Abstract
BACKGROUND: Topical steroids as first-line treatment for phimosis are well established, but both the accurate diagnosis of pathological phimosis and the regimen of use of steroid ointment are not widely known, as judged by a review of referrals to a specialist clinic. OBJECTIVE: This study aims to determine the proportion of patients with an accurate diagnosis of phimosis and appropriate use of steroid treatment prior to specialist referral for phimosis. MATERIALS AND METHODS: Retrospective data were collected for 781 boys with a mean age of 11.8 ± 0.22 years, including the reason for general practitioner referral, previous use of topical steroids, and specialist management. RESULTS: Six hundred patients were referred with a diagnosis of phimosis; 181 were referred with an alternative diagnosis. Only 218 boys had pre-referral steroid treatment. Conservative therapy was used for 614 patients, of whom 489 received topical steroid ointment. Circumcision or dorsal slit procedures were required for failed medical management in 95. CONCLUSIONS: Most boys with phimosis are cured with the use of an appropriate topical steroid; however, very few have steroid ointment as part of their care prior to referral.