Objective: In our country, thermocautery device is used extensively for circumcision per- formed under local anesthesia for fast and safe circumcision. One of the complications that may occur after circumcision with thermocautery is pathological phimosis. However, there aren’t stud- ies in the literature regarding the medical treat- ment of pathological phimosis after circumcision with thermocautery. We aimed to investigate the effectiveness of topical corticosteroid application in the treatment of pathological phimosis devel- oped after circumcision with thermocautery.
Material and Methods: Data of 68 patients (aged: 1-8 years) who developed phimosis second- ary to circumcisions performed by one surgeon between the years 2009 and 2018 were analysed retrospectively from a computerised database. Cases of phimosis developed after circumcisions performed using thermocautery and scalpel were analysed in two separate groups, and the effective- ness of topical steroid treatment was evaluated.
Results: In the thermocautery group, 32 pa- tients who developed Grade 5 phimosis didn’t respond to steroid therapy, while only three of 16 (18.75%) cases with Grade 4 phimosis responded partially to topical steroid treatment. All these 48 cases were treated with surgery. In the scalpel group, no therapeutic response was elicited in four cases who developed Grade 5 phimosis. Howev- er, four out of eight (50%) patients with Grade 4 and six out of eight (75%) patients with Grade 3 phimosis responded to steroid therapy, and full re- traction of the foreskin was achieved. In the scal- pel group, ten cases underwent surgical revision.
Conclusion: Topical steroid creams may be partially beneficial in cases of pathological phimosis after circumcision. However, they do not show efficacy in cases of high-grade phimosis after thermo- cautery use.
Keywords: Cautery, circumcision, phimosis, topical steorid
Abstract
Objective: In our country, thermocautery device is used extensively for circumcision per- formed under local anesthesia for fast and safe circumcision. One of the complications that may occur after circumcision with thermocautery is pathological phimosis. However, there aren’t stud- ies in the literature regarding the medical treat- ment of pathological phimosis after circumcision with thermocautery. We aimed to investigate the effectiveness of topical corticosteroid application in the treatment of pathological phimosis devel- oped after circumcision with thermocautery.
Material and Methods: Data of 68 patients (aged: 1-8 years) who developed phimosis second- ary to circumcisions performed by one surgeon between the years 2009 and 2018 were analysed retrospectively from a computerised database. Cases of phimosis developed after circumcisions performed using thermocautery and scalpel were analysed in two separate groups, and the effective- ness of topical steroid treatment was evaluated.
Results: In the thermocautery group, 32 pa- tients who developed Grade 5 phimosis didn’t respond to steroid therapy, while only three of 16 (18.75%) cases with Grade 4 phimosis responded partially to topical steroid treatment. All these 48 cases were treated with surgery. In the scalpel group, no therapeutic response was elicited in four cases who developed Grade 5 phimosis. Howev- er, four out of eight (50%) patients with Grade 4 and six out of eight (75%) patients with Grade 3 phimosis responded to steroid therapy, and full re- traction of the foreskin was achieved. In the scal- pel group, ten cases underwent surgical revision.
Conclusion: Topical steroid creams may be partially beneficial in cases of pathological phimosis after circumcision. However, they do not show efficacy in cases of high-grade phimosis after thermo- cautery use.
Keywords: Cautery, circumcision, phimosis, topical steorid