Editorial Dr. Macedo The phimosis is a rather common problem in the pediatrics practice, and its treatment is greatly influenced by cultural and religious patterns and even by habits acquired by the pediatrician when advising their patients. The phimosis is a rather common problem in the pediatrics practice, and its treatment is greatly influenced by cultural and religious patterns and even by habits acquired by the pediatrician when advising their patients. The “massage” is frequently the pattern orientation for all patients without considering the difference between true phimosis with fibrous ring or simple physiological adherence. In the fibrous ring situation, the massage creates fissures and a chronic inflamatory process, which might worsen the case significantly as well as intensify the dread and fear that the patient might get when having his genitals being examined. Traditionally, the surgery is indicated when there is neither local nor sistemic complications (balanopostites and associated urinary infection) after quitting the diapers. It is a safe and sound procedure in experienced hands. Whereas, the use of topic creams, usually a corticotherapy has always been considered a valid option although it has not been studied scientificaly as an alternative to the surgery treatment. It is worth commenting that the studies available in the literature as a topic treatment do not distinguish in the studied patients the true phimosis from the simple balanopreputial adherence, thus damaging the analysis of the findings. Another crucial point in those studies is in relation to the age of the patients, which do not take into consideration the natural history of the spontaneous resolution of the adherence up to the age of 3, which is 90% of the cases. In other words, the good results in a general male population prior to three years old might not be the result of the ointment, but the own natural evolution of the adherence. Thus, for any drug to be precribed as an alternative to the postectomy, it has to be compared with the patients who really need a surgery. The results of more than 300 patients with a real postectomy indication will come out soon. They underwent a two month application of bethametasone and hyaluronidase and there was six month follow up of those patients after concluding the treatment. This study will be presented at the European Congress of Pediatric urology together with the American Pediatrics Academy at Uppsalla, Sweden, in June. See video Doctor Antonio Macedo Jr