To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision
Main Author: | |
---|---|
Publication Date: | 2010 |
Other Authors: | , , , |
Format: | Article |
Language: | eng |
Source: | Repositório Institucional da UNIFESP |
Download full: | http://repositorio.unifesp.br/handle/11600/5606 http://dx.doi.org/10.1590/S1677-55382010000100012 |
Summary: | PURPOSE: To compare the efficacy and costs of circumcision versus topical treatment using a prospective pharmacoeconomic protocol. MATERIALS AND METHODS: We treated 59 patients (3-10 years of age) randomized into two groups: 29 underwent an 8-week course of topical treatment with 0.2% betamethasone-hyaluronidase cream twice a day; and 30 underwent circumcision. Topical treatment success was defined as complete exposure of the glans. In cases of treatment failure, circumcision was performed and its cost imputed to that of the initial treatment. The pharmacoeconomic aspects were defined according to the Brazilian National Public Health System database and the Brazilian Community Pharmacies Index. RESULTS: The two groups were statistically similar for all clinical parameters evaluated. Topical treatment resulted in complete exposure of the glans in 52% of the patients. Topical treatment was associated with preputial pain and hyperemia. However, treatment suspension was unnecessary. Minor complications were observed in 16.6% of the surgical group patients. The mean cost per patient was US$ 53.70 and US$ 125.20, respectively, for topical steroid treatment (including the costs related to treatment failure) and circumcision. The total costs were US$ 2,825.32 and US$ 3,885.73 for topical treatment and circumcision, respectively. CONCLUSIONS: Topical treatment of phimosis can reduce costs by 27.3% in comparison with circumcision. Therefore, topical treatment of phimosis should be considered prior to the decision to perform surgery. |
id |
UFSP_fe2551c1e1a44f30965b9205c2003882 |
---|---|
oai_identifier_str |
oai:repositorio.unifesp.br:11600/5606 |
network_acronym_str |
UFSP |
network_name_str |
Repositório Institucional da UNIFESP |
repository_id_str |
3465 |
spelling |
Nobre, Yuri D. [UNIFESP]Freitas, Ricardo G. [UNIFESP]Felizardo, Maria J. [UNIFESP]Ortiz, Valdemar [UNIFESP]Macedo Junior, Antonio [UNIFESP]Universidade Federal de São Paulo (UNIFESP)2015-06-14T13:41:32Z2015-06-14T13:41:32Z2010-02-01International braz j urol. Sociedade Brasileira de Urologia, v. 36, n. 1, p. 75-85, 2010.1677-5538http://repositorio.unifesp.br/handle/11600/5606http://dx.doi.org/10.1590/S1677-55382010000100012S1677-55382010000100012.pdfS1677-5538201000010001210.1590/S1677-55382010000100012WOS:000283288200025PURPOSE: To compare the efficacy and costs of circumcision versus topical treatment using a prospective pharmacoeconomic protocol. MATERIALS AND METHODS: We treated 59 patients (3-10 years of age) randomized into two groups: 29 underwent an 8-week course of topical treatment with 0.2% betamethasone-hyaluronidase cream twice a day; and 30 underwent circumcision. Topical treatment success was defined as complete exposure of the glans. In cases of treatment failure, circumcision was performed and its cost imputed to that of the initial treatment. The pharmacoeconomic aspects were defined according to the Brazilian National Public Health System database and the Brazilian Community Pharmacies Index. RESULTS: The two groups were statistically similar for all clinical parameters evaluated. Topical treatment resulted in complete exposure of the glans in 52% of the patients. Topical treatment was associated with preputial pain and hyperemia. However, treatment suspension was unnecessary. Minor complications were observed in 16.6% of the surgical group patients. The mean cost per patient was US$ 53.70 and US$ 125.20, respectively, for topical steroid treatment (including the costs related to treatment failure) and circumcision. The total costs were US$ 2,825.32 and US$ 3,885.73 for topical treatment and circumcision, respectively. CONCLUSIONS: Topical treatment of phimosis can reduce costs by 27.3% in comparison with circumcision. Therefore, topical treatment of phimosis should be considered prior to the decision to perform surgery.Federal University of São Paulo Department of Urology Section of Pediatric UrologyUNIFESP, Department of Urology Section of Pediatric UrologySciELO75-85engSociedade Brasileira de UrologiaInternational braz j urolphimosiscircumcisionmalesteroidspharmacoeconomicsTo circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcisioninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALS1677-55382010000100012.pdfapplication/pdf824986${dspace.ui.url}/bitstream/11600/5606/1/S1677-55382010000100012.pdf43111243993058aac481459efce05b50MD51open accessTEXTS1677-55382010000100012.pdf.txtS1677-55382010000100012.pdf.txtExtracted texttext/plain28724${dspace.ui.url}/bitstream/11600/5606/21/S1677-55382010000100012.pdf.txta877416ab86c2b48afb50966af79df9aMD521open accessTHUMBNAILS1677-55382010000100012.pdf.jpgS1677-55382010000100012.pdf.jpgIM Thumbnailimage/jpeg6567${dspace.ui.url}/bitstream/11600/5606/23/S1677-55382010000100012.pdf.jpg0f67e704d3f41874cb3e99b5df013f86MD523open access11600/56062023-06-05 20:05:04.873open accessoai:repositorio.unifesp.br:11600/5606Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-06-05T23:05:04Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision |
title |
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision |
spellingShingle |
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision Nobre, Yuri D. [UNIFESP] phimosis circumcision male steroids pharmacoeconomics |
title_short |
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision |
title_full |
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision |
title_fullStr |
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision |
title_full_unstemmed |
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision |
title_sort |
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision |
author |
Nobre, Yuri D. [UNIFESP] |
author_facet |
Nobre, Yuri D. [UNIFESP] Freitas, Ricardo G. [UNIFESP] Felizardo, Maria J. [UNIFESP] Ortiz, Valdemar [UNIFESP] Macedo Junior, Antonio [UNIFESP] |
author_role |
author |
author2 |
Freitas, Ricardo G. [UNIFESP] Felizardo, Maria J. [UNIFESP] Ortiz, Valdemar [UNIFESP] Macedo Junior, Antonio [UNIFESP] |
author2_role |
author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Nobre, Yuri D. [UNIFESP] Freitas, Ricardo G. [UNIFESP] Felizardo, Maria J. [UNIFESP] Ortiz, Valdemar [UNIFESP] Macedo Junior, Antonio [UNIFESP] |
dc.subject.eng.fl_str_mv |
phimosis circumcision male steroids pharmacoeconomics |
topic |
phimosis circumcision male steroids pharmacoeconomics |
description |
PURPOSE: To compare the efficacy and costs of circumcision versus topical treatment using a prospective pharmacoeconomic protocol. MATERIALS AND METHODS: We treated 59 patients (3-10 years of age) randomized into two groups: 29 underwent an 8-week course of topical treatment with 0.2% betamethasone-hyaluronidase cream twice a day; and 30 underwent circumcision. Topical treatment success was defined as complete exposure of the glans. In cases of treatment failure, circumcision was performed and its cost imputed to that of the initial treatment. The pharmacoeconomic aspects were defined according to the Brazilian National Public Health System database and the Brazilian Community Pharmacies Index. RESULTS: The two groups were statistically similar for all clinical parameters evaluated. Topical treatment resulted in complete exposure of the glans in 52% of the patients. Topical treatment was associated with preputial pain and hyperemia. However, treatment suspension was unnecessary. Minor complications were observed in 16.6% of the surgical group patients. The mean cost per patient was US$ 53.70 and US$ 125.20, respectively, for topical steroid treatment (including the costs related to treatment failure) and circumcision. The total costs were US$ 2,825.32 and US$ 3,885.73 for topical treatment and circumcision, respectively. CONCLUSIONS: Topical treatment of phimosis can reduce costs by 27.3% in comparison with circumcision. Therefore, topical treatment of phimosis should be considered prior to the decision to perform surgery. |
publishDate |
2010 |
dc.date.issued.fl_str_mv |
2010-02-01 |
dc.date.accessioned.fl_str_mv |
2015-06-14T13:41:32Z |
dc.date.available.fl_str_mv |
2015-06-14T13:41:32Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
International braz j urol. Sociedade Brasileira de Urologia, v. 36, n. 1, p. 75-85, 2010. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/5606 http://dx.doi.org/10.1590/S1677-55382010000100012 |
dc.identifier.issn.none.fl_str_mv |
1677-5538 |
dc.identifier.file.none.fl_str_mv |
S1677-55382010000100012.pdf |
dc.identifier.scielo.none.fl_str_mv |
S1677-55382010000100012 |
dc.identifier.doi.none.fl_str_mv |
10.1590/S1677-55382010000100012 |
dc.identifier.wos.none.fl_str_mv |
WOS:000283288200025 |
identifier_str_mv |
International braz j urol. Sociedade Brasileira de Urologia, v. 36, n. 1, p. 75-85, 2010. 1677-5538 S1677-55382010000100012.pdf S1677-55382010000100012 10.1590/S1677-55382010000100012 WOS:000283288200025 |
url |
http://repositorio.unifesp.br/handle/11600/5606 http://dx.doi.org/10.1590/S1677-55382010000100012 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
International braz j urol |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
75-85 |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
bitstream.url.fl_str_mv |
${dspace.ui.url}/bitstream/11600/5606/1/S1677-55382010000100012.pdf ${dspace.ui.url}/bitstream/11600/5606/21/S1677-55382010000100012.pdf.txt ${dspace.ui.url}/bitstream/11600/5606/23/S1677-55382010000100012.pdf.jpg |
bitstream.checksum.fl_str_mv |
43111243993058aac481459efce05b50 a877416ab86c2b48afb50966af79df9a 0f67e704d3f41874cb3e99b5df013f86 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
_version_ |
1783460322176139264 |