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2 year old have almost closed foreskin. Will it be cured by applying betametasone cream?

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My child specialist has prescribed Betametasone cream to be applied on his penis since the foreskin has almost closed. ?He has said it will open up without any surgery id applied twice for 1 month. Should I apply that or aplly Sofradex cream ? What other options other than surgery are available. My son is 8 months old.
Posted Thu, 6 Dec 2012 in Penis Problems
Answered by Dr. Santosh Kondekar 38 minutes later

Infants up to 2 years may have foreskin shut… no need to panic even if it is closed until 3 years unless any of the following is associated

1. Infections, repeated fever, discharge, pus, or redness around
2. Dysuria or bladder pain or pain or discomfort around urinary area or abdomen
3. Ballooning of prepuce
4. Poor stream of urine… frequent small amount urination
5. Sonography of bladder shows bladder wall thickening or any reflux

In all these cases earliest surgery may be indicated after antibiotic course.

Various creams including oils, moisturizers, lubricants, soframycin or steroid cream may be used to treat prepucial stenosis.

Even painkiller xylocaine jelly may be tried. All else may fail as these may not cure it.

In addition, in addition steroid creams may flourish infection. Child should be kept a close watch for infection while on these creams. The technique of prepucial stretching with ointment needs to be keenly understood, as pain or foreful procedured may cause complications.

Please let me know if any further queries, if you could not understand any medical terms mentioned above.

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Follow-up: 2 year old have almost closed foreskin. Will it be cured by applying betametasone cream? 2 hours later
But doctor when he passes urine, he does it with a lot of pressure. The procedure of urination is not easy. Hence I am concerned. At present, I am applying Betamethasone cream by slightly pulling the foreskin back so that it opens up and he can pass urine without any pressure. But how much will it help and is there any problem/side effects of applying this cream since he is only 8 months old. Will applying this cream solve his problem ? Do you suggest any cream with less side effect or any other remedial action so that I dont need to carry out the operation later ?
Answered by Dr. Santosh Kondekar 1 hour later
Hi again,

Most infants and toddlers pass urine with pressure. Infants may even cry with episode of urine but the flow and amount of urine will be good 50-100 ml. If the pressure is required and barely little 15-30 ml urine comes, then it is likely to cause pressure damage and there may be no point in waiting for circumcision or any other surgery if needed.

See, the block may be seen at foreskin but it can be anywhere say at meatus, urethra or in bladder.. All this needs to be evaluated before a doctor plans a surgery.

Steroid creams will not show effect in 10 days but may take 2-3 months and surely not guaranteed. By chance if you forcibly pull foreskin a lot, it may be painful and may be stuck backward creating more problems.

Cream may solve the problem in mild cases and that is why your doctor may have prescribed it. However, if it causes infection or does not cure in 3 months, better to give up.

Cream with less side effect may be xylocaine jelly but must be used maximum once a day, again this needs to be discussed with your doctor how the analgesic jelly will help lubricate foreskin to be trained to roll backwards millimeter by millimeter over 3 months.
There is no definite solution than passage of time to understand if the cream is working so that operation may be avoided.

A good number of children overcome phimosis with cream partially and many will not and will need surgery. Let the doctor also try to do some tests that may help rule out any associated obstruction.

Thank you.
Above answer was peer-reviewed by
Follow-up: 2 year old have almost closed foreskin. Will it be cured by applying betametasone cream? 46 hours later
Hii !
So doctor what do you suggest - should I go in for a sonography since he also has problem of passing stool irregularly say after a period of 3-5 days if given milk of magnesia regularly. He was tried with many laxatives but nothing worked out. He is at present on mother's milk and cerelac diet with occassionly feeds of banana. At present he is on Shelcal and Syrup A-Z medication.
Should I apply sofradex / betametasone cream for 1 month and then see ?
I would also like to clarify if total amount of urine to be passed by an infant in a day is 100ml or at one time it should be 50-100 ml?
Answered by Dr. Santosh Kondekar 2 hours later
Hi again,

Thanks for the follow up.

You may get sonography done; not for constipation but to see if any urinary reflux. If urinary reflux or bladder wall thickening is found, the choice will be for early surgical intervention.

Often the sonography may be normal even in constipation. Ointments may work and worth giving a try as your doctor had suggested.

Calcium and vitamin supplements are fine. Urine if passed 4 hourly should be around 60 to 100 ml for 10 kg child.

Hope I answered all your questions. Please use any answer clarification before closing and rating this answer. I will be happy to explain or expand on any issue you may have.


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