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Outcome of Topical Steroid Application in Children with Non-retractile Prepuce

True phimosis is overdiagnosed due to the failure to distinguish it from physiological phimosis, which is a normal developmental non retractability of the foreskin. The non-retractile prepuce in children is a cause of parental anxiety and concern. This leads to the majority of the children undergoin...

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Autores principales: Makhija, Deepa, Shah, Hemanshi, Tiwari, Charu, Dwiwedi, Pankaj, Gandhi, Suraj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522916/
https://www.ncbi.nlm.nih.gov/pubmed/29641424
http://dx.doi.org/10.34763/devperiodmed.20182201.7174
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author Makhija, Deepa
Shah, Hemanshi
Tiwari, Charu
Dwiwedi, Pankaj
Gandhi, Suraj
author_facet Makhija, Deepa
Shah, Hemanshi
Tiwari, Charu
Dwiwedi, Pankaj
Gandhi, Suraj
author_sort Makhija, Deepa
collection PubMed
description True phimosis is overdiagnosed due to the failure to distinguish it from physiological phimosis, which is a normal developmental non retractability of the foreskin. The non-retractile prepuce in children is a cause of parental anxiety and concern. This leads to the majority of the children undergoing surgical procedures. Pathological phimosis needs to be differentiated from physiologic phimosis to avoid unnecessary circumcision. In recent years, topical steroid application use in cases of non-retractile prepuce has shown a good success rate and is well accepted by the parents. It has low risks, is cost effective and avoids anaesthetic and surgical complications. This is an observational study of 100 children with non-retractile foreskin who were managed by local application of topical steroid cream (0.1% Mometasone) over a period of 6 weeks. The non-retractibility was classified according to Kikiro’s classification. These patients were analyzed on the basis of age at presentation, complaints at the first presentation, grade of phimosis at first presentation (as per Kikiro’s classification), results of the topical steroid application as assessed at 6 weeks after starting application and after stopping of the steroid administered for 6 weeks. The results were analyzed on the basis of the resolution of symptoms and the decrease in Kikiro’s grade. Those patients in whom there was no response to treatment or who developed recurrence after stopping steroid treatment underwent circumcision. A total of 19 patients required surgical intervention in the form of circumcision. The use of topical steroids yields satisfactory results in patients with a non-retractile prepuce. It could be a first-line treatment for management in such cases and is an effective alternative designed to avoid unnecessary circumcision.
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spelling pubmed-85229162021-11-19 Outcome of Topical Steroid Application in Children with Non-retractile Prepuce Makhija, Deepa Shah, Hemanshi Tiwari, Charu Dwiwedi, Pankaj Gandhi, Suraj Dev Period Med Original articles/Prace oryginalne True phimosis is overdiagnosed due to the failure to distinguish it from physiological phimosis, which is a normal developmental non retractability of the foreskin. The non-retractile prepuce in children is a cause of parental anxiety and concern. This leads to the majority of the children undergoing surgical procedures. Pathological phimosis needs to be differentiated from physiologic phimosis to avoid unnecessary circumcision. In recent years, topical steroid application use in cases of non-retractile prepuce has shown a good success rate and is well accepted by the parents. It has low risks, is cost effective and avoids anaesthetic and surgical complications. This is an observational study of 100 children with non-retractile foreskin who were managed by local application of topical steroid cream (0.1% Mometasone) over a period of 6 weeks. The non-retractibility was classified according to Kikiro’s classification. These patients were analyzed on the basis of age at presentation, complaints at the first presentation, grade of phimosis at first presentation (as per Kikiro’s classification), results of the topical steroid application as assessed at 6 weeks after starting application and after stopping of the steroid administered for 6 weeks. The results were analyzed on the basis of the resolution of symptoms and the decrease in Kikiro’s grade. Those patients in whom there was no response to treatment or who developed recurrence after stopping steroid treatment underwent circumcision. A total of 19 patients required surgical intervention in the form of circumcision. The use of topical steroids yields satisfactory results in patients with a non-retractile prepuce. It could be a first-line treatment for management in such cases and is an effective alternative designed to avoid unnecessary circumcision. Sciendo 2018-04-12 /pmc/articles/PMC8522916/ /pubmed/29641424 http://dx.doi.org/10.34763/devperiodmed.20182201.7174 Text en © 2018 Deepa Makhija, Hemanshi Shah, Charu Tiwari, Pankaj Dwiwedi, Suraj Gandhi, published by Sciendo https://creativecommons.org/licenses/by/4.0/This work is licensed under the Creative Commons Attribution 4.0 International License.
spellingShingle Original articles/Prace oryginalne
Makhija, Deepa
Shah, Hemanshi
Tiwari, Charu
Dwiwedi, Pankaj
Gandhi, Suraj
Outcome of Topical Steroid Application in Children with Non-retractile Prepuce
title Outcome of Topical Steroid Application in Children with Non-retractile Prepuce
title_full Outcome of Topical Steroid Application in Children with Non-retractile Prepuce
title_fullStr Outcome of Topical Steroid Application in Children with Non-retractile Prepuce
title_full_unstemmed Outcome of Topical Steroid Application in Children with Non-retractile Prepuce
title_short Outcome of Topical Steroid Application in Children with Non-retractile Prepuce
title_sort outcome of topical steroid application in children with non-retractile prepuce
topic Original articles/Prace oryginalne
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522916/
https://www.ncbi.nlm.nih.gov/pubmed/29641424
http://dx.doi.org/10.34763/devperiodmed.20182201.7174
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