Evidence map›Paper›PMID 39150601›Full record

ReviewInternational urology and nephrology2025

Effectiveness of low to moderate potency topical corticosteroids for phimosis resolution in children: results of a network meta-analysis.

Suresh Shanmugham, E Lyn Lee, Suresh Kumar, Mohammed Zuber, Nabeela Noreen, Frederick Charles Smales, Siew Mooi Ching, Sajesh K Veettil

Abstract readReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Review in International urology and nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Suresh ShanmughamDepartment of Pharmacy Practice, School of Pharmacy, IMU University, 57000, Kuala Lumpur, Malaysia.
E Lyn LeeDepartment of Pharmacy Practice, School of Pharmacy, IMU University, 57000, Kuala Lumpur, Malaysia.
Suresh KumarDepartment of Pharmacy Practice, School of Pharmacy, IMU University, 57000, Kuala Lumpur, Malaysia.
Mohammed ZuberClinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, GA, USA.
Nabeela NoreenRajshahi Medical College, Medical College Road, Laxmipur Rajpara, Postal code: 6100, Rajshahi, Bangladesh.
Frederick Charles SmalesSchool of Dentistry, IMU University, 57000, Kuala Lumpur, Malaysia.
Siew Mooi ChingDepartment of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
Sajesh K VeettilDepartment of Pharmacy Practice, School of Pharmacy, IMU University, 57000, Kuala Lumpur, Malaysia. SajeshVeettil@imu.edu.my.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe use of topical corticosteroids (TCSs) has become an efficient, less-invasive treatment for phimosis. Whether any significant difference in efficacy exists between TCSs based on their potency is unclear.

methodsElectronic databases were searched up to March 2024 for randomised controlled trials (RCTs) comparing the use of any type or concentration of TCSs with placebo or no treatment in boys with any degree of physician diagnosed phimosis. A random-effects network meta-analysis (NMA) using a consistency model within a frequentist approach was employed. The primary outcome was partial or complete resolution of phimosis reported as a pooled risk ratio (RR) with 95% CI. Relative ranking was assessed with surface under the cumulative ranking curve (SUCRA) probabilities.

resultsSeventeen RCTs, containing 2057 participants were identified. NMA suggested that, compared with control, the high (RR 3.19 (95% CI 1.42 to 7.16), moderate (RR 2.68 (95% CI 1.87 to 3.83) and low (RR 3.05 (95% CI 1.63 to 5.71) potency TCSs statistically significantly increased complete or partial clinical resolution of phimosis. The SUCRA plot revealed that high potency (SUCRA = 0.76) was ranked first followed by low and moderate TCSs. When we assessed comparative efficacy among TCSs based on potency, none of the classes were superior to others. The certainty of the evidence for an effect of moderate potent TCSs was that of moderate GRADE quality.

conclusionModerate to low potency TCSs are of comparable therapeutic effect in the treatment of phimosis to that of highly potent formulations. More high-quality RCTs are warranted.

Indexed as

Administration, TopicalAdrenal Cortex HormonesPhimosisChildGlucocorticoidsHumansMaleRandomized Controlled Trials as TopicTreatment OutcomeAdrenal Cortex HormonesGlucocorticoidsNetwork meta-analysisPhimosisSystematic reviewTopical corticosteroids

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.