Paraphimosis
Revision as of 19:46, 31 March 2012 by Rossdonaldson1 (talk | contribs)
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