Phimosis and paraphimosis

UC3 paraphimosis: retracted foreskin that cannot be pulled over the glans
Etiology ...catheterisation, apparently
Clinical presentation
Pathogenesis physical constriction → ↓ venous return in glans → ↑ swelling... eventually leading to necrosis
Diagnostic investigations clinical.
Management - reduce with pressure, ice packs, dextrose-soaked gauze/granulated sugar
- Dundee technique: perforation of foreskin (after local anaesthetic +/- sedation!!)
surgical reduction if unable or necrotic

NB Phimosis = inability to retract the foreskin (distal prepuce) proximally over the glans penis

  • can be normal variant up to 3 years of age