Bülent ŞEN, İlker AKYOL, Hasan SOYDAN, Kenan KARADEMİR, Kadir BAYKAL

Çocuklarda fimozis tedavisinde topikal prednizolon kullanımı

Çocukluk çağındaki fimoziste topikal prednizolon tedavisinin etkinliği ve güvenilirliğinin araştırılması. Ağustos 2005-Mart 2006 tarihleri arasında Çocuk Ürolojisi polikliniğine (balano)postit, sünnet derisinde balonlaşma ve üriner enfeksi-yon nedeniyle başvuran 60 olgu çalışmaya dahil edildi. Fimozis, sünnet derisinin glans penis ve dış üretral mea ile ilişkisi-ne göre derecelendi. Tüm olgulara %0,125 prednizolon içeren krem, 2 hafta süreyle günde 2 kez uygulandı. Daha sonra ihtiyaca göre, toplam 8 haftayı geçmeyecek şekilde 2 şer haftalık uzatmalarla tedaviye devam edildi. Fimozis derecesi, tedavi bittikten en az 4 hafta sonra tekrar değerlendirildi. Başarı kriteri, fimozisin en az 3 derece azalması ve belirtilerin tamamen geçmesi olarak belirlendi. Çalışmaya dahil edilen 60 olgunun 55’i takibe geldi. Olguların yaş ortalaması 18 ay (3-36 ay), ortalama takip süresi 9 (6-14) hafta idi. Sekizinci haftanın sonunda 48 (%87.2) olguda tedavi başarısı elde edildi. Bir olguda meydana gelen lokal mantar enfeksiyonu topikal antifungal tedavi ile düzeldi. Başka hiçbir olguda steroid kullanımına bağlı yan etki gözlenmedi. Fimozis tedavisinde, prepisyuma uygulanan topikal prednizolon tedavisi etkili ve güvenli bir tedavi yöntemi olarak bulunmuştur.

Anahtar Kelimeler:

Prednizolon, Fimozis, Çocuk

Topical prednisolon treatment for phimosis in children

Evaluation of the effectiveness and safety of topical prednisolon treatment in children with phimosis. We included the patients who applied to the Paediatric Urology Clinic because of (balano) posthitis, ballooning of preaputium during voiding and urinary tract infections. Phimosis was graded according to the relationship of preaputium with glans penis and external urethral meatus. Topical %0.125 prednisolon treatment was prescribed for 2 times day for 2 weeks and treatment was continued for additional 2 week-periods-up to 8 weeks at longest as needed. Phimosis grade at least 4 weeks after treatment ended was recorded to assess the durability of the treatment. Success criterion was at least 3 downgrading of the phimosis and a complete resolution of the symptoms. Fifty six of the 60 patients who were included in the study came back for follow-up. Mean patient age, duration of treatment, and follow-up period were 18 months and 9 weeks respectively. Treatment was succesful in 49 patients (%87.2) and there were no adverse events related with therapy in 55 patients. A local fungal infection which resolved upon topical antifungal treatment occured in only 1 patient. Topical prednisolon treatment is a safe and effective method in paediatric phimosis

Keywords:

Prednisolone, Phimosis, Child,

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