Phimosis treatment with topical corticoids in children older than 36 months and under 36 months with surgical treatment indication, in primary care

Description

Introduction: Phimosis is a physiological condition with spontaneous resolution over 90% within the first three years of life. If not resolved or complications are added, probability of disease progression is high. Corticosteroid therapy is suggested as first line, by its cost effectiveness, high resolution rate and no adverse effects. Objective: To describe the results of topical corticosteroids treatment in children with more than 36 months or younger with a medical indication for treatment, in primary care. Methods: longitudinal, prospective, concurrent study analyzed 31 patients during 3 years, diagnosed with high degree phimosis greater than 36 months, and younger with complications. Response to betamethasone 0.05% treatment was assessed. Resolution, relapses and adverse effects up to 16 weeks and 2 years after treatment were recorded. Results: Short term total resolution reached 83.3%, and 16.7% was sent to surgery. In two-year follow-up, total resolution reached 73.3%, and 26.7% was sent to surgery. In relation to the treatment groups, in children with high degree phimosis and age 80.8% were resolved in a short term and 69.2% in two-year follow-up. The group of recurrent infections showed 100% resolution, without relapses. Conclusion: Topical betamethasone 0.05% is effective, safe and accessibility treatment in primary care for persistent phimosis in children older than 3 years and in younger children with need for circumcision. Keywords: phimosis,