[Effect of topical glucocorticoid in treating phimosis on urinary tract infection of vesicoureteral reflux in infants]

Zhonghua Yi Xue Za Zhi. 2022 Oct 18;102(38):3007-3011. doi: 10.3760/cma.j.cn112137-20220329-00657.
[Article in Chinese]

Abstract

Objective: To evaluate the effect of topical glucocorticoid in treating phimosis on urinarytract infection(UTI) of vesicoureteral reflux(VUR) in infants. Methods: Clinical data of infants with UTI diagnosed as primary VUR admitted to our hospital from January 2016 to January 2021 were retrospectively analyzed. The children were divided into three groups:the effective group (topical glucocorticoid was effective in the treatment of phimosis), the ineffective group(topical glucocorticoid was ineffective in the treatment of phimosis), and the untreated group(phimosis was not treated). Age of onset, degree of reflux, side and other indicators were compared to understand the effectiveness of topical glucocorticoid in treating phimosis, and the clinical characteristics of repeated UTI with VUR in treated phimosis and untreated phimosis. Results: A total of 544 children were included. Among them, 59 cases were treated with topical glucocorticoid for phimosis, 48 cases in the effective group, and their age was (12.5±8.4) months;11 cases in the ineffective group,and their age was (11.2±8.9) months. There were 485 cases in the untreated group, and their age was (13.1±9.3) months.The effective rate of topical glucocorticoid in the treatment of phimosis was 81.36%. There were 12 cases(12/48) of recurrent UTI in the effective group and 213 cases (213/485)of recurrent UTI in the untreated group, and the difference between the two groups was statistically significant (P=0.008). Conclusion: Treatment of phimosis with topical glucocorticoid is an effective, easy to perform, and cost-effective method, and can effectively reduce the risk of recurrent UTI in infants with primary VUR.

目的: 探讨糖皮质激素外用治疗包茎对原发膀胱输尿管反流(VUR)婴幼儿发生尿路感染(UTI)的影响。 方法: 回顾性分析2016年1月至2021年1月首都医科大学附属北京儿童医院收治的诊断为原发VUR婴幼儿出现UTI的临床资料。将患儿按照是否治疗包茎及包茎治疗效果分为3组:糖皮质激素外用治疗包茎有效组(简称有效组)、糖皮质激素外用治疗包茎无效组(简称无效组)和未治疗包茎组(简称未治疗组)。对发病月龄、反流程度、侧别等指标进行比较,分析糖皮质激素外用治疗包茎的有效性及治疗包茎与未治疗包茎的VUR患儿发生反复UTI的临床特点。 结果: 共纳入患儿544例。其中59例应用糠酸莫米松乳膏治疗包茎,有效组48例,月龄(12.5±8.4)个月;无效组11例,月龄(11.2±8.9)个月。未治疗组485例,月龄(13.1±9.3)个月。糖皮质激素外用治疗包茎有效率为81.36%。有效组12例(12/48)复发UTI,未治疗组213例(213/485)复发UTI,两组相比差异有统计学意义(P=0.008)。 结论: 局部外用糖皮质激素治疗生理包茎是一种有效、易操作且费用少的方法,并能有效降低原发VUR婴幼儿复发UTI的风险。.

MeSH terms

  • Child
  • Glucocorticoids / therapeutic use
  • Humans
  • Infant
  • Male
  • Phimosis*
  • Retrospective Studies
  • Urinary Tract Infections* / diagnosis
  • Urinary Tract Infections* / drug therapy
  • Vesico-Ureteral Reflux* / drug therapy

Substances

  • Glucocorticoids