Skip to main content
Top
Published in: International Urology and Nephrology 3/2016

01-03-2016 | Urology - Review

Is steroids therapy effective in treating phimosis? A meta-analysis

Authors: Jiaming Liu, Jin Yang, Yuntian Chen, Sihang Cheng, Chao Xia, Tuo Deng

Published in: International Urology and Nephrology | Issue 3/2016

Login to get access

Abstract

Purpose

We evaluated a systematic review on the therapeutic efficacy of topical steroids in children with phimosis to provide data for the clinical options of pediatric phimosis.

Methods

We searched the related original studies on topical steroid therapy in pediatric phimosis before August 2014. Two reviewers independently performed the study selection, data extraction, risk of bias and reporting quality assessment with confirmation by cross-checking. The quality of eligible studies was appraised with the ‘Cochrane handbook.’ The meta-analysis was performed by REVMAN 5.2 software.

Results

Eleven studies were included with 1669 patients among which 1093 received topical steroids and 576 cases treated with placebo or only manual reduction. Significant difference of the treatment efficacy was detected among the three methods [OR 7.46, 95 % CI (4.42, 12.58), p < 0.00001]. In subgroup analysis, significant difference of the treatment efficacy was also detected whether with placebo or manual reduction only [respectively, OR 5.04, 95 % CI (3.19, 7.95), p < 0.00001; OR 16.28, 95 % CI (6.06, 43.69), p < 0.00001].

Conclusions

Compared to the placebo or manual reduction method, the topical steroid therapy is more effective in the treatment of phimosis in children. Although there is still controversy in the different type and dosage of steroid, this could be used against phimosis before circumcision.
Literature
2.
go back to reference Oster J (1968) Further fate of the foreskin. Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child 43(228):200–203PubMedCentralCrossRefPubMed Oster J (1968) Further fate of the foreskin. Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child 43(228):200–203PubMedCentralCrossRefPubMed
5.
go back to reference Golubovic Z, Milanovic D, Vukadinovic V, Rakic I, Perovic S (1996) The conservative treatment of phimosis in boys. Br J Urol 78(5):786–788CrossRefPubMed Golubovic Z, Milanovic D, Vukadinovic V, Rakic I, Perovic S (1996) The conservative treatment of phimosis in boys. Br J Urol 78(5):786–788CrossRefPubMed
6.
go back to reference Lindhagen T (1996) Topical clobetasol propionate compared with placebo in the treatment of unretractable foreskin. Eur J Surg 162(12):969–972PubMed Lindhagen T (1996) Topical clobetasol propionate compared with placebo in the treatment of unretractable foreskin. Eur J Surg 162(12):969–972PubMed
8.
go back to reference Lee JW, Cho SJ, Park EA, Lee SJ (2006) Topical hydrocortisone and physiotherapy for nonretractile physiologic phimosis in infants. Pediatr Nephrol (Berlin, Germany) 21(8):1127–1130. doi:10.1007/s00467-006-0104-8 CrossRef Lee JW, Cho SJ, Park EA, Lee SJ (2006) Topical hydrocortisone and physiotherapy for nonretractile physiologic phimosis in infants. Pediatr Nephrol (Berlin, Germany) 21(8):1127–1130. doi:10.​1007/​s00467-006-0104-8 CrossRef
10.
go back to reference Esposito C, Centonze A, Alicchio F, Savanelli A, Settimi A (2008) Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial. World J Urol 26(2):187–190. doi:10.1007/s00345-007-0231-2 CrossRefPubMed Esposito C, Centonze A, Alicchio F, Savanelli A, Settimi A (2008) Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial. World J Urol 26(2):187–190. doi:10.​1007/​s00345-007-0231-2 CrossRefPubMed
12.
go back to reference Nascimento FJ, Pereira RF, Silva JL 2nd, Tavares A, Pompeo AC (2011) Topical betamethasone and hyaluronidase in the treatment of phimosis in boys: a double-blind, randomized, placebo-controlled trial. Int Braz J Urol 37(3):314–319CrossRefPubMed Nascimento FJ, Pereira RF, Silva JL 2nd, Tavares A, Pompeo AC (2011) Topical betamethasone and hyaluronidase in the treatment of phimosis in boys: a double-blind, randomized, placebo-controlled trial. Int Braz J Urol 37(3):314–319CrossRefPubMed
13.
go back to reference Chu CC, Chen KC, Diau GY (1999) Topical steroid treatment of phimosis in boys. J Urol 162(3 Pt 1):861–863CrossRefPubMed Chu CC, Chen KC, Diau GY (1999) Topical steroid treatment of phimosis in boys. J Urol 162(3 Pt 1):861–863CrossRefPubMed
15.
go back to reference Yilmaz E, Batislam E, Basar MM, Basar H (2003) Psychological trauma of circumcision in the phallic period could be avoided by using topical steroids. Int J Urol 10(12):651–656CrossRefPubMed Yilmaz E, Batislam E, Basar MM, Basar H (2003) Psychological trauma of circumcision in the phallic period could be avoided by using topical steroids. Int J Urol 10(12):651–656CrossRefPubMed
17.
18.
go back to reference Rao LS, Long WS, Kaneko T, Blumenberg M (2003) Regulation of transcription factor activity by extracellular signals in epidermal keratinocytes. Acta Dermatovenerol 12:3–14 Rao LS, Long WS, Kaneko T, Blumenberg M (2003) Regulation of transcription factor activity by extracellular signals in epidermal keratinocytes. Acta Dermatovenerol 12:3–14
19.
go back to reference Radoja N, Komine M, Jho SH, Blumenberg M, Tomic-Canic M (2000) Novel mechanism of steroid action in skin through glucocorticoid receptor monomers. Mol Cell Biol 20(12):4328–4339PubMedCentralCrossRefPubMed Radoja N, Komine M, Jho SH, Blumenberg M, Tomic-Canic M (2000) Novel mechanism of steroid action in skin through glucocorticoid receptor monomers. Mol Cell Biol 20(12):4328–4339PubMedCentralCrossRefPubMed
20.
go back to reference Monsour MA, Rabinovitch HH, Dean GE (1999) Medical management of phimosis in children: our experience with topical steroids. J Urol 162(3 Pt 2):1162–1164PubMed Monsour MA, Rabinovitch HH, Dean GE (1999) Medical management of phimosis in children: our experience with topical steroids. J Urol 162(3 Pt 2):1162–1164PubMed
21.
22.
go back to reference Favorito LA, Balassiano CM, Rosado JP, Cardoso LE, Costa WS, Sampaio FJ (2012) Structural analysis of the phimotic prepuce in patients with failed topical treatment compared with untreated phimosis. Int Braz J Urol 38(6):802–808CrossRefPubMed Favorito LA, Balassiano CM, Rosado JP, Cardoso LE, Costa WS, Sampaio FJ (2012) Structural analysis of the phimotic prepuce in patients with failed topical treatment compared with untreated phimosis. Int Braz J Urol 38(6):802–808CrossRefPubMed
25.
go back to reference Munro NP, Khan H, Shaikh NA, Appleyard I, Koenig P (2008) Y-V preputioplasty for adult phimosis: a review of 89 cases. Urolgoy 72(4):918–920CrossRef Munro NP, Khan H, Shaikh NA, Appleyard I, Koenig P (2008) Y-V preputioplasty for adult phimosis: a review of 89 cases. Urolgoy 72(4):918–920CrossRef
26.
go back to reference Berdeu D, Sauze L, Ha-Vinh P, Blum-Boisgard C (2001) Cost-effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect. BJU Int 87(3):239–244CrossRefPubMed Berdeu D, Sauze L, Ha-Vinh P, Blum-Boisgard C (2001) Cost-effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect. BJU Int 87(3):239–244CrossRefPubMed
27.
go back to reference Van Howe RS (1998) Cost-effective treatment of phimosis. Pediatrics 102(4):43CrossRef Van Howe RS (1998) Cost-effective treatment of phimosis. Pediatrics 102(4):43CrossRef
Metadata
Title
Is steroids therapy effective in treating phimosis? A meta-analysis
Authors
Jiaming Liu
Jin Yang
Yuntian Chen
Sihang Cheng
Chao Xia
Tuo Deng
Publication date
01-03-2016
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 3/2016
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-015-1184-9

Other articles of this Issue 3/2016

International Urology and Nephrology 3/2016 Go to the issue

Urology – Letter to the Editor

An unexpected number of bladder stones