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Paraphimosis: Symptoms, Reduction and Surgical Treatment

Definition of Paraphimosis

Paraphimosis is a urological emergency with a prepuce being trapped behind the glans penis. Phimosis is a significant risk factor. The foreskin with phimosis leads to a circular narrowing at the base of the glans with swelling and decreased blood flow to the glans (Choe, 2000).

Signs and Symptoms of Paraphimosis

Painful edema of the foreskin, ischemic discoloration of the glans.

Treatment of Paraphimosis

Reduction of the Prepuce

Reduction of the prepuce is the initial treatment trial: 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 reduction is not possible, proceed with dorsal slit.

Preputioplasty or Dorsal Slit

The reposition will become possible after longitudinal dorsal incision of the phimotic ring [fig. dorsal incision]. After reduction, the wound is closed with a transverse suture.

Circumcision

Circumcision is used for primary treatment or after resolution of the inflammation after reduction.

References

Choe 2000 CHOE, J. M.: Paraphimosis: current treatment options.
In: Am Fam Physician
62 (2000), Nr. 12, S. 2623–6, 2628

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