A Prospective observational study on the usefulness and safety of topical steroid in the treatment of Childhood Phimosis at the Andaman and nicobar Islands

To determine the effectiveness and adverse effects (if any) of one or two months of application of Clobetasol propionate cream to the prepuces of younger boys to cure non-retractability of various degrees

A prospective experimental study of a single intervention of short duration followed by rescue of non-responders with definitive treatment in a Medical College Hospital Out Patient Department in a tropical island setting.

200 boys between one and ten years age with phimosis attending OPD of Department of Surgery and Pediatrics in a tropical island Medical College Teaching Hospital, except for those with the declared exclusion criteria, were studied. After recording the grade of non-retractability of their prepuce, all the boys had a thin layer of Clobetasol propionate cream applied twice daily on their prepuces. They were reviewed a month later and again another month later for any adverse effects and for cure of their nonretractability. After two months the steroid applications were stopped and those who were not cured in two months, were circumcised. All subjects were followed up monthly for another six months, and those who recurred were also circumcised.

Twice daily Clobetasol propionate cream application cured 138/150 (92%) of boys with perceived phimosis without any discovered adverse effects and only three of these initially cured boys needed circumcision after 6 months.

Clobetasol proprionate cream application is very useful and safe in treating childhood phimosis at the tropical islands setting of this study.