PARAPHIMOSIS MANAGEMENT FOR GENERAL PRACTITIONERS

• Paraphimosis is a condition where foreskin becomes trapped behind glans penis and cannot be reduced to normal position.
• The foreskin may be retracted during penile examination, penile cleaning, urethral catheterization, or cystoscopy
• If the foreskin is left retracted for a long period, some of the foreskin tissue may become edematous (swollen with fluid), which makes subsequent reduction of the foreskin difficult. Constricting ring initially impairs venous blood and lymphatic flow from the glans penis and prepuce, in turn causing edema of the glans. The ensuing tissue ischemia and vascular engorgement cause painful swelling of the glans and prepuce and may eventually lead to gangrene or auto amputation of the distal penis

Prevention and management:

• Paraphimosis can be avoided by bringing the foreskin back into its reduced position after retraction is no longer necessary
• Paraphimosis can often be effectively treated by manual manipulation of the swollen foreskin tissue. This involves compressing the glans and moving the foreskin back to its normal position, perhaps with the aid of a lubricant, cold compression, and local anesthesia as necessary
• If this fails, the tight edematous band of tissue can be relieved surgically with a dorsal slit or circumcision.