Phimosis: Difference between revisions

Revision as of 19:43, 31 March 2012

Unable to retract foreskin over glans
Most uncircumcised infants have normal, physiologic phimosis
- Nearly all cases resolve by 5yr of age
Only emergency if causes acute urinary retention

Discharge

Tintinalli

Authors:

@@ Line 14: / Line 14: @@
 ===Disposition===
 Discharge
-==Paraphimosis==
-===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 (Penis)]] indicated if e/o impaired perfusion and urologist unavailable
-===Disposition===
-*Refer all cases to urology to determine need for circumcision
 ==See Also==
-[[Dorsal Slit (Penis)]]
+*[[Dorsal Slit (Penis)]]
+*[[Paraphymosis]]
 ==Source==
 Tintinalli
+[[Category:GU]]
 [[Category:Peds]]