To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S1677-55382010000100012 http://repositorio.unifesp.br/handle/11600/5606 |
Resumo: | 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. |
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To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcisionphimosiscircumcisionmalesteroidspharmacoeconomicsPURPOSE: 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 UrologySciELOSociedade Brasileira de UrologiaUniversidade Federal de São Paulo (UNIFESP)Nobre, Yuri D. [UNIFESP]Freitas, Ricardo G. [UNIFESP]Felizardo, Maria J. [UNIFESP]Ortiz, Valdemar [UNIFESP]Macedo Junior, Antonio [UNIFESP]2015-06-14T13:41:32Z2015-06-14T13:41:32Z2010-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion75-85application/pdfhttp://dx.doi.org/10.1590/S1677-55382010000100012International braz j urol. Sociedade Brasileira de Urologia, v. 36, n. 1, p. 75-85, 2010.10.1590/S1677-55382010000100012S1677-55382010000100012.pdf1677-5538S1677-55382010000100012http://repositorio.unifesp.br/handle/11600/5606WOS:000283288200025engInternational braz j urolinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-05T00:04:02Zoai:repositorio.unifesp.br/:11600/5606Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-05T00:04:02Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.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.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.por.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.none.fl_str_mv |
2010-02-01 2015-06-14T13:41:32Z 2015-06-14T13:41:32Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S1677-55382010000100012 International braz j urol. Sociedade Brasileira de Urologia, v. 36, n. 1, p. 75-85, 2010. 10.1590/S1677-55382010000100012 S1677-55382010000100012.pdf 1677-5538 S1677-55382010000100012 http://repositorio.unifesp.br/handle/11600/5606 WOS:000283288200025 |
url |
http://dx.doi.org/10.1590/S1677-55382010000100012 http://repositorio.unifesp.br/handle/11600/5606 |
identifier_str_mv |
International braz j urol. Sociedade Brasileira de Urologia, v. 36, n. 1, p. 75-85, 2010. 10.1590/S1677-55382010000100012 S1677-55382010000100012.pdf 1677-5538 S1677-55382010000100012 WOS:000283288200025 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.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 application/pdf |
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 |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
_version_ |
1814268411948040192 |