Penis and scrotum - Paraphimosis

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Penis and scrotum

Inflammatory lesions

Paraphimosis

Reviewers: Antonio Cubilla, M.D. and Alcides Chaux, M.D. (see Author/Reviewers page)

Revised: 20 February 2010, last major update February 2010

Definition

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● Condition in which the foreskin cannot be easily advanced over glans and becomes trapped between coronal sulcus and glans corona

● May be secondary to forceful retraction of phimotic foreskin over glans, causing marked swelling which blocks replacement of foreskin

Clinical features

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● Painful, associated with urinary retention and constriction

● Edema due to obstruction rarely causes penile ischemia and infarction

● One of the few male GU emergencies (others are priapism, testicular torsion, Fournier's gangrene)

Causes:

● Phimosis: leads to a circular scar, which can form a tourniquet when foreskin is retracted, preventing proper venous and lymphatic drainage

● Iatrogenic: medical staff fails to reduce foreskin after urethral catheterization or genital exam

● Poor urogenital hygiene, chronic balanoposthitis, genital piercing (West J Emerg Med 2009;10:281)

Treatment

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● Reduction by manipulation, surgery (dorsal slit procedure, circumcision) or alternative methods (eMedicine #1; #2)

Clinical images

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End of Penis and scrotum > Inflammatory Lesions > Paraphimosis

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