paraphimosis
Paraphimosis is a serious condition that manifest only in uncircumcised males, where the retracted foreskin cannot be pulled back to its normal position over the glans penis. The foreskin becomes trapped beneath the head of penis and acts as tourniquet to compromise blood supply to penis.
- Inability to pull the foreskin back to its normal position over glans.
- Pain.
- Discomfort.
- swelling of glans.
- in severe cases after prolonged retraction , it can lead to discolouration and gangrene of glans penis.
It can be diagnosed with history and physical examination.
Paraphimosis is an emergency and needs intervention urgently. Prolonged cases may result in loss of penis.
- Application of local anaesthetic agent over the penis and then gently compression over it while pulling the foreskin back towards the tip is the first line of management.
- If this does not help , then a small incision in the foreskin to relieve the pressure can be performed.
- In severe cases, circumcision(removal of foreskin) is performed.
Mishandling of foreskin( not returning it back after retracting for cleaning, urination, intercourse,
catherization, cystoscopy or penile examination)
Phimosis (tight foreskin)
Infection
Penile piercing or trauma to penis
Severe infection
Loss of penis due to gangrene(loss of blood supply)
If the condition is diagnosed and treated well in time, then there are good chances of recovery. In that case, recovery is complete and without complication
Non-surgical intervention is usually performed in the emergency room, and once the foreskin is back in place and there is symptoms relief , patient can go home. Surgical intervention can be done as day case emergency procedure under local anesthesia or intravenous sedation. Once the patient is comfortable and there are signs of improvement, patient is discharged.
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