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I enclose extracts from medical studies .... at a brief read all the studies are on kids and stretchability rates differ considerably with children, at puberty and as adult --- big problem is that retraction was only measurable in the flaccid state --- very interesting is that no adhesions were found after this treatment leads me to wonder if steroids applied to outer foreskin could "heat up" and dissolve the epithelium ... the other good point on beta .05 is ... it seems there is no known bad side effect ...

As Dewan points out, phimosis is often used as a quite general term by doctors, --- I mean what should we make of comments like "Successful treatment depends upon the presence of a normal, supple foreskin at the outset," (Wright-JE)

Dewan makes an excellant definition of phimosis (in its ring form), and does a comparison of a number of previous studies - without actually getting his fingers messy himself ..- so it seems no-one has actually studied the effectiveness of beta05 on phimotic rings ... these studies are all very recent we could be hopeful that Dewan`s conclusion-summaries be followed up ...

Robin

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Wright-JE
The treatment of childhood phimosis with topical steroid [see comments] [published erratum appears in Aust N Z J Surg 1995 Sep;65(9):698], Comment in: Aust N Z J Surg 1994 Dec;64(12):861. Comment in: Aust N Z J Surg 1995 Jan;65(1):57-8
University of Newcastle Medical School, New South Wales, Australia.
Aust-N-Z-J-Surg. 1994 May; 64(5): 327-8
Abstract
A prospective study of the efficacy of topical steroid in the treatment of childhood phimosis is reported. Boys referred to a paediatric surgical practice with pathological non-retractable foreskins were treated for at least 1 month with topical beta methasone cream. One hundred and thirty-nine patients were treated and 111 completed the study. A satisfactory result, defined as foreskin retractability appropriate for the boys' age, was achieved in 80% of patients. In 10% the response was inadequate at the end of the study period, but these boys were still under treatment or surveillance because their parents declined circumcision. In 10%, circumcision was performed because of failure of treatment. In six patients this was due to balanitis xerotica obliterans (lichen sclerosis et atrophicus) which does not respond to conservative treatment. Successful treatment depends upon the presence of a normal, supple foreskin at the outset, and on parental compliance.

Kikiros CS, Beasley SW, Woodward AA.
The response of phimosis to local steroid application.
Pediatr Surg Int 1993; 8: 329-32.
Local application of steroid ointment to the foreskin results in resolution of phimosis in the majority of cases, but if the foreskin has a circumferential white scar, it is slightly less likely to respond. Following cessation of steroids, phimosis re-develops in a proportion of patients.
The main current surgical indication for circumcision is phimosis, although recurrent balanitis and paraphimosis may be considered relative indications. .... Phimosis, which is defined as constriction of the preputial orifice so that it cannot be drawn back over the glans, ...
Thick fibrous scars of the prepuce appear to be more resilient to local steroids, .... It is possible that the daily gentle retraction of the foreskin to expose that part onto which the ointment is applied has contributed to the improved retractibility, but in an earlier unpublished study there was a significant difference between the application of steroids and the application of a placebo (non-steroid preparation).