Review literature: (Choe, 2000).
Definition of Paraphimosis
Paraphimosis is a urological emergency with a prepuce being trapped behind the glans penis. Major risk factor is phimosis. The foreskin with phimosis leads to a circular narrowing of the base of the glans with swelling and decreased blood flow to the glans.
Signs and Symptoms of Paraphimosis
Painful edema of the foreskin, ischemic discoloration of the glans.
Treatment of Paraphimosis
Reduction of the Prepuce
After local anesthesia (penile block), manual compression of the glans and reduction of the foreskin is done. In children, general anesthesia may be appropriate.
If a reduction is not possible, it may be possible by using cooling and osmotic mechanisms (application of sugar, injecting of hyalorone). These published techniques are rarely applied in practice.
Definitely, the reduction of the foreskin is achieved with a longitudinal dorsal incision of the phimotic ring [fig. dorsal incision in paraphimosis]. After reduction, the wound is closed with a transverse suture.
Circumcision should be carried out after healing of the dorsal incision or resolution of inflammation after reduction.
Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Choe 2000 CHOE, J. M.:
- Paraphimosis: current treatment options.
In: Am Fam Physician
62 (2000), Nr. 12, S. 2623–6, 2628