Success of conservative treatment of phimosis, does the topical corticosteroid application regime influence this?

Abstract

Introduction. Currently there is no single application guideline established for the topical corticosteroid treatment of phimosis. We set out to compare the  effectiveness of two of the most widely used guidelines, as well as the importance of other factors in the success of conservative treatment.
Material and methods. Retrospective cohort-type analytical study, including children with uncomplicated phimosis who received two different regimens of topical corticosteroid application (with a rest period and a descending dose). The final result of circumcision or cure was studied based on the guideline and other epidemiological factors.
Results. 159 children with a mean age of 6 years were included. The regimen with rest was applied in 57.9% of the patients with an adherence of 93.4% and a cure rate of 83.7%, compared to 79.1% in the group with a descending regimen (non-significant difference). An increased risk of circumcision was observed in patients  with previous topical treatment and with scarred foreskin and a protective role of adherence to treatment. The presence of previous balanitis or the degree of phimosis is not associated with greater treatment failure.
Conclusions. The application guidelines studied do not show significant differences in the cure rate. However, adherence is greater with the rest pattern, so it seems advisable. Balanitis and a high degree of phimosis would not be an initial contraindication to conservative treatment.