Phimosis + Paraphimosis

Question 1

What is paraphimosis?

Answer 1

The inability to pull forward a retracted foreskin over the glans.
Most often due to a tight band of foreskin.

Question 2

What are some complications of paraphimosis?

Answer 2

Oedematous glans
Vascular engorgement
Penile ischaemia
Infections - such as Fournier’s gangrene

Question 3

What are risk factors for paraphimosis?

Answer 3

Phimosis
Urethral catheter
Poor hygiene
Prior paraphimosis

Question 4

How does paraphimosis present?

Answer 4

Progressive pain
Swelling in glans / distal prepuce
Inability to pull foreskin back over the glans after retraction

Question 5

How is paraphimosis managed?

Answer 5

Reduced quickly - as worsening swelling makes this harder.
Anaesthesia - local penile block

If reduction fails a dorsal slit or emergency circumcision may be needed.

Definitive management then involves circumcision as an outpatient if not already done

Question 6

What is phimosis?

Answer 6

Where the foreskin is too tight to be pulled back over the head of the penis (glans)

Question 7

What is balanitis?

Answer 7

Inflammation of the head of the penis - normally due to poor hygiene or phimosis

Question 8

How can phimosis be treated?

Answer 8

If symptomatic - circumcision

Question 9

What is circumcision?

Answer 9

Removing part or all of the foreskin