General surgery outpatient department in 2018. We followed up 50 patients who underwent  application of betamethasone ointment followed by dilatation and application of betamethasone impregnated antibiotic cream twice daily over a period of six weeks. We recorded basic demographic features, parent anxiety, parental compliance, parent satisfaction, complete response and persistence of phimosis at the end of the treatment.

Results: The median age of the patients was 36 with  range (23-48) months. At the end of six weeks, with regard to all outcome measures namely parent compliance, parent satisfaction, symptom resolution. Moreover, phimosis persisted in 3 (6%) of the patients treated with dilatation and betnovate ointment.

Conclusions: This study shows that Dilatation and local application of betnovate ointment is a better alternative to circumcision.

Full Text:



Orsola A, Caffaratti J, Garat JM: Conservative treatment of phimosis in children using a topical steroid. Urology. 2000; 56: 307-10. [ Links ]

Elmore JM, Baker LA, Snodgrass WT: Topical steroid therapy as an alternative to circumcision for phimosis in boys younger than 3 years. J Urol. 2002; 168: 1746-7; discussion 1747. [ Links ]

Chu CC, Chen KC, Diau GY: Topical steroid treatment of phimosis in boys. J Urol. 1999; 162: 861-3. [ Links ]

Ozkan S, Gurpinar T: A serious circumcision complication: penile shaft amputation and a new reattachment technique with a successful outcome. J Urol. 1997; 158: 1946-7. [ Links ]

Berdeu D, Sauze L, Ha-Vinh P, Blum-Boisgard C: Cost-effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect. BJU Int. 2001; 87: 239-44. [ Links ]

Gulobovic Z, Milanovic D, Vukadinovic V, Rakie I, Perovic S: The conservative treatment of phimosis in boys. Br J Urol. 1996; 78: 786-8. [ Links ]

Wright JE: The treatment of childhood phimosis with topical steroid. Aust N Z J Surg. 1994; 64: 327-8. Erratum in: Aust N Z J Surg. 1995; 65: 698. [ Links ]

Jorgensen ET, Svensson A: The treatment of phimosis in boys, with a potent topical steroid (clobetasol propionate 0.05%) cream. Acta Derm Venereol. 1993; 73: 55-6. [ Links ]

Atilla MK, Dundaroz R, Odabas O, Ozturk H, Akin R, Gokcay E: A non-surgical approach to the treatment of phimosis: local non-steroidal anti-inflammatory ointment application. J Urol. 1997; 158: 196-7. [ Links ]

Kikiros CS, Beasley SW, Woodward AA. The response of phimosis to local steroid application. Pediatr Surg. Int. 1993; 8: 329-32. [ Links ]

Kayaba H, Tamura H, Kitajima S, Fujiwara Y, Kato T, Kato T: Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol. 1996; 156: 1813-5. [ Links ]

Sokol RR, Rohlf FJ: Biometry, 3rd (ed.), New York, USA: Freeman WH, 1995. [ Links ]

Shankar KR, Rickwood AM: The incidence of phimosis in boys. BJU Int. 1999; 84: 101-2. [ Links ]

Marzaro M, Carmignola G, Zoppellaro F, Schiavon G, Ferro M, Fusaro F, et al.: Phimosis: when does it require surgical intervention? Minerva Pediatr. 1997; 49: 245-8. [ Links ]

Lund L, Wai KH, Mul LM, Yeung CK: Effect of topical steroid on non-retractile pre-pubertal foreskin by a prospective, randomized, double-blind study. Scand J Urol Nephrol. 2000; 34: 267-9. [ Links ]

Lee KS, Koizumi T, Nakatsuji H, Kojima K, Yamamoto A, Kavanishi Y, et al.: Treatment of phimosis with betamethasone ointment in children. Nippon Hinyokika Gakkai Zasshi. 2001; 92: 619-23. [ Links ]

Monsour MA, Rabinovitch HH, Dean GE: Medical management of phimosis in children: our experience with topical steroids. J Urol. 1995; 162: 1162-4. [ Links ]

Ashfield JE, Nickel KR, Siemens DR, MacNeily AE, Nickel JC: Treatment of phimosis with topical steroids in 194 children. J Urol. 2003; 169: 1106-8. [ Links ]

- MARQUES, Tatiana C.; SAMPAIO, Francisco J.B. and FAVORITO, Luciano A.. Treatment of phimosis with topical steroids and foreskin anatomy. Int. braz j urol. [online]. 2005, vol.31, n.4.


  • There are currently no refbacks.