RESUMO
Many of the boys diagnosed with 'phimosis', who are referred for circumcision, do not have a dermatopathology and thus there is no indication for surgery. If an unretractable prepuce causes hygienic problems, and also in the case of dermatopathology, topical corticosteroid application may be an effective alternative to circumcision. In a literature search 13 studies were found on the effectiveness and the safety of topical steroid application for phimosis. Three of the studies were placebo controlled. A total of 1121 boys with an unretractable prepuce were treated with a topical corticosteroid, which was mostly applied twice daily. After a treatment duration of 4 to 8 weeks, about 75% of the patients achieved complete retractability of the prepuce. In the studies evaluated, local or systemic adverse effects were not noted. Different types of corticosteroids gave similar results. Topical corticosteroid application for the treatment of unretractable prepuce complaints seems to be effective and safe, and is therefore recommended before surgical intervention is considered.