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paraphimosis

paraphimosis

Mx of paraphimosis by reduction in ED

analgesia

  • consider:
    • topical local anaesthesia such as EMLA cream or 2% lignocaine gel
    • inhalational anaesthesia such as nitrous oxide
    • analgesics adjuncts such as oxycodone

reduce the oedema

  • consider:
    • prolonged compression with ice
    • osmotic agents applied topically:
      • granulated sugar in a glove or condom for up to 2 hrs
      • 50% dextrose - via soaked gauze wrapped around oedematous foreskin, reapply prn, for up to 2hrs

when ready, manual reduction

  • grasp distal penis with gloved hand, squeeze penis circumferentially for several minutes to further reduce oedema
  • apply lubricant
  • reduce foreskin by using thumbs to push down on the glans, and the fingers below the swollen foreskin, pulling the foreskin up over the glans
paraphimosis.txt · Last modified: 2014/03/22 12:54 (external edit)