PARAPHIMOSIS

Question 1

(1) A true urologic EMERGENCY
(2) Occurs when the retracted foreskin develops a FIXED CONSTRICTION proximal to the glans.
(3) The penis distal to the constricting foreskin may become swollen and painful, or even gangrenous, and urinary retention may result.
(4) Can often be REDUCED BY COMPRESSION OF THE GLANS for several minutes to reduce edema and allow for successful reduction.

Answer 1

Paraphimosis

Question 2

How would you Attempt manual reduction

Answer 2

(a) Compress the glans firmly for 5-10 minutes to reduce its size
1) Tightly wrapping the glans with a 2-inch elastic bandage for 5 minutes will reduce edema.
2) Consider icing area as well.
(b) Move the prepuce distally while the glans is pushed proximally.
(c) A dorsal penile nerve block can be performed to lessen patient’s pain during reduction.
1) Discuss with physician supervisor before administering

Question 3

What do you do if the manual reduction is unsuccessful

Answer 3

a dorsal slit of the foreskin is necessary

(a) Discuss with physician supervisor before performing.
(b) Incision of the band will allow for foreskin reduction.

Question 4

Referral?

Answer 4

Refer the patient to urologist for elective circumcision to reduce the risk of recurrence.