UROLOGY
PARAPHYMOSIS
Child in pain after foreskin retracted, unable to reduce
Prompt

Response
Image left: paraphimosis, grossly oedematous foreskin, plethoric and engorged glans, suggestif of obstructed venous return. High risk of ischameia

Image left: paraphimosis, grossly oedematous foreskin, plethoric and engorged glans, suggestif of obstructed venous return. High risk of ischameia
PromptManagment methods
ResponseManual traction
- Circumferential pressure to reduce swelling and distal traction
- Consider use of osmotic agent (Sugar) to reduce swelling
- Requires penile block/sedation
- Multiple needle pricks to allow drainage of oedematous foreskin
- Dorsal slit (cosmetically undesirable)
- circumcision