Samujh Ram, Vinod M S and Kanojia Ravi
Accepted Abstracts: Surgery Curr Res
Randomized controlled study with the use of a topical steroid, 0.1% Mometasone furoate, for the treatment of phimosis to evaluate the response compared to placebo cream and to propose an ideal treatment regimen for childhood phimosis is reported. A total of 80 patients (age group 3-10 years) were selected to apply either 0.1% Mometasone furoate or a chosen placebo. The cr?me was applied as per a common regimen in both the groups. The subjects were evaluated at 1, 4 and 8 weeks after the application. At the end of therapy, any persistent adhesion was released with adhesionolysis on an OPD basis. Long term effect was evaluated at 6 months and 12 months. The nonresponders among placebo group were offered steroid therapy at the end of study to evaluate response. There were 40 patients in drug group and 36 in the placebo group. After four weeks therapy 38 patients (95%) of the drug group and 7 patients (19.5%) from the placebo group showed resolution of phimotic ring. Between the two groups the grade at first week did not show statistically significant difference with mean grades of 3.275 and 4.611 with P value of 0.16. Grades at 4 weeks were 1.575 and 4.083 respectively indicating a positive response to steroid therapy. P value was highly significant at 0.017. At the end of one year follow up cure rate in steroid group was 82%. With these results the present study showed that topical application of 0.1% Mometasone cream along with OPD based adhesionolysis is a safe, simple, and effective procedure with no significant side effects for treating phimosis in prepubertal boys. Therefore, this could be the first choice of treatment for boys with severe phimosis instead of circumcision.
Samujh Ram has completed Master of Surgery (MS) & Magister Chirurgiae (Pediatric Surgery) from Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India in the year 1998 & 1991 respectively. He is Fellow of Royal College of Surgeons in Ireland. Presently he is working as Professor of Pediatric Surgery at PGIMER, Chandigarh (India). He has published more than 69 papers in the reputed national & international journals and chaired scientific sessions in the medical conferences. He is editor of the Journal of Progress in Pediatric Urology.
