Paraphimosis: Difference between revisions
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**Use 22-25ga needle to make multiple punctures in foreskin and then perform compression | **Use 22-25ga needle to make multiple punctures in foreskin and then perform compression | ||
**Inject hyaluronidase into the swollen foreskin to decrease edema | **Inject hyaluronidase into the swollen foreskin to decrease edema | ||
**[[Dorsal Slit|Dorsal Slit | **[[Dorsal Slit (Penis)|Dorsal Slit]] indicated if e/o impaired perfusion and urologist unavailable | ||
==Disposition== | ==Disposition== | ||
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==See Also== | ==See Also== | ||
[[Dorsal Slit (Penis)]] | *[[Dorsal Slit (Penis)]] | ||
*[[Phimosis]] | |||
==Source== | ==Source== | ||
Revision as of 19:46, 31 March 2012
Background
- Foreskin trapped behind glans
- Urologic emergency
- May result in necrosis of glans if not reduced
Diagnosis
- Pain, erythema, swelling distal to constricting ring of foreskin
Treatment
- Reduction
- Perform as soon as possible
- Consider penile block or procedural sedation
- Use bag of ice (3min intervals) or manual compression before attempting reduction
- Use thumbs to push the glans into the foreskin while index fingers pull foreskin back into normal position
- If fails obtain emergent urology consult and/or perform the following:
- Use 22-25ga needle to make multiple punctures in foreskin and then perform compression
- Inject hyaluronidase into the swollen foreskin to decrease edema
- Dorsal Slit indicated if e/o impaired perfusion and urologist unavailable
Disposition
- Refer all cases to urology to determine need for circumcision
See Also
Source
Tintinalli