Abstract

EFFECT OF HYDROCORTISONE TOPICAL CREAM IN CHILDREN WITH PHIMOSIS

Sah R. P.*, MS, Sah Pankaj, MBBS, Singh A. K., MD, Kushwaha G., Sah R. G., PhD

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Abstract

Introduction: Physiological phimosis is a normal developmental nonretractability of the foreskin which is not distinguished from true phimosis, the latter is frequently misdiagnosed. Parent’s anxiety and concern about their children's non-retractile prepuce are constant. As a result of this, most of the children end up having surgery. To prevent needless circumcision, physiological and pathological phimosis must be distinguished from one another. Recently, topical steroid treatment has been used successfully and favorably by parents in situations with non-retractile prepuce. It eliminates anesthesia and surgical problems, has low risks, and is cost effective. Materials and Methods: The study was conducted in Kanti Children Hospital, Kathmandu, Nepal from 2016 to 2018. One hundred and twenty patients (age range= 1 to 10 years) treated in the paediatric surgery OPD has been recruited for this study. Kikiros and Woodward retractibility grading was used for selection of patients. Results: This study followed 120 children with non-retractile foreskin who were treated locally with topical steroid cream (1% Hydrocortisone) over 8 week period. In accordance with Kikiro's classification, the non-retractibility was categorized. Age at presentation, complaints at initial examination, grade of phimosis at initial presentation (as per Woodward and Kikiro's classification), and outcomes of topical steroid application was evaluated at 8 weeks after starting application and after ceasing steroid administered for 8 weeks were taken into consideration when analyzing these patients. Out of 120 patients, 105 (87.5%) experienced a full recovery after using steroid cream, while the other 15 (12.5%) patients who had no improvement after eight weeks underwent circumcision.

Keywords: Phimosis, circumcision, paediatric, pathological, physiological, and topical hydrocortisone.