Paraphimosis

Question 1

Paraphimosis

Answer 1

Inability to pull forward a retracted foreskin over the glans penis

Question 2

Pathophysiology

Answer 2

Due to the presence of a tight constricting band

• glans becomes oedematous due to reduced venous return - vascular engorgement of the distal penis and further oedema
• penile ischaemia and worsening infection

Question 3

Risk factors

Answer 3

• Phimosis
• Indwelling urethral catheter (due to non-replaced foreskin)
• poor hygiene
• prior paraphimosis

Question 4

Clinical Features

Answer 4

Progressive pain and swelling in glans

Unable to retract foreskin back over glans

Question 5

Mx of paraphimosis

Answer 5

Medical emergency

Analgesia

Reduced as soon as possible

Consider circumcision after reduction

Question 6

Methods of Reduction

Answer 6

Manual pressure

Dextrose-soaked gauze

Dundee Technique

Question 7

Dundee Technique

Answer 7

needle punctures into the glans penis, squeezing the area to allow drainage of oedematous fluid, before attempting reduction of the glans