Paraphimosis + Priapism

Question 1

What is paraphimosis

Answer 1

Painful swelling of the foreskin distal to phimotic ring

Question 2

Causes of paraphimosis

Answer 2

Post catheterisation/ cystoscopy

Question 3

Treatment of paraphimosis

Answer 3

Compression with iced glove
Granulated sugar for 1-2 hours
Punctures in oedematous skin

Question 4

Complications of paraphimosis

Answer 4

Necrosis

Question 5

What is priapism

Answer 5

Prolonged erection (>4 hours) Painful, not associated with sexual arousal

Question 6

Causes of priapism

Answer 6

Intracorporeal injection
Trauma
Idiopathic
Neurological

Question 7

Symptoms of priapism

Answer 7

True compartment syndrome- rigid and tender due to vascular stasis + decreased venous outflow
OR
Non-ischaemic, unregulated blood entry due to trauma

Question 8

Diagnosis of priapism

Answer 8

Aspirate blood- dark indicates ischaemic cause

Colour duplex USS can show high (non-ischaemic) or low (ischaemic) blood flow

Question 9

Treatment of priapism

Answer 9

ISCHAEMIC 
Aspiration
Surgical shunt
Penile prosthesis 
Alpha agonist
NON ISCHAEMIC
may resolve spontaneously 
Arterial embolisation