Table of Contents
Mx of paraphimosis by reduction in ED
analgesia
reduce the oedema
when ready, manual reduction
paraphimosis
AAFP - 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