Topical Corticosteroids in the Treatment of Phimosis in Children

Zitat von mdpi

Conclusions

Most non-retractility of the foreskin in childhood is physiological and resolves spontaneously, and should be managed with reassurance rather than intervention. For boys who genuinely require treatment for symptomatic phimosis, topical corticosteroids are an effective first-line option. They probably improve or resolve phimosis in the majority of non-scarred cases, appear safe when used in short, localized courses, are inexpensive, and are well accepted, and they allow most boys to avoid circumcision and retain the prepuce. Accordingly, international guidelines now recommend a topical corticosteroid as first-line therapy for primary symptomatic phimosis, reserving surgery for pathological (scarred) phimosis and balanitis xerotica obliterans, for treatment failures, and for boys with specific urological indications. On current evidence, a trial of topical corticosteroid is therefore a reasonable first-line treatment for symptomatic phimosis in boys, with careful clinical vigilance for the minority whose disease reflects underlying lichen sclerosus.