Title: Phimosis: Nonsurgical Versus Surgical Management
Authors: Jain Neeraj Kumar, Gupta Neeraj, Lonare Rajesh, Maini Sunil Kumar, Wankhede Swapnil, Saxena Anand, Rakhonde Anant Kumar, Bhargava Arpit
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.57
Abstract
Background: Phimosis is non-retractile foreskin or prepuce over the glans.. The two types of phimosis, physiological and pathological must be differentiated. The phimosis can be treated by conservative methods by application of topical steroid cream. The objective of this study was to compare the efficacy of nonsurgical separation with topical clobetasol propionate 0.05% cream therapy versus circumcision for treatment of phimosis.
Methods: This study was done on 104 patients presenting with symptoms of phimosis were included in the study. The clinical examination of prepuce and penis was done. The patients were classified according to Kirkiros classification. Patients were divided in 2 groups. Group A included patients underwent immediate circumcision and group B included patients underwent nonsurgical separation with topical clobetasol cream therapy for 1month and outcome was analyzed.
Results: Out of total 104 patients, immediate circumcision was done in 36 patients. Patient treated with clobetasol were 68 the complete response was obtained in 43 (63.23%) The phimotic ring disappeared in 63.23% patients, after 4 weeks of topical clobetasol propionate 0.05% cream application. No or partial response of clobetasol cream was found in 25 (36.76%) patients, they underwent circumcision.
Conclusions: This study concludes that nonsurgical separation with topical clobetasol cream therapy is quite effective for treatment of grade 0,1,2 &3 phimosis and Circumcision was only choice for grade 4&5 phimosis.
Keywords: Phimosis, adhesiolysis, clobetasol therapy, non-surgical separation, circumcision.
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