Cost‐effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect

@article{Berdeu2001CosteffectivenessAO,
  title={Cost‐effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect},
  author={Daniel Berdeu and Laurent Sauze and Philippe Ha-Vinh and Claudine Blum-Boisgard},
  journal={BJU International},
  year={2001},
  volume={87}
}
Objective To compare the cost‐effectiveness of surgery and topical steroids as treatments for phimosis (defined as a clinically verifiable, pathological, cicatricial stenosis of the prepuce) and to evaluate the financial basis of these treatments. 
Outcome and recurrence in treatment of phimosis using topical betamethasone in children in Hong Kong
TLDR
The effect of daily retraction and cleansing of prepuce on preventing recurrence of phimsosis and the efficacy of treating phimosis with topical steroid and its long‐term outcome and side effects were studied.
Local steroid therapy as the first‐line treatment for boys with symptomatic phimosis – a long‐term prospective study
TLDR
Phimosis is a common paediatric urological disorder and often necessitates circumcision, and local steroid therapy (LST) as the first choice therapy for such children is prospectively evaluated.
Evaluating the role of topical steroids as a primary intervention for treatment of phimosis in pediatric age group
TLDR
Phimosis hinders proper hygiene of the penis, which favors the incidence of foreskin infections, frequent infections of the urinary tract, sexually transmitted diseases and penile carcinoma in adults.
Triple incision to treat phimosis in children: an alternative to circumcision?
TLDR
To evaluate the functional and cosmetic results and patient satisfaction after triple incision plasty for phimosis in children, a large number of children have undergone the procedure.
Calibration and dilatation with topical corticosteroid in the treatment of stenosis of neourethral meatus after hypospadias repair
To assess the early disclosure and treatment of meatal stenosis after hypospadias repair, using calibration of the neourethral meatus at regular intervals to detect stenosis, and to assess the
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision.
TLDR
Topical treatment of phimosis can reduce costs by 27.3% in comparison with circumcision, therefore, topical treatment ofphimosis should be considered prior to the decision to perform surgery.
Is steroids therapy effective in treating phimosis? A meta-analysis
TLDR
Compared to the placebo or manual reduction method, the topical steroid therapy is more effective in the treatment of phimosis in children, although there is still controversy in the different type and dosage of steroid.
MANAGEMENT OF PHIMOSIS WITH USE OF BETAMETHASONE AND PREPUCIAL DILATATION –A PROSPECTIVE STUDY
TLDR
Dilatation and local application of betnovate ointment is a better alternative to circumcision than circumcision with regard to all outcome measures namely parent compliance, parent satisfaction, symptom resolution and persistence of phimosis.
[Treatment of phimosis with locally applied 0.05% clobetasol propionate. Prospective study with 108 children].
TLDR
This study confirms the efficacy and safety of local steroid therapy in the treatment of phimosis in children and confirms that surgical treatment ofphimosis should therefore be reserved for failures of medical treatment and has now become much less frequent.
...
...

References

SHOWING 1-10 OF 57 REFERENCES
[Phimosis can be treated with local steroids].
  • E. Ruud, J. Holt
  • Medicine
    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke
  • 1997
TLDR
Topical steroids are recommended as first treatment of choice for phimosis, when treatment is necessary, and significantly less recurrence in the patients who improved within one month.
The treatment of phimosis in boys, with a potent topical steroid (clobetasol propionate 0.05%) cream.
TLDR
In an open trial, including 54 boys with phimosis, treatment with clobetasol propionate cream was shown to be effective, without side effects, and surgery was avoided in 70% of the patients.
[Conservative treatment of phimosis in childhood].
TLDR
The authors describe the method and achieved results of local non-surgical treatment using a corticoid cream made in the Czech Republic and treated phimosis in a total of 44 boys.
A nonsurgical approach to the treatment of phimosis: local nonsteroidal anti-inflammatory ointment application.
TLDR
Nonsteroidal anti-inflammatory ointment application for phimosis may be an alternative to surgery and steroid application.
Therapeutic retraction of the foreskin in childhood.
TLDR
A retrospective study was conducted of 91 boys who had had a non-retractable but non-fibrosed prepuce treated by retraction under general anaesthesia, finding that 67 (85%) obtained relief.
Complications of circumcision.
TLDR
There are multiple complications that can occur following circumcision, ranging from the insignificant to the tragic, and it usually will fall to the urologist to consult in the management of these complications and to repair such problems as they arise.
[Phimosis: when does it require surgical intervention?].
TLDR
The authors report the results of topic corticosteroid treatment of fimosis in 83 patients aged 1-14 years, with good outcome in 86.7% of cases.
The conservative treatment of phimosis in boys.
TLDR
Treatment with 0.05% betamethasone cream is a simple and safe method for the treatment of phimosis in boys older than 3 years and strongly supports the saying, "The fortunate foreskin of an infant boy will usually be left well alone by everyone but its owner'.
[Topical steroids in the treatment of phimosis in children].
TLDR
Childhood phimosis can be successfully treated with steroid application, and the treatment should be offered prior to an operation.
...
...