Emergency: Paraphimosis

Question 1

Define/cause of paraphimosis?

Answer 1

Inability to replace the foreskin to its original position after it has been retracted.

Leads to venous congestion and potentially causing oedema and ischaemia of the glans penis.

Caused by NOT REPLACING a retracted foreskin.
Often seen following catheterisation or other medical procedures involving retraction of the foreskin.

Question 2

Presentation of paraphimosis?

Answer 2

Swollen and painful glans
Tight band of foreskin behind the glans.
Retracted foreskin

If not treated, can lead to signs of ischaemia e.g. discolouration and severe pain.

Question 3

Diagnosis/IVx of paraphimosis?

Answer 3

Clinical diagnosis

Question 4

Management of paraphimosis?

Answer 4

Applying manual pressure over a period of time to reduce oedema of the glans.

Dorsal slit procedure -cut foreskin and relieve constriction.