Application of the Topical Hydrocortisone Ointment Decreases Post-Circumcision Meatal Stenosis in Neonates: A Cross-Sectional Study

Salimi, Amrollah; Besharati, Mahsa; Rashidi Nia, Shervin; Shahmoradi, Sara; Eftekhari, Seyyed Shahin

doi:10.22038/ijp.2017.23023.1927

Application of the Topical Hydrocortisone Ointment Decreases Post-Circumcision Meatal Stenosis in Neonates: A Cross-Sectional Study

Authors

Amrollah Salimi ¹

Mahsa Besharati ²

Shervin Rashidi Nia ²

Sara Shahmoradi ²

Seyyed Shahin Eftekhari ²

¹ Department of Pediatric Surgery, Hazrat Masoume Hospital, Qom University of Medical Sciences, Qom, Iran.

² Student Research Committee of Qom University of Medical Sciences, Qom, Iran.

10.22038/ijp.2017.23023.1927

Abstract

Background: Meatal stenosis is of common late complication of neonatal circumcision, albeit the appropriate post-operative care and conventional consumption of topical agents such as tetracycline. Nevertheless, its underlying etiology still remained vague. Lack of protective effects of foreskin and subsequent inflammation reaction due to chemical and mechanical irritation is thought to be the most probable cause.
Materials and Methods: A retrospective review of the medical records of the male neonates, were considered eligible who referred to our pediatric tertiary center (Hazrat-e-Masumeh hospital, Qom city) for circumcision between May 2014 and April 2016. Neonates with severe phimosis and buried penis were excluded from the study. Based on the medical records the patients were divided into two groups. Patients were operated similarly, and then, those who received 1% hydrocortisone ointment post-operatively (n=91) and those who received the conventional treatment with tetracycline cream instead of hydrocortisone (n=91).
Results: The mean age of neonates was 19.2 ±3.6 and 21.4 ±2.1 days for tetracycline and hydrocortisone groups, respectively. Meatal stenosis has occurred in 27(29.67%) patients of the tetracycline group, and 11(12.08%) of the hydrocortisone group (P=0.008). Mean time to develop meatal stenosis in the tetracycline group was less than that of the hydrocortisone group (2.3 ±0.4 vs. 3.8 ±0.65 weeks, respectively, P=0.03). There was no adverse effect associated with application of 1% topical ointment of hydrocortisone.
Conclusion
According to the results, applying the topical ointment of hydrocortisone can more effectively reduce post-circumcision meatal stenosis compared with tetracycline cream. Nonetheless, conducting further investigations designing as randomized clinical trial or experimental studies is highly encouraged.

Keywords

Circumcision

Meatal stenosis

Neonates

Topical hydrocortisone