The problem with prepuce retraction is caused not only by its narrowing, called phimosis, but also frequently by the inner prepuce adhesion to glans. The spontaneous prepuce retraction is received in 80% cases of boys up to the age of two, whereas in remaining cases, after the age of two it is necessary to take up the medical treatment. The purpose of the research was to estimate the effectiveness of conservative therapy using steroid ointments which was undertaken in boys referred to Outpatient Paediatric Surgery Centre with recognition of phimosis.
Material and methods: Cases of 315 boys referred to Outpatient Paediatric Surgery Centre due to phimosis were analyzed between April 2004 and May 2007. At the first appointment the boys were divided into 3 main groups: I--children with foreskin adhesion without visible stenosis (near 20%), who had the prepuce adhesion released in a local anaesthetic with Emla cream; II--children with narrowed foreskin (phimosis) who were treated with the use of conservative therapy by means of topical steroids (about 70%); III--children with stenosed prepuce (phimosis) developed to a large extent, who were immediately qualified to a surgery therapy without trying the conservative therapy (near 10%).
Results: Among all patients about 1/5 needed the prepuce adhesion releasing with the use of Emla ointment only. High efficiency of conservative treatment with topical steroids was revealed both in primary and acquired phimosis. Reduction of the therapy time of children treated with topical steroids because of primary phimosis in relation to those treated surgically was taken into account.
Conclusion: Conservative treatment of phimosis is highly effective and safe method which may also be an initial stage to operative treatment or to cure scarring after surgical treatment as well.