Paraphimosis Flashcards
What is paraphimosis?
the inability to pull forward a retracted foreskin over the glans penis
What causes paraphimosis?
Tight constricting band as part of the foreskin that prevents the retraction
What happens the glans when paraphimosis occurs?
becomes increasingly oedematous due to reduced venous return, causing vascular engorgement od the distal penis and further oedema
What are the complications go paraphimosis?
penile ischaemia, worsening infection and Fourniers gangrene
What are the risk factors for paraphimosis?
Phimosis, indwelling urethral catheter due to non replaced foreskin, poor hygiene and having one before
What are the clinical features of paraphimosis?
Progressive pain and swelling in the glans or distal prepuce following retraction of their foreskin, being unable to retract it back over their glans
What is the management for paraphimosis?
Reduced as soon as possible, analgesia- penile block via local anaesthetic
What are the methods of reducing paraphimosis?
Manual pressure
Dextrose soaked gauze, dundee technique
How does manual pressure reduce paraphimosis?
reduce oedema, squeeze gently but constantly, before applying force to the glans to reduce it into the prepuce
How does dextrose soaked gauze reduce paraphimosis?
osmotic effect, draw out the fluid from the glans, reduce oedema and allow reduction
What is the dundee technique?
needle punctures into the glans penis and squeezing the area to allow drainage of oedematous fluid
What happens if manual reduction fails for paraphimosis?
dorsal slit or emergency circumcision
