Treatment of phimosis with topical steroids and foreskin anatomy

ABSTRACT

OBJECTIVES: To correlate topical steroidal treatment of stenosed foreskin with the different degrees of glans exposure and the length of time the ointment is applied. MATERIALS AND METHODS: We studied 95 patients with phimosis, divided according to the degree of foreskin retraction. Group A presented no foreskin retraction, group B presented exposure of only the urethral meatus, group C presented exposure of half of the glans, and group D presented exposure of the glans, which was incomplete because of preputial adherences to the coronal sulcus. Patients were submitted to application of 0.05 percent betamethasone ointment on the distal aspect of the prepuce twice daily for a minimum of 30 days and a maximum of 4 months. RESULTS: Of 95 patients, 10 (10.52 percent) abandoned the treatment and 15 patients in groups C and D were excluded from the study. Among the remaining 70 patients, only 4 patients (5.7 percent) in group A did not obtain adequate glans exposure after treatment. In group A (38 patients), fully retractable foreskins were obtained in 19 patients (50 percent) after 1 month of treatment. In group B (28 patients), fully retractable foreskins were obtained in 18 patients (64.2 percent) after 1 month. CONCLUSIONS: Treatment was successful in 94.2 percent of patients, irrespective of the type of foreskin anatomy. The improvement may require several months of treatment. Patients with impossibility of urethral meatus exposure present around 10 percent treatment failure.