Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescents

Detalhes bibliográficos
Autor(a) principal: Guimarães, Flávio Manuel Gomes
Data de Publicação: 2017
Outros Autores: Martins, Albino Monteiro
Tipo de documento: Artigo
Idioma: por
Título da fonte: Revista Brasileira de Medicina de Família e Comunidade (Online)
Texto Completo: https://www.rbmfc.org.br/rbmfc/article/view/1454
Resumo: Introduction: Primary phimosis is a frequent problem in child health clinic with a prevalence of 11% at 3 years of age. Objective: The aim of this review is to evaluate the efficacy of topical corticosteroids (CCT) in reduction of foreskin retractile limitation in children and adolescents. Methods: The research was performed using the National Guideline Clearing House, Canadian Medical Association Practice Guidelines InfoBase, Cochrane Library, DARE, Bandolier, Evidence Based Medicine Online, Trip Database Online and PubMed databases using the terms “phimosis and steroids”. Clinical guidelines, meta-analyses, systematic reviews and randomized controlled trials (RCTs) were searched in Portuguese, English and Spanish. The Levels of Evidence of Oxford Centre for Evidence Based Medicine were used. Results: A total of 148 articles were found, of which only six fulfilled the inclusion criteria: one guideline and five RCTs. Since 2013 the European Society of Pediatric Urology recommends the use of CCT in primary phimosis. The RCTs included a total of 624 children and adolescents aged between zero and 15 years and different CCTs and therapeutic approaches were tested. A significant improvement in prepuce retraction was observed with the use of CCT compared to placebo achieving a therapeutic efficacy of 66% and 90%. Conclusion: The studies used in this work support the use of CCTs in the treatment of primary phimosis in children and adolescents. However, we consider to be of added value the implementation of larger and methodologically homogeneous studies in order to clarify what is the best CCT therapeutic method.
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spelling Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescentsEficacia del uso de corticoesteroides tópicos en el tratamiento de la fimosis primaria en niños y adolescentesEficácia do uso de corticoides tópicos no tratamento da fimose primária em crianças e adolescentesAdrenal Cortex Hormones. Phimosis. Therapeutics. Child. Adolescent.Corticoesteroides. Fimosis. Terapéutica. Niño. Adolescente.Corticosteroides. Fimose. Terapêutica. Criança. Adolescente.corticosteroidesfimoseterapêutica.Introduction: Primary phimosis is a frequent problem in child health clinic with a prevalence of 11% at 3 years of age. Objective: The aim of this review is to evaluate the efficacy of topical corticosteroids (CCT) in reduction of foreskin retractile limitation in children and adolescents. Methods: The research was performed using the National Guideline Clearing House, Canadian Medical Association Practice Guidelines InfoBase, Cochrane Library, DARE, Bandolier, Evidence Based Medicine Online, Trip Database Online and PubMed databases using the terms “phimosis and steroids”. Clinical guidelines, meta-analyses, systematic reviews and randomized controlled trials (RCTs) were searched in Portuguese, English and Spanish. The Levels of Evidence of Oxford Centre for Evidence Based Medicine were used. Results: A total of 148 articles were found, of which only six fulfilled the inclusion criteria: one guideline and five RCTs. Since 2013 the European Society of Pediatric Urology recommends the use of CCT in primary phimosis. The RCTs included a total of 624 children and adolescents aged between zero and 15 years and different CCTs and therapeutic approaches were tested. A significant improvement in prepuce retraction was observed with the use of CCT compared to placebo achieving a therapeutic efficacy of 66% and 90%. Conclusion: The studies used in this work support the use of CCTs in the treatment of primary phimosis in children and adolescents. However, we consider to be of added value the implementation of larger and methodologically homogeneous studies in order to clarify what is the best CCT therapeutic method.Introducción: La fimosis primaria es un problema común en la consulta médica con una prevalencia del 11% a los 3 años de edad. Objetivo: El objetivo de esta revisión es evaluar la evidencia de la eficacia de los corticoesteroides tópicos (CCT) en la reducción de la limitación de retractilidad del prepucio en niños y adolescentes. Métodos: Se realizaron encuestas en las bases de datos de National Guideline Clearing House, Canadian Medical Association Pratice Guidelines Infobase, Cochrane Library, DARE, Bandolier, Evidence Based Medicine Online, Trip Database Online e Pubmed, utilizando las palabras clave “phimosis and steroids”. Se incluyeron guidelines, revisiones sistemáticas, metaanálisis y ensayos controlados aleatorios (ECA), en portugués, inglés y español. Se utilizó la escala Levels of Evidence da Oxford Centre for Evidence Based Medicine. Resultados: Se han encontrado 148 artículos, de los cuales seis cumplieron los criterios de inclusión: 1 guideline y 5 ECA. La guideline de la Sociedad Europea de Urología Pediátrica publicada en 2013 recomienda el uso de CCT en la fimosis primaria. El ECA incluyó un total de 624 niños y adolescentes de entre cero y 15 años. Se ha mejorado la retractilidad del prepucio en comparación con el placebo a una efectividad terapéutica del CCT descrito entre 66% y 90%. Conclusión: Los estudios apoyan la efectividad del tratamiento con corticoesteroides en la fimosis primaria en niños y adolescentes. En el futuro es apropiado el diseño de estudios metodológicamente homogéneos y más grandes para probar cual es el mejor tratamiento de CCT.Introdução: A fimose primária é um problema frequente na consulta de saúde infantil, com prevalência de 11% aos 3 anos de idade. Objetivo: O objetivo desta revisão é avaliar a evidência da eficácia do uso de corticoides tópicos (CCT) na redução da limitação da retratilidade do prepúcio em crianças e adolescentes. Métodos: Pesquisa efetuada nas bases de dados National Guideline Clearing House, Canadian Medical Association Pratice Guidelines Infobase, Cochrane Library, DARE, Bandolier, Evidence Based Medicine Online, Trip Database Online e Pubmed, utilizando os descritores “Phimosis and steroids”. Pesquisaram-se normas de orientação clínica (NOC), meta-análises, revisões sistemáticas e ensaios clínicos aleatorizados e controlados (ECAC), nas línguas portuguesa, inglesa e espanhola. Foi usada a escala Levels of Evidence of Oxford Centre for Evidence Based Medicine. Resultados: Foram encontrados 148 artigos, dos quais 6 cumpriram os critérios de inclusão: 1 NOC e 5 ECAC. A orientação da Sociedade Europeia de Urologia Pediátrica publicada em 2013 recomenda o uso de CCT na fimose primária. Os ECAC incluíram no total 624 crianças e adolescentes entre os zero e os 15 anos. Foram testados diferentes CCT e esquemas terapêuticos. Verificou-se uma melhoria da retratilidade do prepúcio comparativamente com o placebo, com uma eficácia terapêutica dos CCT descrita entre 66% e 90%. Conclusão: Os estudos suportam a eficácia dos CCT no tratamento da fimose primária em crianças e adolescentes. No futuro é pertinente o desenho de estudos metodologicamente homogêneos e de maior dimensão para clarificar qual o melhor CCT e esquema terapêutico.Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)2017-10-04info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionRevisão Baseada na Evidênciaapplication/pdfhttps://www.rbmfc.org.br/rbmfc/article/view/145410.5712/rbmfc12(39)1454Revista Brasileira de Medicina de Família e Comunidade; Vol. 12 No. 39 (2017): Janeiro-dezembro; 1-6Revista Brasileira de Medicina de Família e Comunidade; Vol. 12 Núm. 39 (2017): Janeiro-dezembro; 1-6Revista Brasileira de Medicina de Família e Comunidade; v. 12 n. 39 (2017): Janeiro-dezembro; 1-62179-79941809-5909reponame:Revista Brasileira de Medicina de Família e Comunidade (Online)instname:Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)instacron:SBMFCporhttps://www.rbmfc.org.br/rbmfc/article/view/1454/862Copyright (c) 2017 Flávio Manuel Gomes Guimarães, Albino Monteiro Martinsinfo:eu-repo/semantics/openAccessGuimarães, Flávio Manuel GomesMartins, Albino Monteiro2020-05-21T18:31:33Zoai:ojs.rbmfc.org.br:article/1454Revistahttp://www.rbmfc.org.br/index.php/rbmfchttps://www.rbmfc.org.br/rbmfc/oai||david@sbmfc.org.br2179-79941809-5909opendoar:2020-05-21T18:31:33Revista Brasileira de Medicina de Família e Comunidade (Online) - Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)false
dc.title.none.fl_str_mv Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescents
Eficacia del uso de corticoesteroides tópicos en el tratamiento de la fimosis primaria en niños y adolescentes
Eficácia do uso de corticoides tópicos no tratamento da fimose primária em crianças e adolescentes
title Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescents
spellingShingle Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescents
Guimarães, Flávio Manuel Gomes
Adrenal Cortex Hormones. Phimosis. Therapeutics. Child. Adolescent.
Corticoesteroides. Fimosis. Terapéutica. Niño. Adolescente.
Corticosteroides. Fimose. Terapêutica. Criança. Adolescente.
corticosteroides
fimose
terapêutica.
title_short Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescents
title_full Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescents
title_fullStr Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescents
title_full_unstemmed Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescents
title_sort Efficacy of topical corticosteroids in the treatment of primary phimosis in children and adolescents
author Guimarães, Flávio Manuel Gomes
author_facet Guimarães, Flávio Manuel Gomes
Martins, Albino Monteiro
author_role author
author2 Martins, Albino Monteiro
author2_role author
dc.contributor.author.fl_str_mv Guimarães, Flávio Manuel Gomes
Martins, Albino Monteiro
dc.subject.por.fl_str_mv Adrenal Cortex Hormones. Phimosis. Therapeutics. Child. Adolescent.
Corticoesteroides. Fimosis. Terapéutica. Niño. Adolescente.
Corticosteroides. Fimose. Terapêutica. Criança. Adolescente.
corticosteroides
fimose
terapêutica.
topic Adrenal Cortex Hormones. Phimosis. Therapeutics. Child. Adolescent.
Corticoesteroides. Fimosis. Terapéutica. Niño. Adolescente.
Corticosteroides. Fimose. Terapêutica. Criança. Adolescente.
corticosteroides
fimose
terapêutica.
description Introduction: Primary phimosis is a frequent problem in child health clinic with a prevalence of 11% at 3 years of age. Objective: The aim of this review is to evaluate the efficacy of topical corticosteroids (CCT) in reduction of foreskin retractile limitation in children and adolescents. Methods: The research was performed using the National Guideline Clearing House, Canadian Medical Association Practice Guidelines InfoBase, Cochrane Library, DARE, Bandolier, Evidence Based Medicine Online, Trip Database Online and PubMed databases using the terms “phimosis and steroids”. Clinical guidelines, meta-analyses, systematic reviews and randomized controlled trials (RCTs) were searched in Portuguese, English and Spanish. The Levels of Evidence of Oxford Centre for Evidence Based Medicine were used. Results: A total of 148 articles were found, of which only six fulfilled the inclusion criteria: one guideline and five RCTs. Since 2013 the European Society of Pediatric Urology recommends the use of CCT in primary phimosis. The RCTs included a total of 624 children and adolescents aged between zero and 15 years and different CCTs and therapeutic approaches were tested. A significant improvement in prepuce retraction was observed with the use of CCT compared to placebo achieving a therapeutic efficacy of 66% and 90%. Conclusion: The studies used in this work support the use of CCTs in the treatment of primary phimosis in children and adolescents. However, we consider to be of added value the implementation of larger and methodologically homogeneous studies in order to clarify what is the best CCT therapeutic method.
publishDate 2017
dc.date.none.fl_str_mv 2017-10-04
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Revisão Baseada na Evidência
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.rbmfc.org.br/rbmfc/article/view/1454
10.5712/rbmfc12(39)1454
url https://www.rbmfc.org.br/rbmfc/article/view/1454
identifier_str_mv 10.5712/rbmfc12(39)1454
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://www.rbmfc.org.br/rbmfc/article/view/1454/862
dc.rights.driver.fl_str_mv Copyright (c) 2017 Flávio Manuel Gomes Guimarães, Albino Monteiro Martins
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Flávio Manuel Gomes Guimarães, Albino Monteiro Martins
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)
publisher.none.fl_str_mv Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)
dc.source.none.fl_str_mv Revista Brasileira de Medicina de Família e Comunidade; Vol. 12 No. 39 (2017): Janeiro-dezembro; 1-6
Revista Brasileira de Medicina de Família e Comunidade; Vol. 12 Núm. 39 (2017): Janeiro-dezembro; 1-6
Revista Brasileira de Medicina de Família e Comunidade; v. 12 n. 39 (2017): Janeiro-dezembro; 1-6
2179-7994
1809-5909
reponame:Revista Brasileira de Medicina de Família e Comunidade (Online)
instname:Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)
instacron:SBMFC
instname_str Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)
instacron_str SBMFC
institution SBMFC
reponame_str Revista Brasileira de Medicina de Família e Comunidade (Online)
collection Revista Brasileira de Medicina de Família e Comunidade (Online)
repository.name.fl_str_mv Revista Brasileira de Medicina de Família e Comunidade (Online) - Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)
repository.mail.fl_str_mv ||david@sbmfc.org.br
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