THE RESPONSE OF PHIMOSIS TO LOCAL STEROID APPLICATION

The effectiveness of topical steroid application in relieving phimosis was studied in 63 boys treated with local application of steroid oint ment to the foreskin. Betamethasone valerate 0.05% (42 patients), hydr ocortisone 1% (18 patients), or hydrocortisone 2% (3 patients) was app lied three times daily for 4 weeks. Thirty-seven of the patients treat ed with 0.05% betamethasone valerate ointment (half-strength Betnovate ) showed an initial improvement and circumcision was performed on 5 no n-responders. Six patients showed initial improvement but later redeve loped phimosis: they were given a further course of treatment, resulti ng in 2 satisfactory responses and 4 failures requiring circumcision. Two patients using 2% hydrocortisone and 16 using 1% hydrocortisone oi ntment showed improvement, but 2 of the latter group ultimately requir ed circumcision. Overall, a permanent improvement was achieved in 51 o f the 63 patients, with the ability to retract the foreskin after one or more treatments. The remaining 12 boys required circumcision. Local application of steroid ointment to the foreskin results in resolution of phimosis in the majority of cases, but if the foreskin has a circu mferential white scar, it is slightly less likely to respond. Followin g cessation of steriods, phimosis re-develops in a proportion of patie nts.