Lund L, Wai K H, Mui L M, Yeung C K
Division of Paediatric Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T.
Scand J Urol Nephrol. 2000 Aug;34(4):267-9. doi: 10.1080/003655900750042013.
The present study, conducted in Hong Kong, aimed to evaluate the effect of topical steroid in non-retractile prepubertal foreskin by a prospective, randomized, double-blind design.
137 boys with non-retractile foreskin were randomized to betamethasone (n = 66) or placebo (n = 71 ) for 4 weeks with application of the cream twice daily. Non-responders to treatment were offered steroid treatment for a further 4 weeks.
The mean pretreatment grade of the foreskin in the steroid and control groups was 5.08 +/- 0.66 and 4.97 +/- 0.70, respectively. At the 4-week follow-up, 49 of the former (74%) had a retractile foreskin (grade less than or equal to 3, mean 2.38 +/- 1.41). In contrast, only 31 of the control group (44%) had a retractile foreskin (less than or equal to 3, mean 3.55 +/- 1.55) (p < 0.001). Only 14 boys were circumcised because 43 of the remaining 57 boys had a retractile foreskin after 4 weeks of treatment.
when treatment is necessary, application of topical steroid as a first line of treatment may avoid surgery in almost 90% of cases.
本研究在香港开展，旨在通过前瞻性、随机、双盲设计评估局部用类固醇对青春期前不能回缩包皮的疗效。
137例不能回缩包皮的男孩被随机分为倍他米松组（n = 66）或安慰剂组（n = 71），为期4周，每日涂抹乳膏两次。对治疗无反应者再给予4周的类固醇治疗。
类固醇组和对照组包皮的平均治疗前分级分别为5.08±0.66和4.97±0.70。在4周随访时，前者中有49例（74%）包皮可回缩（分级小于或等于3，平均为2.38±1.41）。相比之下，对照组中只有31例（44%）包皮可回缩（小于或等于3，平均为3.55±1.55）（p<0.001）。仅14名男孩接受了包皮环切术，因为其余57名男孩中有43名在治疗4周后包皮可回缩。
必要时，局部用类固醇作为一线治疗方法可在近90%的病例中避免手术。
