To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision

Detalhes bibliográficos
Autor(a) principal: Nobre, Yuri D. [UNIFESP]
Data de Publicação: 2010
Outros Autores: Freitas, Ricardo G. [UNIFESP], Felizardo, Maria J. [UNIFESP], Ortiz, Valdemar [UNIFESP], Macedo Junior, Antonio [UNIFESP]
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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spelling 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
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