Alternative Treatmnents to Circumcision for Phimosis in Children

Authors

  • Phitsanu Mahawong Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Keywords:

Alternative treatements, circumcision, phimosis, children

Abstract

Phimosis is a common condition among children. Physiologic phimosis resolves spontaneously by 3-4 years of age. Only a few older children have persistent phimosis which may cause problems such as recurrent balanitis or balanoposthitis. These children absolutely need treatment for their phimosis. Although circumcision is a standard treatment of phimosis, there is a trend toward more conservative management. The most popular alternative treatment is topical steroid with stretching method and the second most popular is prepuce plasty. Not only these optimal treatments yield similar functional outcomes but they cost less and produce more pleasant cosmetic outcomes when compared with conventional circumcision.

Downloads

Download data is not yet available.

References

Hsieh TF, Chang CH, Chang SS. Forreskin development before aldolescence in 2149 schoolboys. Int J Urol 2006; 13(7): 968-70.

Imamura E. Phimosis of infant and young children in Japan. Acta Paediatr Jpn 1997; 39(4): 403-5.

McGregor TB, Pike JG, Leonard MP. Phimosis-a diagnostic dilemma? Can J Urol 2005; 12(2): 2598-602.

Kumar P, Deb M, Das K. Preputial adhesions-a misunderstood entity. Indian J Pediatr 2009; 76(8): 829-32.

Oster J. Further fate of the foreskin. Incidence of preputial adhesions, phimosis, and smegma among Danish school boys. Arch Dis Child 1968; 43(228): 200-3.

Jasaitiene D, Valiukeviciene S, Vaitkiene D, Jievaltas M, Barauskas V, Gudinaviciene, et al. Lichen sclerosus et atrophicus in pediatric and adult male patients with congenital and acquired phimosis. Medicina (Kaunas) 2008; 44(6): 460-6.

Gargollo PC, Kozakewich HP, Bauer SB, Borer JG, Peters CA, Retik AB, et al. Balanitis xerotica obliterans in boys. J Urol 2005; 174(4 Pt 1): 1409-12.

Bochove-Overgaauw DM, Gelders W, De Vylder AM. Routine biopsies in pediatric circumcision: (non) sense? J Pediatr Urol 2009; 5(3): 178-80.

Kiss A, Kiraly L, Kustasy B, Merksz M. High incidence of balanitis xerotica obliterans in boys with phimosis. Pediatr Dermatol 2005; 22(4): 305-8.

Bromage SJ, Crump A, Pearce I. Phimosis as a presenting feature of diabetes. BJU Int 2008; 101(3): 338-40.

Yusuke H, Yoshinori H, Kenichi M, Akio H. Granulomatous balanoposthitis after intravesical Bacillus-Calmette-Guerin instillation therapy. Int J Urol 2006; 13(10): 1361-3.

Shankar KR, Rickwood AM. The incidence of phimosis in boys. BJU Int 1999; 84(1): 101-2.

Machmouchi M, Alkhotani A. Is neonatal circumcision judicious? Eur J Pediatr Surg 2007; 17(4): 266-9.

Shah T, Raistrick J, Taylor I, Young M, Menebhi D, Stevens R. A circumcision service for religious reasons. BJU Int 1999; 83(7): 807-9.

Taeusch HW, Martinez AM, Partridge JC, Sniderman S, Armstrong-Wells J, Fuentes-Afflick E, et al. Pain during Mogen or Plastibell circumcision. J Perinatol 2002; 22(3): 214-8.

Mahomed A, Zaparackaite I, Adam S. Improving outcome from Plastibell circumcision in infants. Int Braz J Urol 2009; 35(3): 310- 3.

Lau JT. A filed Kocher clamp for circumcision in children. Singapore Med J 1983; 24(2): 113-4.

Tucker SC. Cergueiro J, Sterne GD, Bracka A. Circumcision: a refined technique and 5 year review. Ann R Coll Surg Engl 2001; 83(2): 121-5.

Harahap M, Siregar AS. Circumcision: a review and a new technique. J Dermatol Surg Oncol 1988; 14(4): 383-6.

Schmitz RF, Schulpen TW, Rediopawiro MS, Lien MS, Madem GC, Van Der Werken C. Religious cir cumcision under local anaesthesia with a new disposable clamp. BJU Int 2001; 88(6): 581-5.

Basar H, Yilmaz E, Baar MM, Batislam E, Tuglu D. Window technique on circumcision. Int Urol Nephrol 2006; 38(3-4): 599-601.

Amir M, Raja MH, Niaz WA. Neonatal circumcision with Gomco clamp-a hospital-based retrospective study of 1000 cases. J Pak Med Assoc 2000; 50(7): 224-7.

OûSullivan DC, Heal MR, Powell CS. Circumcision: how do urologist do it? Br J Urol 1996; 78(2): 265-70.

Horowitz M, Gershbein AB. Gomco circumcision: When is it safe? J Pedistr Surg 2001; 36(7): 1047-9.

Weiss HA, Larke N, Halperin D, Schenker l. Complications of circumcision in male neonates, infants and children: a systemic review. BMC Urol 2010; 16: 10: 2.

Ceylan K, Burhan K, Yimaz Y, Can S, Kus A, Mustafa G. Severe complications of circumcision: an analysis of 48 cases. J Pediatr Urol 2007; 3(1): 32-5.

Yegane RA, Kheirollahi AR, Salehi NA, Bashashati M, Khoshdel JA, Ahmadi M. Late complications of circumcision in Iran. Pediatr Surg Int 2006; 22(5): 442-5.

Hoffman S, Metz P, Ebbehoi J. A new operation for phimosis: prepuce-saving technique with multiple Y-V plasties. Br J Urol 1984; 56(3): 319-21.

Nieuwenhuijs JL, Dik P, Klijn AJ, de Jong TP. Y-V plasty of the foreskin as an alternative to circumcision for surgical treatment of phimosis during childhood. J Pediatr Urol 2007; 3(1): 45-7.

Munro NP, Khan H, Shaikh NA, Appleyard I, Koenig P. Y-V preputioplasty for adult phmosis: a review of 89 cases. Urology 2008; 72(4): 918-20.

Dessanti A, Ginesu G, Iannuccelli M, Balata A. Phimosis. Preputial plasty using traversal widening on the dorsal side with EMLA local anesthetic cream. J Pediatr Surg 2005; 40(4): 713-5.

Wahlin N. çTripple incison plastyé. A convenient procedure for preputial relief. Scand J Urol 1992; 26(2): 107-10.

Fischer-Klein Ch, Rauchenwald M. Tripple incision to treat phimosis in children: an alternative to circumcision? BJU Int 2003; 92(4): 459-62.

Barber NJ, Chappell B, Carter PG, Britton JP. Is preputioplasty effective and acceptable? J R Soc Med 2003; 96(9): 452-3.

Lane TM, South LM. Lateral preputioplasty for phimosis. J R Coll Surg Edinb. 1999; 44(5): 310-2.

Christianakis E. Sutureless prepuceplasty with wound healing by second intention: an alternative surgical approach in childrenûs phimosis treatment. BMC Urol 2008; 8: 6.

Emmett AJ. Four V-flap repair of preputial stenosis (phimosis). Plast Reconstr Surg 1975; 55(6): 687-9.

Emmette AJ. Zplasty reconstruction for preputial stenosis-a surgical alternative to circumcision. Aust Paediatr J 1982; 18(3): 219-20.

He Y, Zhou XH. Balloon dilation treatment of phimosis in boys. Report of 512 cases. Chin Med J (Engl) 1991; 104(6): 491-3.

Lee JW, Cho SJ, Park EA, Lee SJ. Topical hydrocortisone and physiotherapy for nonretractile physiologic phymosis in infants. Pediatr Nephrol 2006; 21(8): 1127-30.

Zampieri N, Corroppolo M, Camoglio FS, Giacomello L, Ottolenghi A. Phimosis: Stretching methods with or without application of topical steroids? J Pediatr 2005; 147(5): 705-6.

Ghysel C, Vander Eeckt K, Bogaert GA. Long-term efficacy of skin stretching and a topical corticoid cream application for unretractable foreskin and phimosis in prepubertal boys. Urol Int 2009; 82(1): 81-8.

Berdeu D, Sauze L, Ha-Vinh P, Blum-Boisgard C. Cost-effectiveness analysis of treatments for phimosis: a comparison of surgical and medical approaches and their economic effect. BJU Int 2001; 87(3): 239-44.

Orsola A. Caffaratti J, Garat JM. Conservative treatment of phimosis in children using a topical steroids. Urology 2000; 56(2): 307-10.

Ng WT, Fan N, Wong CK, Leung SL, Yuen KS, Sze YS, et al. Treatment of childhood phimosis with a moderately potent topical steroid. ANZ J Surg 2001; 71(9): 541-3.

Letendre J, Barrieras D, Franc-Guimond J, Abdo A, Houle AM. Topical triamcinolone for persistent phimosis. J Urol 2009; 182(4 Suppl): 1759-63.

Yilmaz E, Batislam E, Basar MM, Basar H. Phychologic trauma of circumcision in the phallic period could be avoided by using topical steroids. Int J Urol 2003; 10(12): 651-6.

Marques TC, Sampaio FJ, Favorito LA. Treatment of phimosis with topical steroids and foreskin anatomy. Int Braz J Urol 2005;31(4): 370-4.

Zampieri N, Corroppolo M, Zuin V, Bianchi S, Camoglio FS. Phimosis and topical steroids: new clinical findings. Pediatr Surg Int 2007; 23(4): 331-5.

Palmer LS. Palmer JS. The efficacy of betamethasone for treating phimosis: a comparison of two regimens. Urology 2008; 72(1): 68-71.

Pileggi Fde O, Vicente YA. Phimotic ring topical corticoid cream (0.1% mometasone furoate) treatment in children. J Pediatr Surg 2007; 42(10): 1749-52.

Esposito C, Centonze A, Alicchio F, Savanelli A, Settimi A. Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial. World J Urol 2008; 26(2): 187-90.

Zavras N, Christianakis E, Mpourikas D, Ereikat K. Conservative treatment of phimosis with fluticasone propionate 0.05%: a clinical study in 1185 boys. J Pediatr Urol 2009; 5(3): 181-5.

Sookpotarom P, Porncharoenpong S, Veichapipat P. Topical steroid is effective for the treatment of phimosis in young children. J Med Assoc Thai 2010; 93(1): 77-83.

Kayaba H, Tamura H, Kitajima S, Fujiwara Y, Kato T. Analysis of shape and retractibility of the prepuce in 603 Japanese boys. J Urol 1996; 156(5): 1813-5.

Kotera S. Conservative method for the treatment of phimosis with an estrogen containing cream on children. Jpn J Urol Surg 1995; 8: 575-8.

Yanagisawa N, Baba K, Yamagoe M, Iwaoto T. Conservative treatment of childhood phimosis with topical conjugated equine estrogen ointment. Int J Urol 2000; 7(1): 1-3.

Atilla MK, Dundaroz R, Odabas O, Ozturk H, Akin R, Gokcay E. A nonsurgical approach to the treatment of phimosis: local nonsteroidal anti-inflamatory ointment application. J Urol 1997; 158(1): 196-7.

Downloads

Published

2010-12-01

How to Cite

Mahawong, P. (2010). Alternative Treatmnents to Circumcision for Phimosis in Children. Insight Urology, 31(2), 79–87. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/252371

Issue

Section

Review article

Most read articles by the same author(s)

> >>